Single-Port Access Subtotal Hysterectomy with Transcervical Morcellation: A Pilot Study

Yoon, Gun; Kim, Tae-Joong; Lee, Yoo-Young; Kim, Chul-Jung; Choi, Chel Hun; Lee, Jeong‐Won; Kim, Byoung-Gie; Bae, Duk-Soo

doi:10.1016/j.jmig.2009.09.018

Cited by 45 publications

(30 citation statements)

References 15 publications

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“…Recently it has been reported that gynecologic approaches using the SPA system, including TLH, LAVH, and adnexal surgery, were feasible [6][7][8][9] . For a learning curve analysis of SPA surgery, Escobar et al [10] reported a retrospective, multi-institutional analysis of BRCA car- riers and women at high risk for breast/ovarian cancer who underwent LESS risk-reducing salpingo-oophorectomy with and without hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Learning Curve and Surgical Outcome for Single-Port Access Total Laparoscopic Hysterectomy in 100 Consecutive Cases

Paek

Kim

Lee

et al. 2011

Gynecol Obstet Invest

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Aims: To define the learning curve for single-port access (SPA) total laparoscopic hysterectomy (TLH) and evaluate the surgical outcomes. Methods: Patient demographics and segmental operating times of all 100 patients who underwent SPA-TLH by a single surgeon were analyzed. Patients were arranged in order based on surgery date. Results: 100 patients underwent SPA-TLH. There was no conversion to conventional laparoscopy or laparotomy. The median time until the removal of a specimen (TR) was 45 min and the median time for closure of the vaginal cuff (TC) was 18 min. The median total operating time from skin opening to closure (TO) was 80 min. TR, TC, and TO decreased significantly over the study period. The TC decreased significantly from the first 20 cases to the next 20 (p = 0.028) and the TO from the second 20 cases to the next 20 (p = 0.029). Conclusions: Proficiency for SPA-TLH was achieved after 40 cases. Operating time and postoperative hemoglobin drop decreased with experience, without increasing complication.

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Section: Discussionmentioning

confidence: 99%

Learning Curve and Surgical Outcome for Single-Port Access Total Laparoscopic Hysterectomy in 100 Consecutive Cases

Paek

Kim

Lee

et al. 2011

Gynecol Obstet Invest

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“…In gynecology, single-port and 2-port surgeries are being used for hysterectomy, adnexectomy, enucleation of ovarian cysts, myomectomy and even in gynecologic cancer. A lot of studies have reported that single-port surgery is a safe and feasible method[1,2,3,4,5,6,7,8,9,10,11,12]. Compared with conventional laparoscopic surgery, single-port surgery reduces wound infection and postoperative pain in addition to reducing the number of scars [13,14,15,16,17,18].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Single-Port, Two-Port and Four-Port Laparoscopic Surgery for Cyst Enucleation in Benign Ovarian Cysts

Kim

Song

Seong

et al. 2013

Gynecol Obstet Invest

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Objective: To compare the perioperative outcomes of three laparoscopic approaches for performing ovarian cyst enucleation. Methods: A total of 148 patients underwent laparoscopic cyst enucleation at the CHA Gangnam Medical Center between September 2010 and May 2011. We reviewed retrospectively the medical records including patient demographics, operative outcomes and complications. Results: We assigned the 148 patients into three groups: single-port (group A: 40), 2-port (group B: 30) and 4-port (group C: 78). There were no statistically significant differences in patient characteristics. The operation times were 90.4 ± 43.6, 74.7 ± 22.0 and 63.8 ± 30.5 min, and the estimated blood loss was 179.3 ± 253.9, 73 ± 75.2 and 89.9 ± 106.7 ml, respectively. Mean operation time was longer (p < 0.001) and estimated blood loss was higher (p = 0.005) in group A than in the other groups. There was no statistical difference in perioperative complications among the three groups. In group A, additional port insertion rate was higher than in groups B and C (p < 0.001). Conclusion: Single-port surgery required longer operation time, had a higher estimated blood loss and used additional ports more frequently during the operation than the other groups. However, 2-port surgery had no significant differences from 4-port surgery in the surgical outcomes. Therefore, 2-port surgery can be an alternative surgical option for 4-port surgery in ovarian cyst enucleation.

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“…21 Whereas Yoon et al, in a study that included 7 cases of subtotal hysterectomies done using morcellators, showed an average blood loss of 200 mL. 22 The values are exciting; however, in a single randomized study that evaluated this parameter, Cho et al reported that the drop in hemoglobin levels was statistically higher in patients that underwent single-port surgery (2.0 0.7g/dL) compared to those who underwent multiple-port video--laparoscopy (1.7 0.6g/dL). The authors believe that this difference may be reduced with an increase in the surgeons' experience performing the less invasive procedure.…”

Section: Discussionmentioning

confidence: 99%

Single-site laparoscopy in gynecology: preliminary study of a series of 50 cases

Filho

Noviello

Damasceno

et al. 2014

Rev. Assoc. Med. Bras.

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Objective: to describe the initial experience of a gynecology team, at a tertiary care center, when performing single-port laparoscopic surgery. Method: this is a retrospective study reviewing the medical records of 50 patients treated at the outpatient gynecology clinic of our institution between June 2012 and July 2013 who underwent single-port laparoscopic surgery. This study was approved by the institution's Ethics in Research Committee. Result: the mean age of patients is 37.8 years, ranging from 18 to 70 years, and the most frequent surgical indications were adnexal mass (72%) and chronic pelvic pain (24%). The mean operative time was 94.4 minutes with a mean hospital stay of 25.8 hours. There were no perioperative complications. We recorded two conversions to laparotomy due to technical difficulties during the procedure. All cases of conversion had pelvic adhesions. All operative complications were successfully treated and none were considered severe. Conclusion: this is one of the largest case series in the literature regarding surgical treatment by single-port laparoscopy in gynecology and presents evidence on reduction of surgical morbidity and satisfactory cosmetic results. We conclude that single-port laparoscopy is a viable minimally invasive technique, and that it contributes to the construction of a new scenario in modern gynecological surgery.

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Single-Port Access Subtotal Hysterectomy with Transcervical Morcellation: A Pilot Study

Cited by 45 publications

References 15 publications

Learning Curve and Surgical Outcome for Single-Port Access Total Laparoscopic Hysterectomy in 100 Consecutive Cases

Learning Curve and Surgical Outcome for Single-Port Access Total Laparoscopic Hysterectomy in 100 Consecutive Cases

Comparison of Single-Port, Two-Port and Four-Port Laparoscopic Surgery for Cyst Enucleation in Benign Ovarian Cysts

Single-site laparoscopy in gynecology: preliminary study of a series of 50 cases

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