Laparoscopic supracervical hysterectomy using a single-umbilical puncture (mini-laparoscopy).

Laparoscopic supracervical hysterectomy with bilateral salpingo-oophorectomy utilizing the single-puncture technique (mini-laparoscopy) is presented here for the first time. The surgical outcome of four patients in whom this minimally invasive approach was employed demonstrates the effectiveness of the single-puncture technique as an alternative to the currently used multiple-puncture method for hysterectomy. Laparoscopic supracervical hysterectomy with removal of the uterus and adnexa through the umbilical puncture site is an effective alternative for patients with a healthy cervix, no associated genital prolapse and moderate uterine enlargement. Advantages of this new modality include reduced blood loss and operating time, and the decreased possibility of surgical injury to the ureters, bladder and bowels. The risk of development of malignancy in the retained stump is almost eliminated by the laparoscopic removal of the upper endocervical canal and cauterization of the lower endocervical canal and exocervix.