Two-port myomectomy using bag-contained manual morcellation: A comparison with three-port myomectomy using power morcellation

Yang, Juseok; Song, Yong Jung; Na, Yong Jin; Kim, Hwi Gon

doi:10.1016/j.tjog.2019.01.029

Cited by 8 publications

(6 citation statements)

References 23 publications

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“…The surgeon can manage cervical myoma or posterior wall myoma smoothly with favorable surgical outcomes via LETS-M. The diameter and weight of myomas in our study were larger than those in most previous reports, either with multiport (mean diameter ranging from 5.9 to 6.5 cm, mean weight ranging from 126.8 to 195.9 g) (10,12,16,17,20) or single-port settings (mean diameter ranging from 5.4 to 7.5 cm, mean weight ranging from 131 to 173.9 g) (7-10, 12, 13, 17, 20, 21). The operation time was relatively short (mean 82.4 to 140 minutes in the multiport setting and 115.6 to 196.5 minutes in the single-port setting).…”

Section: Discussioncontrasting

confidence: 55%

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Laparoendoscopic Two-Site Myomectomy (LETS-M) Using Conventional Laparoscopic Instruments and The Glove-Port Technique

Wu¹,

Sheu²,

Huang³

et al. 2021

Preprint

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We aim to evaluate the surgical outcome of laparoendoscopic two-site myomectomy (LETS-M). The medical records of 204 women receiving LETS-M in a tertiary referral center, including 183 surgeries performed by the experienced surgeon and 21 surgeries performed by 3 well-supervised trainees were retrospectively reviewed. The age of the participants was 39.3±6.4 years. The mean diameter of the largest myoma was 8.5±2.2 cm. The mean weight of the myomas was 281.1±183.1 g. The operation time was 97.6±40.2 min, and the intraoperative blood loss was 99.3±115.2 mL. There were 3 (1%) cases of excessive blood loss (more than 500 mL) and 2 (1%) of postoperative hematoma. The only significant difference between the experienced surgeon and trainees was the operation time (92.3±32.2 min vs. 141.2±54 min, p<.001), while the myoma number, myoma diameter, myoma weight, and intraoperative blood loss were not significantly different. The operation time did not differ among different myoma locations. In multivariate analysis, virginity, myoma number, more than 2 large myomas, and myoma size were independent variables for longer operation times. No patient experienced any major complications. The result revealed that LETS-M is a minimally invasive surgical method that is safe, effective, and easy to learn for managing uterine myoma.

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Section: Discussioncontrasting

confidence: 55%

“…Instead, we performed manual morcellation via the umbilical wound. Yang and colleagues' study revealed that two-port LM with bag-contained manual morcellation were feasible and safe (16).…”

Section: Discussionmentioning

confidence: 99%

Laparoendoscopic Two-Site Myomectomy (LETS-M) Using Conventional Laparoscopic Instruments and The Glove-Port Technique

Wu¹,

Sheu²,

Huang³

et al. 2021

Preprint

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“…Despite many criticisms for violating the basic rules of conventional multiport laparoscopy, reduced port laparoscopy such as TPLS offers potential benefits, which may include decreased postoperative pain, improved cosmesis, fewer trocar sites and wound‐related complication and increased postoperative satisfaction 15 . In addition to endoscopic gynecologic surgery, other surgical departments such as urology, general surgery and thoracic surgery also described TPLS (two abdominal incisions and some authors performed additional trocar placement in vagina or at the same umbilical incision) in their treatment area 7,15–18 . However, our two‐port technique is different from the others because only two instruments are used by a surgeon at the same time: an optic in one hand and an energy device (with grasp, burning and cut functions) in the other hand, so total incision is smaller according to others.…”

Section: Discussionmentioning

confidence: 99%

“…15 In addition to endoscopic gynecologic surgery, other surgical departments such as urology, general surgery and thoracic surgery also described TPLS (two abdominal incisions and some authors performed additional trocar placement in vagina or at the same umbilical incision) in their treatment area. 7,[15][16][17][18] However, our two-port technique is different from the others because only two instruments are used by a surgeon at the same time: an optic in one hand and an energy device (with grasp, burning and cut functions) in the other hand, so total incision is smaller according to others. For example, Song et al published a study that included two-port surgery; they used a home-made port (how many mm is unknown) at the umbilicus for the multichannel method and one 5-mm port at the suprapubic area, so they used three instrument.…”

Section: Discussionmentioning

confidence: 99%

Comparison of novel two‐port and conventional multiport laparoscopic surgery approaches for benign adnexal masses: The Bagli method

Bağlı

Bademkıran

2020

J of Obstet and Gynaecol

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Aim: This study primarily aims to describe the safety and efficacy of a novel two-port (5 and 10-mm) laparoscopic surgery (TPLS) approach for benign adnexal masses compared with conventional multiport laparoscopic surgery (CMLS) in excisional procedures such as salpingectomy and oophorectomy. Methods: This is a retrospective case-control study. Forty-four patients were divided into two groups: two-port (5 mm and 10 mm) laparoscopic surgery group (n: 22) and conventional multiport (three/four port) laparoscopic surgery group (n: 22), with similar indications. All procedures, except ovarian detorsions, included salpingectomy, oophorectomy or salpingo-ophorectomy. The groups were evaluated using their demographic, clinical, intraoperative and postoperative data, and survey questions that were asked were used for analyzing cosmetic satisfaction, surgical satisfaction and preference rates of the TPLS. Results: There were no significant differences between the groups on demographic features. All patients were discharged within 24 h after both the procedures without any major (organ injury) or minor complication. Surgical satisfaction range was 8.82 (±1.01) in TPLS group and 7.27 (±1.6) in the CMLS group, and differences were significant (P = 0.002). Satisfaction with cosmesis was 95% in the TPLS group and 77% in the CMLS group, and this difference was not significant (P = 0.11). The preferences rate of TPLS was 68% among the 44 women. Conclusion: Novel TPLS is feasible and safe in expert hands. In addition, it provides more surgical satisfaction to patients. However, there were not significant differences in long-term cosmesis results between the TPLS and CMLS groups.

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“…This procedure is performed in a lithotomy position using video-monitoring equipment [60]. With the advances in technology for minimally invasive surgery, laparoscopic surgeries using fewer port wounds, single incisions, or the natural orifice have become increasingly popular [81][82][83]. Therefore, the fewer-port laparoscopic technique is also feasible for LOD.…”

Section: A Brief Review Of the Operative Procedures Of Laparoscopic Ovmentioning

confidence: 99%

Molecular Mechanisms of Laparoscopic Ovarian Drilling and Its Therapeutic Effects in Polycystic Ovary Syndrome

Seow¹,

Chang

Chen

et al. 2020

IJMS

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Polycystic ovary syndrome (PCOS) is a common endocrinopathy, characterized by chronic anovulation, hyperandrogenism, and multiple small subcapsular cystic follicles in the ovary during ultrasonography, and affects 5–10% of women of reproductive age. PCOS is frequently associated with insulin resistance (IR) accompanied by compensatory hyperinsulinemia and, therefore, presents an increased risk of type 2 diabetes mellitus (DM). The pathophysiology of PCOS is unclear, and many hypotheses have been proposed. Among these hypotheses, IR and hyperandrogenism may be the two key factors. The first line of treatment in PCOS includes lifestyle changes and body weight reduction. Achieving a 5–15% body weight reduction may improve IR and PCOS-associated hormonal abnormalities. For women who desire pregnancy, clomiphene citrate (CC) is the front-line treatment for ovulation induction. Twenty five percent of women may fail to ovulate spontaneously after three cycles of CC treatment, which is called CC-resistant PCOS. For CC-resistant PCOS women, there are many strategies to improve ovulation rate, including medical treatment and surgical approaches. Among the various surgical approaches, one particular surgical method, called laparoscopic ovarian drilling (LOD), has been proposed as an alternative treatment. LOD results in an overall spontaneous ovulation rate of 30–90% and final pregnancy rates of 13–88%. These benefits are more significant for women with CC-resistant PCOS. Although the intra- and post-operative complications and sequelae are always important, we believe that a better understanding of the pathophysiological changes and/or molecular mechanisms after LOD may provide a rationale for this procedure. LOD, mediated mainly by thermal effects, produces a series of morphological and biochemical changes. These changes include the formation of artificial holes in the very thick cortical wall, loosening of the dense and hard cortical wall, destruction of ovarian follicles with a subsequently decreased amount of theca and/or granulosa cells, destruction of ovarian stromal tissue with the subsequent development of transient but purulent and acute inflammatory reactions to initiate the immune response, and the continuing leakage or drainage of “toxic” follicular fluid in these immature and growth-ceased pre-antral follicles. All these factors contribute to decreasing local and systemic androgen levels, the following apoptosis process with these pre-antral follicles to atresia; the re-starting of normal follicular recruitment, development, and maturation, and finally, the normalization of the “hypothalamus–pituitary–ovary” axis and subsequent spontaneous ovulation. The detailed local and systematic changes in PCOS women after LOD are comprehensively reviewed in the current article.

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Two-port myomectomy using bag-contained manual morcellation: A comparison with three-port myomectomy using power morcellation

Cited by 8 publications

References 23 publications

Laparoendoscopic Two-Site Myomectomy (LETS-M) Using Conventional Laparoscopic Instruments and The Glove-Port Technique

Laparoendoscopic Two-Site Myomectomy (LETS-M) Using Conventional Laparoscopic Instruments and The Glove-Port Technique

Comparison of novel two‐port and conventional multiport laparoscopic surgery approaches for benign adnexal masses: The Bagli method

Molecular Mechanisms of Laparoscopic Ovarian Drilling and Its Therapeutic Effects in Polycystic Ovary Syndrome

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