In the intervention group: 50 patients receive the single port-access laparoscopic-assisted vaginal hysterectomy. Under general anesthesia, the patient was positioned in the supine position with the legs extended, and prepped and draped in the routine sterile fashion. The legs were protected with foam padding. At the start of surgery, a 2-cm intraumbilical incision was made. Adhesiolysis was performed if adhesions between the viscera and peritoneum existed from prior abdominal surgery or past abdominopelvic infection. The single-port system was made based on a modification of Lee et al. procedure [8]. After insertion of the wound protractor (Alexis X-small for 2-4 cm incisions, Applied Medical, CA, USA) into the abdominal cavity, the extraabdominal portion of the wound protractor was rolled up with the wrist portion of a surgical glove (TriflexLP, 7-0; Cardinal Health, OH, USA; Fig. 1). The finger portion of the glove was resected and tied to prevent leakage of carbon dioxide. The first trocar sleeve for laparoscopy was created after a small incision in the upper portion of the glove was made in the midline. After insertion of a trocar sleeve, the surrounding glove was lifted up with two mosquito forceps and tied to the trocar sleeve. Next, carbon dioxide was insufflated to maintain intra-abdominal pressure at 12-14 mmHg, depending on age and condition of the patient. Five- or 10-mm laparoscopes were used as needed. These laparoscopes have an incorporated light source within the camera head that does not compete for the very limited space in the port site. One or two additional 5-mm trocar sleeves were introduced through the single port system to make an imaginary triangle with the previous port for the camera to avoid clashing and to maximize surgical movement. A uterine manipulator was inserted to optimize visualization and accessibility in the surgical field . Then the laparoscopic assisted vaginal hysterectomy was perform as usual. Finally, the approach to the fascia and peritoneum is easier via the umbilicus than an extra-umbilical area; the peritoneum and fascia were approximated and closed layer by layer with 2-0 Vicryl suture and the skin was selectively sutured .