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

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.