Wound retraction system for isobaric laparoendoscopic single-site surgery to treat adnexal tumors: pilot study

Transumbilical laparoendoscopic single-site (LESS) surgery is a recent advancement in minimally invasive surgery. However, this procedure usually requires a specialized multichannel port for introducing the laparoscope and instruments under pneumoperitoneum. In an isobaric procedure, a wound retractor alone can conveniently be used for transumbilical single-site access. Fourteen isobaric LESS adnexal surgeries including 1 emergency procedure with adnexal torsion were performed using multiple instruments inserted through the wound retractor. No extraumbilical incisions or conversion to standard multiple-port laparoscopic surgery were required. Port-related complications were not noted, and the cosmetic results were excellent. A wound retractor offers safe and reliable access for isobaric LESS adnexal surgery as an alternative to the current specialized port systems.