Tissue injuries after single-port and multiport laparoscopic gynecologic surgeries: A prospective multicenter study

Abstract

The present study focused on the degree of tissue injury following single-port laparoscopic surgery (SPLS) and multiport laparoscopic surgery (MPLS) for the treatment of various benign gynecologic diseases. A total of 228 patients were prospectively enrolled at seven academic centers in South Korea between April 2011 and September 2012. Of these, 122 patients underwent SPLS and 106 patients underwent MPLS. The serum levels of C-reactive protein, creatine phosphokinase, lactic dehydrogenase and cancer antigen 125 were measured preoperatively and on postoperative day 4 by immunonephelometry. Cosmetic satisfaction and postoperative pain scores (visual analogue scale) were analyzed. Postoperative changes in the levels of the serum markers were found to be similar between the SPLS and MPLS groups. However, the postoperative pain scores at 48 h were significantly lower in the SPLS group when compared with those in the MPLS (P=0.001). In addition, patient-controlled analgesia was used more frequently by patients in the MPLS group (P=0.003). The present study is the first prospective investigation of tissue injury resulting from SPLS and MPLS in gynecology. In conclusion, the current study demonstrated that serum marker levels during SPLS were similar to those during MPLS in the treatment of benign gynecologic diseases. However, SPLS is a reasonable alternative to MPLS and is associated with comparable tissue injury, improved cosmesis and reduced postoperative pain.

Comparison of Postoperative and Oncologic Outcomes in Laparoscopic and Open Right Colectomy for Colon Cancer: A 5-year Experience

“…Importantly, in our study both these factors were found at significantly lower levels following laparoscopic right colectomy compared to the open surgery group. The levels of LDH, which is also an indicator of tissue injury (15) was not significantly lower in the laparoscopic group compared to the open surgery group.…”

Umbilical Quilting Suture Technique during Single-Port Laparoscopic Surgery

“… 2 SPLS in gynecology has become a reasonable alternative to multiple-port laparoscopic surgery and is associated with comparable tissue injuries, better cosmesis, less postoperative pain, and a shorter recovery period. 3 Of these advantages, the most noticeable benefit of SPLS may be cosmetic improvement, as it is performed via a hidden umbilical incision. 4 , 5 Because scars can have psychological consequences, postoperative scar cosmesis is a critical concern of women, especially young women.…”

“…This scar is markedly shorter than that associated with classic laparotomy, and it is usually hidden within the umbilicus, because the entry of the single trocar is through the umbilicus. 1 – 3 The cosmetic advantage is appealing to gynecologic patients, especially to young women, and the demand for SPLS is increasing. 4 – 6 …”

Early return to work: Single-port vs. multiport laparoscopic surgery for benign ovarian tumor

“…The exclusion criteria were patients who were unemployed; who received open surgery for benign ovarian tumors; had no intention of returning to work; had severe pain before operation; were obese with a body mass index (BMI) > 30 kg/m 2 ( 9 ); had an obviously malignant tumor on imaging or high serum CA125 levels (500 U/ml) or postoperative histopathology ( 10 ); had other concurrent tumors; had severe internal surgical diseases or a history of abdominal surgery.…”