This chapter will introduce the single port robotic system. Topics include an introduction to the robotic single site port, the trocars, and the single site instruments. Step-by-step instruction is provided on how to create the umbilical incision and properly insert the single site port and trocars. The advantages and disadvantages of single port robotic surgery compared to multiple port robotic surgery and laparoscopic single site surgery are reviewed. Surgical tips and tricks are provided throughout each section to maximize efficiency, minimize complications, and overcome inherent limitations of the robotic single site system. The utility of the robotic single site platform for performing minor gynecologic surgery is discussed. Finally, a simple method for umbilical closure is described.

This is the first ever textbook completely devoted to single-incision minimally invasive gynecologic surgery. Expert gynecologic surgeons have collaborated to produce well-referenced and thought-provoking chapters on all common single-incision techniques in use today, including laparoscopic, robotic, and vaginal, with special sections devoted to hysterectomy and gynecologic oncology procedures. Chapter topics range from the history and fundamentals of procedures to a full technical instruction manual for step-by-step execution of common procedures. This text is designed for advanced gynecologic surgeons as well as fellows in minimally invasive gynecologic surgery fellowship programs.

Minimally invasive surgery has emerged as the standard treatment for many gynecologic diseases and conditions. In the past decade, numerous studies have demonstrated the superiority of laparoscopic approaches over standard open procedures in terms of improved quality of life for patients. Innovations in minimally invasive surgical technology—such as multichannel ports, articulating instruments, and flexible high-definition endoscopes—have made it possible for laparoscopic surgeons to perform increasingly complicated gynecologic surgeries through smaller incisions. As such, since the first edition of the atlas published in 2014, technologies and techniques once considered novel have become standard. This second edition, with five new chapters and content updated throughout to reflect the latest evolutions in the field, serves as a guide in robotic, conventional, and single-port laparoscopic surgery, presenting invaluable, up-to-date information about instrumentation, surgical technique, port systems, and the current research and development in robotics. Chapters address unique challenges associated with each technique, such as lack of haptic feedback or articulation and instrument crowding, and describe the advanced laparoscopic skills required to safely and efficiently perform procedures, such as how to move and control a flexible camera or use the robot. Specific topics include conventional laparoscopic myomectomy, adnexal surgery, total and supracervical hysterectomy, and excision of endometriosis excision, as well as related techniques in gynecologic oncology, urogynecology and pelvic reconstructive surgery, tubal surgery and ectopic pregnancy, isthmocele repair, and trachelectomy for early cervical cancer. For single-port laparoscopic techniques, chapters are presented on adnexal surgery, hysterectomy, and gynecologic oncology, while the section on robotic surgery offers guidance on instrumentation, platforms, and basic principles; robotic-assisted laparoscopic myomectomy, total hysterectomy for benign disease, endometriosis management, and total hysterectomy for cancer; as well as techniques for robotic adnexal surgery, urogynecology/pelvic reconstructive surgery, tubal surgery, and complication management, concluding with a review of new and emerging technologies. For students, residents, fellows, operating room personnel, and practicing gynecologic surgeons, the editors share experience amassed while developing novel surgical instrumentation and collaborating on presentations for numerous worldwide events. Internationally renowned experts contribute as well to this practical, illustrated resource on current minimally invasive techniques in gynecologic surgery.

Single incision laparoscopic surgery encompasses a plethora of techniques and styles. Single incision laparoscopy has demonstrated outcomes comparable to traditional multiport laparoscopy with the added benefit of improved cosmesis. This book chapter will review single incision surgery for minor gynecologic surgery, including adnexal surgical procedures and myomectomy. The chapter reviews available data in regard to outcomes in single incision laparoscopy. It also discusses the commercially available single incision surgical access systems, laparoscopes, and accessory instruments. Surgical techniques beneficial in single incision laparosocpy, including uterine manipulation, are also reviewed.

Minimally invasive surgery has become the standard treatment for many diseases and conditions. In the last decade, numerous studies have demonstrated that laparoscopic approaches have improved patients’ quality of life if compared with standard open procedures. Atlas of Single-Port, Laparoscopic, and Robotic Surgery serves as a guide in single-port, standard laparoscopy, and robotic surgery and shows how novel techniques, such as single-port laparoscopy and robotics, have recently evolved. The atlas illustrates the unique challenges that the new single-port surgery modality presents, including instruments crowding and articulation, and the advanced laparoscopic skills required to perform these procedures, such as the ability to move and control a flexible camera. It also illustrates how to efficiently and safely utilize the robot to perform most gynecologic procedures. This exceptional resource provides students, residents, fellows, operating room personnel, and practicing gynecologic surgeons with invaluable information about instrumentation, surgical technique, port systems, and the current research and development in robotics.

Minimally invasive gynecologic surgery is a rapidly growing field, with new modalities and methods being explored constantly. Since the inception of laparoscopic surgery, the goal has been to minimize incision size, which has been further extrapolated to focus on less incisions with Laparoendoscopic Single-site Surgery (LESS). Single site surgery has several advantages, disadvantages, and historically relevant utility. Throughout the ensuing text, the nuances of LESS will be explored and described in detail. Our purpose in this chapter is to explore the history and utility of single site surgery. We hope to set the stage for the extensive coverage and contents of the text to elaborate on LESS and its use in modern Gynecology.

The advent of robotic surgery brought a rise in the proportion of minimally invasive surgery in gynecology. This book provides a practical guide to this innovative field. First it introduces the basics of robotic surgery and then focuses on specific gynecology-related surgeries. Gynecologists currently practicing robotic surgery as well as those who would like to include robotic surgery in their practice will benefit greatly from this book.