Use of operative laparoscopy in single incision and natural orifice transvaginal surgery.

I read with interest the article titled “Single-incision-two port laparoscopic tubal ligation: A cost comparison and technique description” by Drs Nicel Taşdemir, Remzi Abali, Cem Çelik, Erson Aksu, and Didem Akkuş. J Turk Ger Gynecol Assoc 2015; 16: 30-1 that was published online on March 1, 2015 (1). The authors compare the traditional 2-port laparoscopy with a single incision using two 5 mm trocars. We had a different experience while using a laparoscope with an operative channel to place a bipolar cautery in tubal ligations; thus, limiting to a one-port laparoscopy. Furthermore, we used a laparoscope with a 6-mm operative channel to place different instruments in single incision (2) and in natural orifice transvaginal cholecystectomies (3). The operative laparoscope is not a new instrument; however, it should not be disregarded and is probably still utilized in many hospitals. It is my opinion that revisiting laparoscopy techniques using this operative laparoscope could further enhance the concepts of minimally invasive surgery.