title: Single-incision laparoscopic adnexectomy in an obese patient with previous laparotomies.
abstract: BACKGROUND
  No case of single-incision laparoscopic surgery in obese patients who had previously undergone multiple midline vertical laparotomies has been described in the literature to date. Hence we report the first case of single-port laparoscopic salpingo-oophorectomy in an obese patient who was affected by a left adnexal mass and who had previously undergone 3 midline vertical laparotomies.
  
  
  METHODS
  A postmenopausal 57-year-old woman with a body mass index of 31.2 kg/m(2) and a history of 3 midline vertical cesarean deliveries and a right salpingooophorectomy was diagnosed with a left adnexal mass and underwent a single-incision laparoscopic salpingo-oophorectomy.
  
  
  CONCLUSIONS
  The patient was treated successfully. The operative blood loss was minimal. The postoperative hospital stay lasted 18 hours, and postoperative pain was short-lasting. No early or long-term postoperative complications were registered. On histopathologic examination, a diagnosis of ovarian serous cystadenoma was made. Even though this unique case is the first to be reported in the literature, its encouraging results suggest the use of this new surgical technique in similar clinical situations to verify whether the feasibility and safety reported in this article are confirmed.
authors.affiliation: Department of Biomedicine & Prevention, Tor Vergata University Hospital, Rome, Italy. francesco.sesti@uniroma2.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Sesti
authors.forename: Claudio
authors.initials: C
authors.lastname: Boccia
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sorrenti
authors.forename: Alberto
authors.initials: A
authors.lastname: Baffa
authors.forename: Emilio
authors.initials: E
authors.lastname: Piccione
mesh_terms: D015992:Body Mass Index; D015897:Comorbidity; D018293:Cystadenoma, Serous / Q000453:epidemiology / Q000601:surgery*; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000601:surgery*; D010052:Ovariectomy