Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
권호 표지
DOI QR코드

DOI QR Code

Clinical experience with single-port access laparoscopic cystectomy and myomectomy

  • Jeong, Jae-Hyeok (Department of Obstetrics and Gynecology, Hwamyeong Ilsin Christian Hospital) ;
  • Kim, Yu-Ri (Department of Obstetrics and Gynecology, Hwamyeong Ilsin Christian Hospital) ;
  • Hong, Kil-Pyo (Department of Obstetrics and Gynecology, Hwamyeong Ilsin Christian Hospital) ;
  • Ha, Jae-Eun (Department of Obstetrics and Gynecology, Hwamyeong Ilsin Christian Hospital) ;
  • Kim, Eun-Jeong (Department of Obstetrics and Gynecology, Hwamyeong Ilsin Christian Hospital) ;
  • Hong, Da-Kyo (Department of Obstetrics and Gynecology, Hwamyeong Ilsin Christian Hospital) ;
  • Lee, Kyu-Sup (Department of Obstetrics and Gynecology, Pusan National University School of Medicine)
  • Received : 2015.03.26
  • Accepted : 2015.12.01
  • Published : 2016.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: This study was performed to assess our clinical experience with single-port access (SPA) laparoscopic cystectomy and myomectomy and the surgical outcomes of those procedures at our institution. Methods: The authors evaluated the surgical outcomes of SPA laparoscopic cystectomy in 293 patients and SPA laparoscopic myomectomy in 246 patients. The surgical outcomes comprised operation time, the amount of blood loss during the operation, the change in hemoglobin (before and after the operation), the change in hematocrit (before and after the operation), switching to the multi-port access method, complications, transfusions, and the duration of the postoperative hospital stay. Results: The Pearson correlation coefficient and the Spearman correlation coefficient between the operation time and the amount of blood loss were 0.312 and 0.321 for SPA laparoscopic cystectomy, respectively, and 0.706 and 0.674 for SPA laparoscopic myomectomy, respectively. The drops in hemoglobin and hematocrit were $1.33{\pm}0.78g/dL$ and $4.14%{\pm}2.45%$, respectively, in SPA laparoscopic cystectomy, while the corresponding figures were $1.34{\pm}1.13g/dL$ and $4.17%{\pm}3.24%$ in SPA laparoscopic myomectomy, respectively. Conclusion: This study reported the surgical outcomes of SPA laparoscopic cystectomy and myomectomy and compared them to previously published findings on traditional laparoscopic cystectomy and myomectomy. No significant differences were found in the surgical outcomes between SPA and traditional laparoscopic cystectomy and myomectomy.

Keywords

References

  1. Buttram VC Jr, Reiter RC. Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 1981;36:433-45. https://doi.org/10.1016/S0015-0282(16)45789-4
  2. Hasson HM, Rotman C, Rana N, Sistos F, Dmowski WP. Laparoscopic myomectomy. Obstet Gynecol 1992;80:884-8.
  3. Dubuisson JB, Fauconnier A, Chapron C, Kreiker G, Norgaard C. Reproductive outcome after laparoscopic myomectomy in infertile women. J Reprod Med 2000;45:23-30.
  4. Kalogiannidis I, Lambrechts S, Amant F, Neven P, Van Gorp T, Vergote I. Laparoscopy-assisted vaginal hysterectomy compared with abdominal hysterectomy in clinical stage I endometrial cancer: safety, recurrence, and long-term outcome. Am J Obstet Gynecol 2007;196:248.e1-8.
  5. Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, et al. Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2. J Clin Oncol 2009;27:5331-6. https://doi.org/10.1200/JCO.2009.22.3248
  6. Jin C, Hu Y, Chen XC, Zheng FY, Lin F, Zhou K, et al. Laparoscopic versus open myomectomy: a meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol 2009;145:14-21. https://doi.org/10.1016/j.ejogrb.2009.03.009
  7. Oliveira FG, Abdelmassih VG, Diamond MP, Dozortsev D, Melo NR, Abdelmassih R. Impact of subserosal and intramural uterine fibroids that do not distort the endometrial cavity on the outcome of in vitro fertilization-intracytoplasmic sperm injection. Fertil Steril 2004;81:582-7. https://doi.org/10.1016/j.fertnstert.2003.08.034
  8. Bulletti C, DE Ziegler D, Levi Setti P, Cicinelli E, Polli V, Stefanetti M. Myomas, pregnancy outcome, and in vitro fertilization. Ann N Y Acad Sci 2004;1034:84-92. https://doi.org/10.1196/annals.1335.010
  9. Kim YW. Single port transumbilical total laparoscopic hysterectomy (TLH): initial experience in Korea. Korean J Obstet Gynecol 2009;52:480-6.
  10. Yoon BS, Park H, Seong SJ, Park CT, Park SW, Lee KJ. Single-port laparoscopic salpingectomy for the surgical treatment of ectopic pregnancy. J Minim Invasive Gynecol 2010;17:26-9. https://doi.org/10.1016/j.jmig.2009.09.008
  11. Fagotti A, Bottoni C, Vizzielli G, Gueli Alletti S, Scambia G, Marana E, et al. Postoperative pain after conventional laparoscopy and laparoendoscopic single site surgery (LESS) for benign adnexal disease: a randomized trial. Fertil Steril 2011;96:255-9.e2. https://doi.org/10.1016/j.fertnstert.2011.04.006
  12. Paek J, Nam EJ, Kim YT, Kim SW. Overcoming technical difficulties with single-port access laparoscopic surgery in gynecology: using conventional laparoscopic instruments. J Laparoendosc Adv Surg Tech A 2011;21:137-41. https://doi.org/10.1089/lap.2010.0313
  13. Tam YH, Lee KH, Sihoe JD, Chan KW, Cheung ST, Pang KK. Initial experience in children using conventional laparoscopic instruments in single-incision laparoscopic surgery. J Pediatr Surg 2010;45:2381-5. https://doi.org/10.1016/j.jpedsurg.2010.08.036
  14. Podolsky ER, Curcillo PG 2nd. Single port access (SPA) surgery: a 24-month experience. J Gastrointest Surg 2010;14:759-67. https://doi.org/10.1007/s11605-009-1081-6
  15. Kosumi T, Kubota A, Usui N, Yamauchi K, Yamasaki M, Oyanagi H. Laparoscopic ovarian cystectomy using a single umbilical puncture method. Surg Laparosc Endosc Percutan Tech 2001;11:63-5.
  16. Fagotti A, Fanfani F, Marocco F, Rossitto C, Gallotta V, Scambia G. Laparoendoscopic single-site surgery (LESS) for ovarian cyst enucleation: report of first 3 cases. Fertil Steril 2009;92:1168.e13-6.
  17. Lee YY, Kim TJ, Kim CJ, Park HS, Choi CH, Lee JW, et al. Single port access laparoscopic adnexal surgery versus conventional laparoscopic adnexal surgery: a comparison of peri-operative outcomes. Eur J Obstet Gynecol Reprod Biol 2010;151:181-4. https://doi.org/10.1016/j.ejogrb.2010.03.010
  18. Park SN, Hong GY, Kim HY, Kim BR, Lee C. A comparison of single-port laparoscopically assisted vaginal hysterectomy using transumbilical sils port access and three-port laparoscopically assisted vaginal hysterectomy. Korean J Obstet Gynecol 2012;55:22-8. https://doi.org/10.5468/KJOG.2012.55.1.22
  19. Alessandri F, Lijoi D, Mistrangelo E, Ferrero S, Ragni N. Randomized study of laparoscopic versus minilaparotomic myomectomy for uterine myomas. J Minim Invasive Gynecol 2006;13:92-7. https://doi.org/10.1016/j.jmig.2005.11.008
  20. Yoo EH, Kim D. Obstetric outcomes after laparoscopic myomectomy. Korean J Obstet Gynecol 2008;51:1481-6.
  21. Leggett PL, Churchman-Winn R, Miller G. Minimizing ports to improve laparoscopic cholecystectomy. Surg Endosc 2000;14:32-6. https://doi.org/10.1007/s004649900006
  22. Kim IH, Lee GH, Yi HJ, Lee YJ, Na ED. Single port access laparoscopic myomectomy. Korean J Gynecol Endosc Minim Invasive Surg 2011;23:14-8.
  23. Kim SK, Lee JH, Lee JR, Suh CS, Kim SH. Laparoendoscopic single- site myomectomy versus conventional laparoscopic myomectomy: a comparison of surgical outcomes. J Minim Invasive Gynecol 2014;21:775-81. https://doi.org/10.1016/j.jmig.2014.03.002