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Currently, endoscopic surgery is a common treatment for infertility patients. However, some single-incision laparoscopic surgery (SILS) procedures are difficult for the gynecologic generalist; these include anastomosis offallopian tubes, falloposcopic tuboplasty (FT) for tubal occlusion, mass reduction ofadenomyosis, and knot-tying techniques. As a general rule, total laparoscopic surgery is more difficult than laparoscopic assisted surgeryusing a wound retractor for gynecologic generalists. We were able to perform anastomosesin the isthmus and the intramural segment of the tubes through the wound retractor. Mass reduction of adenomyosis was also performed. During FT procedures; furthermore, manualassistance facilitatedthe recanalization process. Thus, a wound retractor is an extremely usefulinstrument for these types of procedures. Although SILS has recently been performed for gynecological diseases, knot-tying techniquefor intracorporeal suturing is one of rate-limiting steps impacting the acceptance of SILS. Wecreated a new, simplified method of knot-tying for SILS. The benefit of this technique isthat it does not require any special skills; any surgeon able to perform intracorporealsuturing should be capable of tying knots during SILS.

Surgical skill and practical technique of endoscopic surgery for infertility patients in our clinic