Single-incision laparoscopic hysterectomy using conventional laparoscopic instruments: initial experience with 25 cases
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To evaluate the feasibility and safety of single-incision laparoscopic hysterectomy using conventional instruments.
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.
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.
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.
KeywordsHysterectomy Laparoscopy Single-incision Conventional instruments
This work was supported by Sichuan Youth Foundation of Science of Technology (Grant Number: 2015JQ0026).
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.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest and nothing to disclose.
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.
- 6.Pelosi MA (1991) Laparoscopic hysterectomy with bilateral salpingo-oophorectomy using a single umbilical puncture. N J Med 88:6Google 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 CrossRefPubMedPubMedCentralGoogle 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 CrossRefPubMedPubMedCentralGoogle 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 CrossRefPubMedPubMedCentralGoogle 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 CrossRefPubMedPubMedCentralGoogle 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 CrossRefPubMedPubMedCentralGoogle Scholar