Higuchi's transverse incision and a modification of this method for minimally invasive surgery.

Okamoto, Aikou; Nagayoshi, Yoko; Kawabata, Ayako; Sakamoto, Masaru; Ueda, Kazu

Study Objective To describe Higuchi's transverse incision and a modification of this method for reduced port surgery (RPS). Design Descriptive study. Setting University hospital. Patients Those with ovarian cyst and uterine myoma. Intervention A platform is placed in the 2-3 cm Higuchi incision just above the pubis or on the pubis. Blunt dissection of the subcutaneous adipose tissue is performed. A T incision of the rectus abdominis fascia and a longitudinal incision of the peritoneum are performed. A LAP PROTECTOR and EZ access (Hakko Medical, Nagano, Japan) are used with the platform for single-incision laparoscopic surgery. The peritoneum and fascia are closed by continuous suture, and the skin is closed using the dermostitch technique. Main Results Higuchi's transverse incision is 2-3 cm in length and is made at a much lower position than the conventional Pfannenstiel transverse incision. The wound is covered by pubic hair, yielding an excellent esthetic outcome. The T incision of the rectus abdominis fascia secures a more extensive surgical field than the Pfannenstiel transverse incision. Conclusion Higuchi's modified transverse incision ensures a sufficient visual field, yields an excellent esthetic outcome, and is safe, suggesting the potential use of this method for RPS.