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BackgroundIn an elective laparoscopic surgery, the cosmetic outcome becomes increasingly important. We conducted a study to evaluate the cosmetic outcome 3 months after a laparoscopic procedure and compared skin adhesive (SA) versus transcutaneous suture (TS).MethodsA randomized, controlled, prospective study was conducted at a single study centre in Hamburg, Germany. Seventy-seven patients undergoing laparoscopic surgery with two lower abdominal port sites met the study requirements. It was decided randomly which port site would be closed with SA. The opposite site was closed with TS. Wounds were assessed after 7–12 days and after 3 months. Cosmetic outcome was measured by a visual analogue scale (VAS) completed by the patient, by the Hollander wound evaluation scale (HWES) and by the judgement of blinded investigators.ResultsSeventy-seven subjects were randomized. Complete data from the 3-month follow-up visit were available from 56 patients (72.7 %). The VAS scale ranged from 0 to 100 mm with “0” representing the best possible cosmetic outcome. Median satisfaction was 2 mm in the TS group and 3 mm in the SA group. The mean was high in both groups 4.6 (s = 13.1) versus 3.8 mm (s = 4.6). The outcome was neither clinically nor statistically significant. Cosmetic outcome was assessed by an investigator, and the HWES showed no difference. In regard to complications, no difference was found between SA and TS, either.ConclusionsIn conclusion this study demonstrated that closure of laparoscopic port-site wounds leads to equivalent outcomes whether SAs or TSs are used. Complications are rare in both methods. Thus, SAs seem to be a valid alternative to sutures in laparoscopic surgery.Registration site: www.clinicaltrials.gov.Registration number: NCT02179723.Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-015-4474-5) contains supplementary material, which is available to authorized users.

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Zusammenfassung Fragestellung: Die laparoskopische suprazervikale Hysterektomie (LASH) ist bei benignen, therapieresistenten uterinen Erkrankungen eine Alternative zur totalen Hysterektomie. Es gibt nur wenig Daten zur Methodik und Präparation, Technik, Komplikationen und postoperativem Befinden aus dem deutschen Sprachraum. Material und Methodik: In sechs vergleichbaren Tageskliniken des VAAO wurden zwischen dem 1. 4. 2003 und dem 31. 3. 2004 191 laparoskopische suprazervikale Hysterektomien (LASH) prospektiv erfasst. Prä-, intra-und postoperativ wurden relevante Daten in einem einheitlichen Fragebogen erhoben. Alle Patientinnen wurden sechs Monate nach der Operation nachbefragt. Ergebnisse: Das Alter der Patientinnen betrug im Mittel 43 Jahre. Die Hauptindikation zur Operation waren Blutungsstörungen und Dysmenorrhö (65%). Die durchschnittliche Operationszeit lag bei 119 Minuten. Das Durchschnittsgewicht der durch Morcellement extrahierten Korpusanteile betrug 239 g. Die Arteriae uterinae wurden überwiegend bipolar koaguliert (81%). Am häu- AbstractStudy Objective: Laparoscopic supracervical hysterectomy (LASH) is an alternative to total hysterectomy for benign conditions in cases where conservative treatment options fail and hysterectomy is indicated. Only little data from German-speaking countries concerning surgical techniques, postoperative wellbeing and complications is available. Methods: The data of 191 patients scheduled for laparoscopic supracervical hysterectomy were prospectively registered between April 1, 2003 and March 31, 2004. A questionnaire was filled in by the physician recording data pre-, intra-and postoperatively. All patients were interviewed six months after surgery and asked about their well-being, possible complaints and their fitness to work by telephone. Results: The average age of the patients was 43 years. The main indications for the operation were abnormal uterine bleeding and dysmenorrhea (65%). The mean operation time was 119 minutes and the average weight of the uterus corpus was 239 g. The uterine arteries were coagulated with bipolar current in most