A hidden incision, a faster recovery: Single-incision gynecologic surgery

For many women facing gynecologic cancer surgery, the thought of major surgery, a large incision and weeks of recovery can feel daunting. Advances in minimally invasive surgery are changing those expectations.

At Atlantic Health, Jason Knight, MD, a gynecologic oncologist, offers an ultra-minimally invasive technique called laparoendoscopic single-site surgery (LESS). The procedure allows surgeons to perform many complex gynecologic cancer procedures through a single incision hidden inside the belly button. For many patients, it provides a virtually scarless result with the same high standard of surgical care.

“Many patients wake up, look at their abdomen and ask, ‘Did the surgery already happen?’” Dr. Knight says. “Instead of several incisions, they just have one small bandage over their belly button.”

One incision. The same surgical precision.

Traditional minimally invasive surgery typically requires three to five small incisions across the abdomen. LESS uses one incision through the belly button for many of the same procedures.

The natural valley of an “innie” belly button offers a unique advantage. Surgeons can hide a longer incision better there than they can elsewhere on the abdomen. The extra space allows surgeons to remove masses or organs while keeping the scar almost invisible. Sometimes, surgeons may remove tissue through the vagina instead.

LESS is especially effective for patients with endometrial cancer, the most common gynecologic cancer. During these procedures, surgeons perform a hysterectomy to remove the uterus, cervix and fallopian tubes. They may also take lymph node biopsies when needed.

Some patients with ovarian cancer may be candidates for LESS after chemotherapy has shrunk the tumor. Your surgeon will recommend the safest approach for your specific diagnosis, cancer stage and overall health.

“We never compromise the quality of surgery,” Dr. Knight says. “With LESS, patients can achieve the same surgical outcomes with a faster recovery.”

A faster recovery that gets patients back to daily life

Nearly 90% of patients who undergo LESS surgery return home the same day. Compared to an overnight hospital stay, that often means less pain medication, an easier recovery and an earlier return to work. Many patients can resume modified activities within a couple of weeks, depending on the procedure and their recovery.

“We know how important our patients are to their families and communities,” Dr. Knight says. “That’s why it’s important to offer these ultra-minimally invasive procedures close to home. Patients can access advanced surgery without traveling far and focus on getting back to their lives.”

What’s next for gynecologic cancer surgery?

LESS procedures remain uncommon because they require years of specialized training and expertise. Dr. Knight helped develop the technique nearly 15 years ago. Today, he is the only surgeon in the region performing single-incision surgery for gynecologic cancers.

Dr. Knight expects access to grow as surgical technology evolves. Major medical device companies are investing in robotic platforms designed to perform single-incision procedures, showing increased interest in the approach.

Another minimally invasive technique, called vaginal natural orifice transluminal endoscopic surgery (vNOTES), leaves no visible scar. Instead, surgeons operate through the vagina. For many gynecologic procedures, however, surgeons prefer LESS because it provides a better view of the upper abdomen.

Putting patients first

Navigating a gynecologic cancer diagnosis is already difficult. Patients shouldn’t have to choose between advanced care and an easier recovery. LESS helps make both possible.

“Innovation at Atlantic Health has always been about more than adopting new technology. We don’t do things just to do them,” Dr. Knight says. “We do things because they improve outcomes. By continuing to invest in innovations, we’re ensuring patients receive the right care, at the right time, with the best possible experience.”