ADVANCEMENTS IN TRANSUMBILICAL SINGLE PORT LAPAROSCOPIC SURGERY FOR GYNECOLOGICAL PROCEDURES IN ATHLETES

Abstract

Purpose: To evaluate the application and advancements of Transumbilical Laparoendoscopic Single-Site Surgery (TU-LESS) in gynecological procedures, particularly focusing on its use in athletic women, where recovery speed, cosmetic outcomes, and minimization of pain are highly prioritized. Methods: We conducted an extensive literature review on "transumbilical single port laparoscopy" and "gynecological surgery" and synthesized experiences from our clinical practice with TU-LESS. The review aimed to assess the operational benefits and challenges of TU-LESS in comparison to traditional laparoscopy, particularly in the context of sports medicine. Results: TU-LESS offers significant advantages over traditional laparoscopic surgery, including cosmetically favorable incisions, reduced postoperative pain, and lower risk of tumor implantation, which are critical considerations for athletes concerned with quick recovery and return to training. However, the technique presents unique challenges such as limited maneuverability due to instrument crowding, restricted field of view, and the absence of a natural triangulation of instruments. Innovations such as the "chopstick method" and "small triangle operation" techniques have been developed to address these difficulties. The "anchoring method" for umbilical plastic suturing further exemplifies the advancements in refining TU-LESS for better outcomes. Although primarily applied in benign gynecological conditions, its use in treating malignant tumors and pelvic floor disorders shows promising growth, indicating potential broader applications in future gynecological practices. Conclusion: Despite skepticism regarding its efficacy and value, TU-LESS aligns well with the evolving trends in minimally invasive surgery and embodies the ethos of patient-centered care with its emphasis on aesthetic outcomes and reduced recovery times. As gynecological surgeons continue to refine their skills and innovate within this technique, TU-LESS is expected to gain widespread acceptance and could soon become a standard practice in gynecological surgery, offering substantial benefits to athletes and active individuals.