Hindawi Publishing Corporation Minimally Invasive Surgery Volume 2013, Article ID 836380, 8 pages http://dx.doi.org/10.1155/2013/836380 Clinical Study Adnexal Masses Treated Using a Combination of the SILS Port and Noncurved Straight Laparoscopic Instruments: Turkish Experience and Review of the Literature Polat Dursun, 1 Tugan Tezcaner, 2 Hulusi B. Zeyneloglu, 1 Irem AlyazJcJ, 1 Ali Haberal, 1 and Ali Ayhan 1 1 Department of Obstetrics and Gynecology, Baskent University, School of Medicine, Ankara, Turkey 2 Department of Surgery, Baskent University, School of Medicine, Ankara, Turkey Correspondence should be addressed to Polat Dursun; pdursun@yahoo.com Received 1 August 2013; Accepted 11 September 2013 Academic Editor: Peng Hui Wang Copyright © 2013 Polat Dursun et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To report our experience treating adnexal masses using a combination of the SILS port and straight nonroticulating laparoscopic instruments. Study Design. his prospective feasibility study included 14 women with symptomatic and persistent adnexal masses. Removal of adnexal masses via single-incision laparoscopic surgery using a combination of the SILS port and straight nonroticulating laparoscopic instruments was performed. Results. All of the patients had symptomatic complex adnexal masses. Mean age of the patients was 38.4 years (range: 21–61 years) and mean duration of surgery was 71 min (range: 45–130 min). All surgeries were performed using nonroticulating straight laparoscopic instruments. Mean tumor diameter was 6 cm (range: 5– 12 cm). All patient pathology reports were benign. None of the patients converted to laparotomy. All the patients were discharged on postoperative d1. Postoperatively, all the patients were satisied with their incision and cosmetic results. Conclusion. All 14 patients were successfully treated using standard, straight nonroticulating laparoscopic instruments via the SILS port. his procedure can reduce the cost of treatment, which may eventually lead to more widespread use of the SILS port approach. Furthermore, concomitant surgical procedures are possible using this approach. However, properly designed comparative studies with single port and classic laparoscopic surgery are urgently needed. 1. Introduction Adnexal masses are one of the most common indications for surgery in gynecology clinics, and laparoscopy is generally accepted as the gold standard treatment. Classical laparo- scopic surgery for adnexal masses is generally performed using ≥3 trocars. On the other hand, single-port access surgery (SPAS), also known as laparoendoscopic single- site surgery (LESS) and single-incision laparoscopic surgery (SILS), is an evolving endoscopic approach for minimal access surgery. Various surgical procedures, including appen- dectomy, cholecystectomy, nephrectomy, oophorectomy, hys- terectomy, adrenalectomy, gastric bypass, Nissen fundoplica- tion, hernia repair, splenectomy, and colon resection, have been performed via SILS. SILS can result in better cosme- sis, shorter recovery time, and less pain than conventional laparoscopy, which requires use of multiple trocar incisions [1, 2]. It was recently reported that adnexal masses could also be treated via SILS [3, 4]. Endoscopic surgery conducted via 3 special luminal ports, including the SILS port (Covidien, Norwalk, CT), GelPort (Applied Medical Resources, Rancho Santa Margarita, CA), and X-cone (Karl Storz, Tuttlingen, Germany), as well as others, is frequently referred to as SILS. SILS requires a 2-3 cm incision on the umbilicus for the placement of the special port. Furthermore, nonconventional roticulating and articulated laparoscopic instruments are necessary for SILS in order to ensure that the instruments do not collide during SILS [5, 6]. SILS performed using conventional laparoscopic instru- ments for appendectomy and cholecystectomy has been