Laparoendoscopic Single Site Surgery for the Treatment of Huge Ovarian Cysts Using an Angiocatheter Needle

Ki, Eun Young; Park, Eun Kyung; Jeong, In Cheol; Bak, Seongeun; Hwang, Hyunsang; Chung, Yoo Hyun; Song, Min Jong

doi:10.3349/ymj.2019.60.9.864

Cited by 15 publications

(11 citation statements)

References 18 publications

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“…Few, heterogeneous reports have been documented in the literature describing similar techniques. Only 5 of these series included cysts of at least 15 cm, as in our series (1)(2)(3)(4)(5)(6). Some of these case series included a larger number of patients, but at the same time, they also included malignant cysts in up to 13% of cases, as described by Ki et al In our opinion, we cannot stress enough the need for strict selection criteria to decrease the risk of an accidental finding of invasive tumor in the final pathological specimen.…”

Section: Discussionmentioning

confidence: 81%

“…Both of these factors can increase the risk of intraoperative spillage because of unintentional cystic rupture. Some case reports have been described in the literature with different surgical techniques to limit possible intra-abdominal spillage, but none of these procedures are suitable for giant cysts occupying the entire abdominal cavity (1)(2)(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Management of Giant Ovarian Cysts Using the Alexis Laparoscopic System®: A Case Series

et al. 2020

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The aim of this study was to review the characteristics of patients who underwent laparoscopic removal of giant ovarian cysts using the Alexis Laparoscopic System® and confirm the safety and feasibility of this technique. Method:We conducted a retrospective review of data of women undergoing the procedure from March 2014 to February 2019. Inclusion criteria were ovarian cysts of at least 15 cm. Exclusion criteria were the presence of solid components and suspicion of neoplasia on imaging.Results: Six patients were included in the series. Median size of the cysts at imaging was 22.8 cm (range 15-30 cm), while median volume was 5.9 L (range 1.9-15.6 L). Mean age of operated women was 59 years (range 21-88 years). All patients underwent exclusive laparoscopic management except one patient who underwent a conversion into midline laparotomy. The size of the skin incision initially performed to puncture the cyst ranged from 2.5 to 4 cm. On final pathological reports, two cysts were mucinous cystadenomas, and four were serous cystadenomas. There was no epithelial ovarian cancer or borderline tumor in any of the specimen operated. Conclusion:Laparoscopic management of giant ovarian cysts using the Alexis Laparoscopic System® is safe and feasible in well-selected cases. Midline laparotomy can thus be avoided, decreasing the risk of post-operative complications and increasing quality of life of patients.

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Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Laparoscopic Management of Giant Ovarian Cysts Using the Alexis Laparoscopic System®: A Case Series

et al. 2020

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“…LESS, which produces a hole incision with a length of about 1.5~3.0cm through the umbilicus has a better cosmetic effect compared with traditional laparoscopic surgery [11]. However, due to the destruction of the normal shape of the umbilicus, the scar will be left, more or less [12]. At the same time, the complete incision and suture of the normal structure of the umbilicus may increase the incidence of umbilical incisional hernia [13].…”

Section: Discussionmentioning

confidence: 99%

Application of Micro-single-hole Laparoscopy Combined with Hysteroscopy in Diagnosis and Treatment of Complex Uterine Cavity Diseases

Sun¹,

Chen²,

Chen³

et al. 2021

JGO

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Object: To investigate the feasibility and safety of hysteroscopic surgery for diagnosis and treatment of complex uterine cavity diseases under the monitor of 5mm-mini-incision micro-single-hole laparoscopic surgery. Methods: A retrospective analysis of 15 patients with complex uterine cavity diseases undergoing hysteroscopic surgery underwent 5mm-mini-incision micro-single-hole laparoscopic surgery was performed in the Department of Obstetrics and Gynecology, the Affiliated Changzhou NO. 2 People's Hospital of Nanjing Medical University from April 2018 to March 2019. Among them, 8 cases were intrauterine adhesion, 3 cases were uterine submucosal fibroid, 3 cases were uterine septum, 1 case was post-cesarean scar pregnancy, ages from 23 to 45 years old, BMI 17.65-25.48kg/m 2 . The operation was performed through a 5mm-mini-incision from the midline of the umbilicus. The 40/50 small abdominal retractor was used to expand the incision approach. A 3-mm small lens (A cystoscope or a hysteroscope was used for some patients) was placed into the single-port approach to perform the laparoscopic surgery; hysteroscopic surgery was performed by hysteroscopy through the cervix. Results: All the 15 patients were successfully operated. One patient with severe intrauterine adhesion had uterine perforation during operation. The uterus was repaired and sutured under micro-single-hole laparoscopy perfectly. No other channels were added during operation, and no laparotomy was performed. The operation time was 20-125 min, in which the surgical path establishment time was 5-10 min, the umbilical reconstruction time was 3-5 min; the intraoperative blood loss was 5-10 ml, and the postoperative hospital stay was 3-7 days. The postoperative umbilical incision healed well, and there was no surgical scar in the abdomen after surgery. No postoperative umbilical hernia and other serious complications occurred. Conclusion: Under the premise of mature umbilical single-port laparoscopy, it is safe and effective to use 5mm-mini-incision micro-single-hole laparoscopic surgery as a monitor during hysteroscopy for the diagnosis and treatment of complex uterine cavity diseases. It will achieve a better cosmetic result than traditional laparoscopy.

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“…Previous studies have also demonstrated the feasibility of SPA laparoscopy for large ovarian tumors. In those studies, surgeons were able to remove tumors with a mean size of 20 cm with SPA laparoscopy (10,12). Almost all patients underwent successful surgery without conversion to laparotomy.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the benefits of SPA laparoscopy illustrated in previous studies, many surgeons remain reluctant to perform a single-port laparoscopic approach for large BOT due to the aforementioned reasons. However, since the introduction of SPA laparoscopy, the advantages of SPA with an extracorporeal approach for large ovarian tumors have been reported in several studies ( 10 – 12 ). It not only provides better cosmesis, less pain, and faster recovery after surgery but the relatively large umbilical incision created in SPA also facilitates extracorporeal procedures and the removal of bulky specimens with ease.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Single-Port Access (SPA) Laparoscopy for Large Ovarian Tumor Suspected to Be Borderline Ovarian Tumor

et al. 2020

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Objectives: To compare the surgical, pathological and oncological outcomes of singleport access (SPA) laparoscopy against laparotomy for large ovarian tumor (>15 cm) suspected to be a borderline ovarian tumor (BOT) on preoperative imaging. Methods: A retrospective review of the patients who underwent SPA laparoscopy (SPA Group) or laparotomy (Laparotomy Group) for suspected BOT was performed. Surgical outcomes, including the rates of iatrogenic spillage of tumor contents, and oncological outcomes, such as recurrence-free survival (RFS) and overall survival (OS), were compared between the two groups. Correlation between intraoperative frozen section analysis and permanent pathology results was also assessed. Results: A total of 178 patients underwent surgical treatment for suspected large BOT. Among them, 105 patients with a mean tumor diameter of 20.9 ± 6.5 cm underwent SPA laparoscopy, and the other 73 patients, with a mean tumor diameter 20.2 ± 5.9 cm, underwent laparotomy. The mean operation time did not differ between the two groups (99.1 ± 41.9 min for SPA Group vs. 107.3 ± 35.7 min for Laparotomy Group, p = 0.085). There was no difference in the occurrence of iatrogenic spillage of tumor contents between the groups either (11.4% in the SPA Group vs. 6.8% in the Laparotomy Group, p = 0.381). However, the postoperative complication rates were significantly higher in the Laparotomy Group compared with SPA Group (16.4% vs. 5.7%, p = 0.025). The surgical approach was not associated with the misdiagnosis rates of frozen section analysis (19% in the SPA Group vs. 26% in the Laparotomy Group, p = 0.484). The most common histologic type of the tumors was mucinous in both groups. Conclusion: SPA laparoscopy is feasible, safe, and not inferior to laparotomy for surgical treatment of large ovarian tumors that suspected to be BOT on preoperative imaging.

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Laparoendoscopic Single Site Surgery for the Treatment of Huge Ovarian Cysts Using an Angiocatheter Needle

Cited by 15 publications

References 18 publications

Laparoscopic Management of Giant Ovarian Cysts Using the Alexis Laparoscopic System®: A Case Series

Laparoscopic Management of Giant Ovarian Cysts Using the Alexis Laparoscopic System®: A Case Series

Application of Micro-single-hole Laparoscopy Combined with Hysteroscopy in Diagnosis and Treatment of Complex Uterine Cavity Diseases

Feasibility of Single-Port Access (SPA) Laparoscopy for Large Ovarian Tumor Suspected to Be Borderline Ovarian Tumor

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