Total laparoscopic hysterectomy with single-port access without vaginal surgery.

There has been increasing attention to decreasing incisional morbidity and improving cosmetic outcomes in laparoscopic surgery by using fewer and smaller ports. Hysterectomy through single-port access has been reported in which the cuff was closed transvaginally. We report total laparoscopic hysterectomy through a single-port without vaginal surgery. Using improved instruments and bidirectional self-retaining sutures, the laparoscopic technique is almost as easy to perform as with the traditional 4-port access. This case illustrates the advantages and limitations of single-access laparoscopy.