title: Single-incision laparoscopic surgery using an articulating monopolar for juvenile cystic adenomyoma.
abstract: We demonstrate the feasibility of single-incision laparoscopic surgery (SILS) by using a novel monopolar cautery and a technique based on conventional multiport laparoscopic surgery in a patient with Juvenile cystic adenomyoma (JCA). A 20-year-old woman with severe dysmenorrhea, and a 3-cm uterine lesion was diagnosed with JCA. 70 cm of absorbable string tied to the tumor parenchyma was used to extract the tumor. The ends of the strings were positioned extracorporeally and the intra-abdominal parts of the strings adjacent to the anchored tumor were grasped by a laparoscopic needle holder for clarifying the incision line surrounding the tumor. The lesion was completely excised using a single-use articulating hook with monopolar cautery, and the hysterotomy site was sutured using barbed string. No complications occurred intraoperatively, and dysmenorrhea had significantly improved three months after surgery. SILS for JCA is a feasible and minimally invasive surgery for women desiring esthetic benefit.
authors.affiliation: Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine , Tokyo , Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Kumakiri
authors.forename: Iwaho
authors.initials: I
authors.lastname: Kikuchi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Sogawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Jinushi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Aoki
authors.forename: Mari
authors.initials: M
authors.lastname: Kitade
authors.forename: Satoru
authors.initials: S
authors.lastname: Takeda
mesh_terms: D018194:Adenomyoma / Q000150:complications / Q000601:surgery*; D004412:Dysmenorrhea / Q000209:etiology; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D012720:Severity of Illness Index; D014594:Uterine Neoplasms / Q000150:complications / Q000601:surgery*; D055815:Young Adult