Single-port laparoscopic salpingectomy using an abdominal wall lifting system.

Objectives: We present our initial experience in single-port laparoscopic salpingectomy for the treatment of tubal pregnancy. By using an abdominal wall lifting system, the technique is gasless and an open top lap-protector can be used. Method: Between 2002 and 2008,175 women with ectopic pregnancies underwent laparoscopic surgery or laparotomy at Saiseikai Utsunomiya Hospital. One hundred fifty patients who had tubal pregnancies underwent salpingectomy by laparoscopy or conventional laparotomy. We began gasless three-port laparoscopic surgery in 2002, and reduced the number of ports to two in 2006. In 2007, we began to perform single-port laparoscopic surgery. For gasless laparoscopic surgery, we make an infraumbilical incision, 1.5-2.0 cm in length, where the abdominal wall lifting system is inserted. After raising the abdominal wall, the scope is introduced through the same incision with a sheath. For single-port laparoscopic surgery, we change the sheath to an open top lap-protector, through which we insert not only a 5 mm scope, but also Ligasure V and other laparoscopic instruments. Using this single-port system, single-port laparoscopic salpingectomy was performed. Results: Ninety-five patients underwent three-port laparoscopic salpingectomies, and the mean operating time was 76±25 min. Sixteen patients underwent two-port laparoscopic salpingectomies, and the mean operating time was 79±32 min. Eleven patients underwent single-port laparoscopic salpingectomies, and the mean operating time was 65±19 min. Using this new method, the operating time was comparable to that of standard laparoscopic methods. Conclusion: Our results showed that single-port laparoscopic salpingectomy is a feasible and safe technique.