Abstract
LESS hysterectomy is a reasonable first procedure for the advanced gynecologic surgeon using familiar instrumentation while following basic principles to avoid instrument clashing. For example, using a 30 degree bariatric scope in the most cephalad port allows the camera head to be controlled in the lowest plane, outside of the patient, above the single incision port. To improve exposure of the lateral attachments of the uterus, a myoma screw is used in the ipsilateral trocar to the side being operated on, to displace the uterus medially while the handle of the myoma screw is displaced outside of the patient, away from the umbilical port, laterally.
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