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

Gynecol Minim Invasive Ther. 2017 Apr-Jun;6(2):66-68. doi: 10.1016/j.gmit.2016.12.001. Epub 2017 Jan 16.

Abstract

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.

Keywords: Higuchi’s transverse incision; reduced port surgery; single-incision laparoscopic surgery.