Single incision laparoscopic surgery for a large endometriotic cyst

We describe a technique for the treatment of large benign ovarian cysts by single port laparoscopic surgery via the umbilical approach. X-cone single port system (Karl Storz) was employed in this surgery. Prebent atraumatic grasping forceps were used in conjunction with the straight laparoscopic instruments. We propose using a "to-fro" peeling technique in the z-axis in SPLS cystectomy. Combined use of prebent and straight laparoscopic instruments enables the cystectomy to be performed in the z-axis, thereby avoiding instruments crossing and hands collision outside the abdomen. The proposed technique proved to be feasible, easy to employ, and safe in SPLS cystectomy, with the additional benefi t of superior cosmetic outcome.