Surgical Endoscopy

, Volume 27, Issue 1, pp 189–198 | Cite as

Management of benign ovarian cysts by a novel, gasless, single-incision laparoscopic technique: keyless abdominal rope-lifting surgery (KARS)

  • Kahraman ÜlkerEmail author
  • Ürfettin Hüseyinoğlu
  • Nergiz Kılıç



To find the most efficacious method to minimize the side effects and maximize the advantages of laparoscopic surgery, this study aimed to define and document a gasless, single-incision abdominal access technique for the management of benign ovarian cysts.


During a 1½ year period, 55 women underwent surgery for a benign ovarian cyst. Conventional carbon dioxide (CO2) laparoscopy was used for 33 of the women, and 22 of the women underwent a novel, gasless, single-incision laparoscopic surgery. An abdominal access pathway through a single intraabdominal incision was used to place transabdominal sutures that elevated the abdominal wall, and the operations were performed through the intra-umbilical entry without the use of trocars. Thus, the new technique was called keyless abdominal rope-lifting surgery (KARS). Two operative groups were compared to assess the feasibility of the new technique.


All the operations could be performed by KARS without conversion to CO2 laparoscopy or laparotomy. However, for two patients in the conventional laparoscopy group, minilaparotomy had to be performed for tissue retrieval. Although the two techniques had many similar results, the total operative times and the abdominal access times in the KARS group were significantly longer than in the conventional laparoscopy group (p < 0.05). Simple oral analgesics were adequate for postoperative pain relief in both groups.


The KARS technique is a gasless, single-incision laparoscopic procedure that can be performed safely and effectively in terms of cosmesis, postoperative pain, and fertility preservation for the management of benign adnexal pathologies.


Abdominal CO2 Gynecology and obstetrics Pneumoperitoneum Surgical (technical) Technical (endoscopy) 



We thank Dr. R. K. Mishra for his kindness and gracious efforts in teaching us the skills needed for laparoscopic surgery.


Kahraman Ülker, Ürfettin Hüseyinoğlu, and Nergiz Kılıç have no conflicts of interest or financial ties to disclose.

Supplementary material

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Supplementary material 3 (WMV 14405 kb)

464_2012_2419_MOESM4_ESM.doc (30 kb)
Supplementary material 4 (DOC 30 kb)


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Kahraman Ülker
    • 1
    Email author
  • Ürfettin Hüseyinoğlu
    • 2
  • Nergiz Kılıç
    • 1
  1. 1.Department of Obstetrics and GynecologyKafkas University Medical FacultyKarsTurkey
  2. 2.Department of Anesthesiology and ReanimationKafkas University Medical FacultyKarsTurkey

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