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Higuchi's transverse incision and a modification of this method for minimally invasive surgery
Aikou Okamoto1, Yoko Nagayoshi1, Ayako Kawabata1
1Department of Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo, Japan.
Study Objective:
To describe Higuchi's transverse incision and a modification of this method for reduced port surgery (RPS).
Design:
Descriptive study.
Setting:
University hospital.
Patients:
Those with ovarian cyst and uterine myoma.
Intervention:
A platform is placed in the 2-3 cm Higuchi incision just above the pubis or on the pubis. Blunt dissection of the subcutaneous adipose tissue is performed. A T incision of the rectus abdominis fascia and a longitudinal incision of the peritoneum are performed. A LAP PROTECTOR and EZ access (Hakko Medical, Nagano, Japan) are used with the platform for single-incision laparoscopic surgery. The peritoneum and fascia are closed by continuous suture, and the skin is closed using the dermostitch technique.
Main Results:
Higuchi's transverse incision is 2-3 cm in length and is made at a much lower position than the conventional Pfannenstiel transverse incision. The wound is covered by pubic hair, yielding an excellent esthetic outcome. The T incision of the rectus abdominis fascia secures a more extensive surgical field than the Pfannenstiel transverse incision.
Conclusion:
Higuchi's modified transverse incision ensures a sufficient visual field, yields an excellent esthetic outcome, and is safe, suggesting the potential use of this method for RPS.
