Vaginal Single-Port Laparoscopy Case Series: Hysterectomy, Cystectomy, and Enlarged Uterus Hysterectomy

INTRODUCTION: Vaginal hysterectomy is the approach of choice whenever feasible. Rates of vaginal hysterectomy remain very low in the United States. Minimally invasive approaches are associated with shortened hospitalization and postoperative recovery times. Compared to laparoscopy, vaginal hysterectomy is associated with shorter operating time, better patient satisfaction, no evidence of difference in return to normal activity, urinary tract injury, and complications. Factors that may preclude vaginal approach include adnexal pathology, severe endometriosis, adhesions, and enlarged uterus. OBJECTIVE: To show that the vaginal single port approach is a feasible approach to vaginal surgery and in some cases may have an advantage over traditional laparoscopy, especially with adnexal surgery or larger uteri. METHODS: Video case series of 3 different vaginal procedures, including hysterectomy, ovarian cystectomy, and enlarged uterus hysterectomy. RESULTS: N/A (not a research study). CONCLUSIONS: The vaginal approach should be considered as a minimally invasive approach to hysterectomy and adnexal surgery. The ability to visualize the adnexa and other organs with this approach assists in making the vaginal surgery more feasible. Compared to laparoscopic and robotic approaches, there is potentially less pain, decreased operative time, improved cosmesis, and decreased risks related to abdominal entry and port placement. The vaginal approach can be more ergonomically friendly compared to traditional laparoscopy. As with the emerging popularity of robotic and laparoscopic surgery, this approach has the potential to help physicians in training gain more proficiency with vaginal surgery.