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Single-incision laparoscopic hysterectomy using conventional laparoscopic instruments: initial experience with 25 cases

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the feasibility and safety of single-incision laparoscopic hysterectomy using conventional instruments.

Methods

Twenty-five patients undergoing single-incision laparoscopic hysterectomy (SI-LAH) using conventional instruments at West China Second University Hospital between July, 2017 and December, 2017 were selected for participation. Another 25 cases undergoing traditional multi-port laparoscopic hysterectomy (MP-LAH) matched with similar uterine size were selected as controls. Characteristics and clinical data of patients including operative time, estimated blood loss, hospital stay, catheter retention time, and intraoperative and postoperative complications were compared between the two groups.

Results

The baseline characteristics of the two groups were comparable. The estimated blood loss was less in SI-LAH with respect to MP-LAH (30 mL [range 20–50] vs 50 mL [range 10–200], P < 0.05), with no statistically significant difference in terms of decrease of hemoglobin level (17 g/dL [range 2–24] vs 18 g/dL [range 5–28], P > 0.05). There were no significant differences between the two groups in terms of operative time (150 min [range 85–225] vs 145 min [range 100–220], P > 0.05), intraoperative injury, catheter retention time, time to exhausting, postoperative hospital stay. In all cases, no additional port incision was needed and no conversion to laparotomy was necessary in two groups. No patient had development of intraoperative or postoperative complications. After a follow-up of 2 months, no incisional hernia occurred in all patients.

Conclusions

Single-incision laparoscopic hysterectomy using conventional instruments is a feasible and safe technique for patients with uterine size less than 12 weeks of pregnancy and no serious pelvic adhesion, requiring for more experienced skill of surgeons.

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References

  1. Reich HDJ, Mc Glynn F (1989) Laparaoscopic hysterectomy. J Gynecol Surg 5:4

    Article  Google Scholar 

  2. Nieboer TE, Johnson N, Lethaby A, Tavender E, Curr E, Garry R, van Voorst S, Mol BW, Kluivers KB (2009) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 3:CD003677. https://doi.org/10.1002/14651858.cd003677.pub4

    Article  Google Scholar 

  3. Johnson N, Barlow D, Lethaby A, Tavender E, Curr E, Garry R (2006) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2:CD003677. https://doi.org/10.1002/14651858.cd003677.pub3

    Article  Google Scholar 

  4. Choi YS, Shin KS, Choi J, Park JN, Oh YS, Rhee TE (2012) Single-port access laparoscopy-assisted vaginal hysterectomy: our initial experiences with 100 cases. Minim Invasive Surg 2012:543627. https://doi.org/10.1155/2012/543627

    Article  PubMed  PubMed Central  Google Scholar 

  5. Tormena RA, Ribeiro SC, Maciel GA, Baracat EC (2015) Single-port laparoscopic hysterectomy: preliminary results. Rev Assoc Med Bras 61(5):446–451. https://doi.org/10.1590/1806-9282.61.05.446

    Article  PubMed  Google Scholar 

  6. Pelosi MA (1991) Laparoscopic hysterectomy with bilateral salpingo-oophorectomy using a single umbilical puncture. N J Med 88:6

    Google Scholar 

  7. Koyanagi T, Motomura S (2011) Transumbilical single-incision laparoscopic surgery: application to laparoscopically assisted vaginal hysterectomy. Arch Gynecol Obstet 283(2):305–309. https://doi.org/10.1007/s00404-010-1358-8

    Article  PubMed  Google Scholar 

  8. Kim TJ, Lee YY, Cha HH, Kim CJ, Choi CH, Lee JW, Bae DS, Lee JH, Kim BG (2010) Single-port-access laparoscopic-assisted vaginal hysterectomy versus conventional laparoscopic-assisted vaginal hysterectomy: a comparison of perioperative outcomes. Surg Endosc 24(9):2248–2252. https://doi.org/10.1007/s00464-010-0944-y

    Article  PubMed  Google Scholar 

  9. Choi YS, Park JN, Oh YS, Sin KS, Choi J, Eun DS (2013) Single-port vs. conventional multi-port access laparoscopy-assisted vaginal hysterectomy: comparison of surgical outcomes and complications. Eur J Obstet Gynecol Reprod Biol 169(2):366–369. https://doi.org/10.1016/j.ejogrb.2013.03.026

    Article  PubMed  Google Scholar 

  10. Park JY, Nho J, Cho IJ, Park Y, Kim DY, Suh DS, Kim JH, Nam JH (2015) Laparoendoscopic single-site versus conventional laparoscopic-assisted vaginal hysterectomy for benign or pre-invasive uterine disease. Surg Endosc 29(4):890–897. https://doi.org/10.1007/s00464-014-3747-8

    Article  PubMed  Google Scholar 

  11. Gynecologists ACoOa (2009) ACOG Committee Opinion No. 444: choosing the route of hysterectomy for benign disease. Obstet Gynecol 114(5):1156–1158. https://doi.org/10.1097/aog.0b013e3181c33c72

    Article  Google Scholar 

  12. Olive DL, Parker WH, Cooper JM, Levine RL (2000) The AAGL classification system for laparoscopic hysterectomy. Classification committee of the American Association of Gynecologic Laparoscopists. J Am Assoc Gynecol Laparosc 7(1):9–15

    Article  CAS  PubMed  Google Scholar 

  13. Fanfani F, Fagotti A, Gagliardi ML, Monterossi G, Rossitto C, Costantini B, Gueli Alletti S, Vizzielli G, Ercoli A, Scambia G (2013) Minilaparoscopic versus single-port total hysterectomy: a randomized trial. J Minim Invasive Gynecol 20(2):192–197. https://doi.org/10.1016/j.jmig.2012.11.007

    Article  PubMed  Google Scholar 

  14. Li M, Han Y, Feng YC (2012) Single-port laparoscopic hysterectomy versus conventional laparoscopic hysterectomy: a prospective randomized trial. J Int Med Res 40(2):701–708. https://doi.org/10.1177/147323001204000234

    Article  CAS  PubMed  Google Scholar 

  15. Jung YW, Lee M, Yim GW, Lee SH, Paek JH, Kwon HY, Nam EJ, Kim SW, Kim YT (2011) A randomized prospective study of single-port and four-port approaches for hysterectomy in terms of postoperative pain. Surg Endosc 25(8):2462–2469. https://doi.org/10.1007/s00464-010-1567-z

    Article  PubMed  Google Scholar 

  16. Chen YJ, Wang PH, Ocampo EJ, Twu NF, Yen MS, Chao KC (2011) Single-port compared with conventional laparoscopic-assisted vaginal hysterectomy: a randomized controlled trial. Obstet Gynecol 117(4):906–912. https://doi.org/10.1097/AOG.0b013e31820c666a

    Article  PubMed  Google Scholar 

  17. Moulton L, Jernigan AM, Carr C, Freeman L, Escobar PF, Michener CM (2017) Single-port laparoscopy in gynecologic oncology: seven years of experience at a single institution. Am J Obstet Gynecol 217(5):610611–610618. https://doi.org/10.1016/j.ajog.2017.06.008

    Article  Google Scholar 

  18. Escobar PF, Fader AN, Paraiso MF, Kaouk JH, Falcone T (2009) Robotic-assisted laparoendoscopic single-site surgery in gynecology: initial report and technique. J Minim Invasive Gynecol 16(5):589–591. https://doi.org/10.1016/j.jmig.2009.05.004

    Article  PubMed  Google Scholar 

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Acknowledgements

This work was supported by Sichuan Youth Foundation of Science of Technology (Grant Number: 2015JQ0026).

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Authors

Contributions

JG: Data collection, data analysis, manuscript writing; ZL: Project development and responsible for surgery; XL and DN: Data collection, data analysis, follow-up; LX and LL: Data collection.

Corresponding author

Correspondence to Zhengyu Li.

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The authors declare that they have no conflicts of interest and nothing to disclose.

Informed consent

Since this is a retrospective study, formal consent is not required. However, an informed consent was obtained from individual participants for taking and publishing photographs.

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Gou, J., Li, Z., Liao, X. et al. Single-incision laparoscopic hysterectomy using conventional laparoscopic instruments: initial experience with 25 cases. Arch Gynecol Obstet 298, 921–926 (2018). https://doi.org/10.1007/s00404-018-4858-6

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  • DOI: https://doi.org/10.1007/s00404-018-4858-6

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