Single-port Access Subtotal Laparoscopic Hysterectomy: A Prospective Case-Control Study

Laparoendoscopic single-site surgery versus conventional laparoscopy for hysterectomy: a systematic review and meta-analysis

“…Data that analyzed pain scores in the recovery unit, thus immediately after surgery, showed significantly lower pain scores after LESS hysterectomy compared to conventional hysterectomy (5 studies, MD −1.09 (−1.66, −0.52), I 2  = 80%, Fig. 4a) [21–23, 28]. The only randomized controlled trial included in this sub-analysis showed no difference between the two groups.…”

“…At 24 h, meta-analysis showed a significant difference between the two groups (11 studies, MD −0.45 (−0.87, −0.03), I 2  = 90%, Fig. 4c) [21, 23, 25, 28]. Though, the subgroup analysis including five RCTs showed non-significant results (MD −0.15 [−0.58, 0.28].…”

“…Eleven studies compared LESS hysterectomy to conventional TLH [13, 20–29], eleven studies compared LESS hysterectomy to LAVH [30–40], and in one study, both procedures were included [41]. Two studies also included supra-cervical hysterectomies [20, 21]. The study by Koyanagi [42] was excluded as all data were already included in another study by the same author [40].…”

“…A total of 1985 women in the LESS group and 2466 women in the conventional hysterectomy were included in six randomized controlled trials [23, 24, 26, 30, 39, 41], five prospective cohort studies [21, 27, 32, 36, 37], and 12 retrospective cohort studies [13, 20, 22, 25, 28, 29, 31, 33–35, 38, 40]. Twenty of the studies (86.9%) were performed in Asia (fifteen in Korea [13, 23–25, 27, 28, 31, 32, 34–39, 41], one in China [26], two in Japan [29, 40], and two in Taiwan [30, 33]), and the other three studies originated from the United States [20], Italy [22], and France [21]. Fourteen studies had a single center design [20–24, 26–30, 33, 36, 37, 39], one RCT was multi-center, and in the other eight studies, the setting was unclear [13, 25, 31, 32, 34, 35, 38, 40].…”

Recommendations for laparoscopic morcellation of uterus and leiomyomas. Position paper of the SEGi (Societ� Italiana di Endoscopia Ginecologica)

“…Likewise the benefits of mini-invasive endoscopic surgery in comparison to the risks related to the laparotomic approach should be shown (7,40). • In the case of myomectomy, the advantages of the mini-invasive approach, including the possible alternative methods of specimen extraction (mini-laparotomic or vaginal-culdocentesis-), should be clearly expressed.…”