Single incision laparoscopic surgery for a large endometriotic cyst.

We describe a technique for the treatment of large benign ovarian cysts by single port laparoscopic surgery via the umbilical approach. X-cone single port system (Karl Storz) was employed in this surgery. Prebent atraumatic grasping forceps were used in conjunction with the straight laparoscopic instruments. We propose using a "to-fro" peeling technique in the z-axis in SPLS cystectomy. Combined use of prebent and straight laparoscopic instruments enables the cystectomy to be performed in the z-axis, thereby avoiding instruments crossing and hands collision outside the abdomen. The proposed technique proved to be feasible, easy to employ, and safe in SPLS cystectomy, with the additional benefit of superior cosmetic outcome.