Abstract
Objective
The purpose of the present study is to demonstrate the feasibility of single-port transumbilical laparoscopic surgery (SPLS) for hysterectomy and elaborate on our experience in order to introduce the single-port approach for gynecologic surgery.
Methods
Between August 2008 and February 2009, 30 patients who initially planned to undergo single-port laparoscopic surgery at Yonsei University Health System in Seoul, Korea were enrolled in this study. The authors used a single-port three-channel system with a wound retractor, surgical gloves, and one 10/11-mm and two 5-mm trocars. All surgical procedures were performed with 30°, 5-mm laparoscope, conventional laparoscopic instruments, and the LigaSure™ system (Valleylab, Boulder, CO, USA). Patient characteristics and surgical outcomes were prospectively evaluated. A visual analog score (VAS) scale was used to measure postoperative pain.
Results
Twenty-nine of 30 patients underwent single-port laparoscopic surgery without conversion to laparotomy or conventional laparoscopic hysterectomy. Median operative time was 100 min (57–155 min), median blood loss was 100 ml (10–400 ml), median postoperative hospital stay was 3 days (2–6 days), and median weight of resected uteri was 167 g (45–482 g). VAS scoring of pain at 6, 24, and 48 h after surgery was 4, 3, and 2, respectively. There were no operative complications.
Conclusion
SPLS is a feasible approach for hysterectomy in terms of operative time, complication rates, and cosmetic results. However, the possible benefits for patients such as better cosmetic outcomes, reduced pain, and lower complication rates should be evaluated in randomized prospective studies.
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Acknowledgements
The authors are grateful to Sydney Sue Kim (Editor, Yonsei University College of Medicine, Seoul, Korea) for her editorial assistance and to Dong-Su Jang (Medical Illustrator, Medical Research Support Section, Yonsei University College of Medicine, Seoul, Korea) for his help with the figures in this study. This study was supported by the Brain Korea 21 Project for Medical Sciences, Yonsei University, and a grant from the Korean Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea (0412-CR01-0704-0001).
Disclosures
Drs. Yong Wook Jung, Young Tae Kim, Dae Woo Lee, Yu Im Hwang, Eun Ji Nam, Jae Hoon Kim, and Sang Wun Kim have no conflicts of interest or financial ties to disclose.
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Jung, Y.W., Kim, Y.T., Lee, D.W. et al. The feasibility of scarless single-port transumbilical total laparoscopic hysterectomy: initial clinical experience. Surg Endosc 24, 1686–1692 (2010). https://doi.org/10.1007/s00464-009-0830-7
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DOI: https://doi.org/10.1007/s00464-009-0830-7