Gasless single-port access laparoscopy using a J-shaped retractor in patients undergoing adnexal surgery

Global scientific production on gasless laparoscopy: a bibliometric analysis

Objectives

To characterize the bibliometric characteristics of the global scientific production of original research on gasless laparoscopy in the Web of Science Core Collection (WoSCC) platform.

Materials and methods

A bibliometric study of original articles published up to the year 2023 was carried out. Articles were included following the selection criteria in the Rayyan web application, indexed in the Scopus database. The bibliometric analysis was performed using the Bibliometrix program in the R programming language and VOSviewer. The bibliometric characteristics evaluated were articles, journals, citations, publications, ten most mentioned articles, journals with the highest number of publications, authors and institutional affiliations; and cooccurrence of terms.

Results

A total of 223 publications were included, with the highest number of articles being published in the years 1999 and 2014. The publication with the most citations was found to be a randomized trial by Galizia G in 2001 with 132 citations. We identified 846 authors involved in the production of articles on gasless laparoscopy, with Nakamura H being the most productive author with 15 articles between the years 2007 and 2020, followed by Takeda A and Imoto S, all three affiliated with "Gifu Prefectural Tajimi Hospital". The country with the highest production was Japan with 64 publications, followed by China and Italy with 46 and 18 publications, respectively. In the top 10 journals with the highest number of publications, "Surgical Endoscopy-Ultrasound and Interventional Techniques" is in first place with 20 articles published on gasless laparoscopy; in addition, most of these are located in Q1 and Q2. Regarding the terms or keywords, it was found that the initial studies had terms related to the disadvantages of pneumoperitoneum and later focused on more specific topics of the application of gasless laparoscopy.

Conclusions

Production on gasless laparoscopy has stagnated, with the topics of interest currently being its application in new, less invasive techniques. The most productive countries are found in the Asian and European continents, with little information collected in Latin America. This fact makes it necessary to increase the production of studies to promote this technique and its possible advantages.

Single-Incision Plus One Port Laparoscopic Surgery for Myomectomy: A Retrospective Study

BACKGROUND

The purpose of this study was to evaluate the effect of single-incision plus one port laparoscopic surgery (SILS + 1) for myomectomy.

METHODS

We retrospectively analyzed data from patients who underwent laparoendoscopic single-site myomectomy (LESS-M group, n = 40) and SILS + 1 (SILS + 1-M group, n = 40) for myomectomy at our hospital from October 2018 through December 2020. The patients' baseline demographic information and clinical data were compared between the two groups.

RESULTS

The results showed that no significant difference in basic characteristics or between the number, size, and location of uterine myomas between the two groups (p < 0.05). However, the surgery was more difficult and the total operating time was significantly longer in the LESS-M group compared to the SILS + 1-M group (83.5 ± 14.2 vs. 108.2 ± 18.1 min, p = 0.001). Moreover, the estimated intraoperative blood loss (113.4 ± 46.5 vs. 211.4 ± 60.3 ml, p = 0.001) and changes in hemoglobin level (13.1 ± 7.6 vs. 18.2 ± 6.0, p = 0.001) were significantly lower in the SILS + 1-M group compared to the LESS-M group. In addition, no serious intraoperative or postoperative complications occurred after surgery in either group. The clinical outcomes in the SILS + 1-M group were associated with a significant reduction in total surgical time compared to the LESS-M group (p < 0.05).

CONCLUSION

SILS + 1 for myomectomy is popular in clinics, with a satisfactory clinical effect.

Comparative study on gasless laparoscopy using a new device versus conventional laparoscopy for surgical management of postmenopausal patients

Objective:

To compare gasless laparoscopy with conventional laparoscopy for the surgical management of postmenopausal patients.

Methods:

The medical records of 80 postmenopausal patients who underwent laparoscopic surgeries between February 2016 and February 2020 were reviewed. Forty patients underwent gasless laparoscopy and 40 patients underwent conventional single-port access (SPA) laparoscopy. The two groups were compared in terms of surgical outcomes.

Results:

Of 80 patients, 42 underwent adnexal surgeries and 38 underwent uterine surgeries such as total hysterectomy or myomectomy. Between the gasless SPA and conventional SPA laparoscopic groups, no significant differences were observed in terms of age, body mass index, parity or history of previous abdominal surgery. The mean retraction setup time from skin incision was 6.8 ± 1.2 min with gasless laparoscopic surgery. There was no significant difference in mean total operation times for the gasless (71.3 ± 31.4 min) and conventional (82.5 ± 36.4 min) groups. There was also no significant difference between the groups in terms of operation type, laparotomy conversion rate or duration of hospitalisation. There were no major complications in either group.

Conclusions:

Gasless laparoscopy is a safe and feasible alternative to conventional laparoscopy for postmenopausal women.