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Schmitt A, Crochet P, Pivano A, Tourette C, Faust C, Baumstarck K, Agostini A. The Effects of a Laparoscopy by Single-Port Endoscopic Access in Benign Adnexal Surgery: A Randomized Controlled Trial. J Minim Invasive Gynecol 2024; 31:397-405. [PMID: 38310954 DOI: 10.1016/j.jmig.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/06/2024]
Abstract
STUDY OBJECTIVE To evaluate whether laparoendoscopic single-site surgery (LESS) offers advantages over conventional laparoscopy (CL) in benign adnexal surgery. DESIGN Randomized controlled study. SETTING Gynecology-Obstetrics Unit of the University Hospital of the Conception in Marseille, France. PATIENTS Patients older than 18 years requiring ovarian cystectomy or salpingo-oophorectomy by laparoscopy for symptomatic ovarian cysts requiring benign or prophylactic surgery. INTERVENTIONS In the case of ovarian cysts, premenopausal patients typically undergo a unilateral cystectomy, whereas postmenopausal patients undergo a unilateral or bilateral salpingo-oophorectomy upon a patient's request. In cases requiring prophylactic surgery, a bilateral salpingo-oophorectomy was performed. All participants were randomly assigned to either the LESS or the CL group. MEASUREMENTS AND MAIN RESULTS Patients in both groups reported similar levels of pain at 24 hours: Simple Numerical Scale was 1.3 (standard deviation, 1.5) in the LESS group vs 1.7 (standard deviation, 1.5) in the CL group (p = .12), and there were no significant differences in postoperative pain at 2 hours, 4 hours, 6 hours, and 7 days. Furthermore, there was no difference in analgesic consumption. Regarding intraoperative criteria, the only difference was the longer operating time in the LESS group than the CL group. We also found that patients' satisfaction with their scar at 1 month may be higher with LESS than with CL. CONCLUSION There was no significant difference between the 2 techniques in postoperative pain, although the LESS technique necessitated a longer operative time than the CL technique, while providing better aesthetic result patients.
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Affiliation(s)
- Andy Schmitt
- Division of Gynecology, Obstetrics, and Reproduction, Gynepôle, Hôpital de la Conception, Marseille, France (Drs. Schmitt, Crochet, Pivano, Tourette, and Agostini).
| | - Patrice Crochet
- Division of Gynecology, Obstetrics, and Reproduction, Gynepôle, Hôpital de la Conception, Marseille, France (Drs. Schmitt, Crochet, Pivano, Tourette, and Agostini)
| | - Audrey Pivano
- Division of Gynecology, Obstetrics, and Reproduction, Gynepôle, Hôpital de la Conception, Marseille, France (Drs. Schmitt, Crochet, Pivano, Tourette, and Agostini)
| | - Claire Tourette
- Division of Gynecology, Obstetrics, and Reproduction, Gynepôle, Hôpital de la Conception, Marseille, France (Drs. Schmitt, Crochet, Pivano, Tourette, and Agostini)
| | - Cindy Faust
- Department of Public Health, Aix-Marseille University, Marseille, France (Drs. Faust and Baumstarck)
| | - Karine Baumstarck
- Department of Public Health, Aix-Marseille University, Marseille, France (Drs. Faust and Baumstarck)
| | - Aubert Agostini
- Division of Gynecology, Obstetrics, and Reproduction, Gynepôle, Hôpital de la Conception, Marseille, France (Drs. Schmitt, Crochet, Pivano, Tourette, and Agostini)
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He H, Li T, Cui M, Jiang Q, Jiang F, Li M, Liu Y. Effect of two different laparoscopic techniques on post-operative wound complications in patients with benign gynaecological diseases: A meta-analysis. Int Wound J 2023; 21:e14382. [PMID: 37830298 PMCID: PMC10828522 DOI: 10.1111/iwj.14382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 10/14/2023] Open
Abstract
Single-port laparoscopy (SPL) has existed for several years. This meta-analysis was conducted to evaluate the efficacy of SPL compared with conventional laparoscopy (CL) in the treatment of benign gynecologic adnexal lesions. The purpose of this meta-analysis is to evaluate the superiority of SPL versus CL in the treatment of post-operative wound pain. The study looked for English-language publications from PubMed, Embase, Cochrane Library and the Web of Science until June 2023. The main result was the visual analogue scale (VAS) after 2, 4, 6, 8, 12, 24 and 48 h after operation. The paper contains 10 related papers by means of e-search. Of these, 4 were randomized controlled trials (RCTs), while 6 were non-RCTs. The results indicated that SPL and CL were significantly different after 2, 24 and 48 h after operation. SPL had lower post-operative pain after 2 h compared with CL (MD, -0.6; 95% CI, -0.98, -0.21; p = 0.002). After the operation, SPL also had a lower incidence of post-operative pain after 24 h compared with CL (MD, -0.59; 95% CI, -1.12, -0.06; p = 0.03). And the difference in pain was at 48 h after the most significant (MD, -0.49; 95% CI, -0.75, -0.23; p = 0.0002). But after 6, 8 and 12 h after operation, there was no significant difference in the degree of pain. Thus, SPL operations may result in a lower degree of pain than CL in both the post-operative and far post-operative phase.
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Affiliation(s)
- Haining He
- Department of Gynaecology and Obstetrics, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Tinglan Li
- People's Hospital of Aba Tibetan and Qiang Autonomous PrefectureAbaChina
| | - Manman Cui
- Department of Gynaecology and Obstetrics, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Qin Jiang
- Department of Gynaecology and Obstetrics, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Fuchuan Jiang
- Department of Gynaecology and Obstetrics, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Min Li
- Department of Gynaecology and Obstetrics, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Yi Liu
- Department of Gynaecology and Obstetrics, Sichuan Provincial People's Hospital, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
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Jiang X, Zuo X, Zhu H. Laparoendoscopic Single-Site Technique Contrasted with Conventional Laparoscopy in Cystectomy for Benign Ovarian Cysts. CURRENT THERAPEUTIC RESEARCH 2023; 99:100713. [PMID: 37519420 PMCID: PMC10372162 DOI: 10.1016/j.curtheres.2023.100713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023]
Abstract
Objective To compare the laparoendoscopic single-site (LESS) technique with conventional laparoscopy in cystectomy for benign ovarian cysts. Materials and methods A retrospective analysis was performed at Yixing People's Hospital from April 2020 until December 2021. Results Thirty-seven patients using the LESS technique were compared with a control group of 45 patients who underwent a traditional laparoscopic ovarian cystectomy. There was no statistically significant difference in the perioperative hemoglobin level changes, cyst rupture rate, postoperative recovery of exhausting time, or pain score at 24 hours after surgery between the 2 groups (P > 0.05). The mean operating time was significantly longer in the LESS group than that of the control group (88.38 ± 30.57 minutes vs 59.44 ± 24.22 minutes; P = 0.001). However, the length of postoperative hospital stay was significantly shorter in the LESS group (3.70 ± 0.57 days vs 4.38 ± 0.86 days; P = 0.001). In addition, total hospitalization expenses were higher in the LESS group (14,709.78 ± 1618.63 yuan vs 12,676.73 ± 1411.78 yuan; P = .001) and the satisfaction score was also significantly higher in the LESS group (z = -2.272; P = 0.023). After a follow-up time of 12 to 24 months, no patient in either group showed wound infection, umbilical hernia, or recurrent cysts. Conclusions The LESS technique for benign ovarian cystectomy is safe, feasible, and equally effective compared with the multiport laparoscopic oophorocystectomy. Although it currently costs more, patients with benign ovarian cysts are highly satisfied with the LESS technique.
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Affiliation(s)
- Xinru Jiang
- Address correspondence to: Xinru Jiang, MM, Department of Gynecology and Obstetrics, Yixing People's Hospital, 75 Tongzhenguan St, Wuxi, Jiangsu 214200, China
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Chen S, Zhang G, Hua K, Ding J. Single-port laparoscopy versus conventional laparoscopy of benign adnexal masses during pregnancy: a retrospective case-control study. J Int Med Res 2022; 50:3000605221128153. [PMID: 36314266 PMCID: PMC9623375 DOI: 10.1177/03000605221128153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To compare operative outcomes between single-port laparoscopy (SPL) and conventional laparoscopy (CL) to remove adnexal masses during pregnancy. METHODS This retrospective case-control study included all patients who had undergone laparoscopic removal of benign adnexal masses during pregnancy between October 2010 and January 2020. Multiple clinical characteristics and operative outcomes were retrospectively analysed and compared between patients who had undergone SPL versus CL, including cosmetic satisfaction with the scar, measured on a 10-point scale (10 indicating very satisfied). RESULTS A total of 64 patients were included (SPL, n = 22; and CL, n = 42). Overall scar satisfaction scores significantly favoured SPL versus CL (9.1 ± 1.7 versus 8.1 ± 1.3, respectively), however, surgery duration was significantly longer for SPL than CL (69.2 ± 21.0 min versus 54.7 ± 20.7 min). No incisional hernia was detected in the study. Operative blood loss, decrease in estimated haemoglobin level, length of hospital stay, and hospitalization expenses were comparable between the two groups. Pregnancy and fetal outcomes were not remarkably different. CONCLUSION For removal of benign adnexal masses during pregnancy, SPL may offer superior cosmetic satisfaction versus CL, and was not associated with additional perioperative danger, economic burden, or adverse pregnancy and neonatal outcomes.
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Affiliation(s)
- Sishi Chen
- Department of Gynaecology, the Obstetrics and Gynaecology Hospital of Fudan
University, Shanghai, China,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases,
Shanghai, China
| | - Ganrong Zhang
- Department of Gynaecology, the Obstetrics and Gynaecology Hospital of Fudan
University, Shanghai, China,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases,
Shanghai, China
| | - Keqin Hua
- Department of Gynaecology, the Obstetrics and Gynaecology Hospital of Fudan
University, Shanghai, China,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases,
Shanghai, China,Ke-Qin Hua, Department of Gynaecology, the Obstetrics
and Gynaecology Hospital of Fudan University, 128 Shenyang Road, Shanghai 200090, China.
| | - Jingxin Ding
- Department of Gynaecology, the Obstetrics and Gynaecology Hospital of Fudan
University, Shanghai, China,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases,
Shanghai, China,Jing-Xin Ding, Department of Gynaecology, the
Obstetrics and Gynaecology Hospital of Fudan University, 128 Shenyang Road, Shanghai 200090,
China.
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Paratubal Cystectomy in a Pregnant Woman Using the Single-Incision Laparoscopic Surgery (SILS) Technique. Case Rep Obstet Gynecol 2022; 2022:2802767. [PMID: 35875340 PMCID: PMC9303160 DOI: 10.1155/2022/2802767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/13/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction The proliferation of prenatal ultrasound has enhanced the detection of adnexal masses during pregnancy. The presentation necessitates a clear approach to investigation and treatment that balances both maternal and fetal risk. Laparoscopy is a safe approach to surgical management in the pregnant patient, and SILS may contribute to minimising perioperative complications. Case Presentation. We present the case of a 21-year-old female in her second trimester of pregnancy presenting with a large 20 cm right adnexal cyst. We proceeded with laparoscopic cystectomy via the SILS technique. There were no intraoperative complications, and she recovered well postoperatively. Conclusion Laparoscopic resection of adnexal lesions is safe during pregnancy and should be favoured over the open approach. SILS minimises incision sites and has potential for reduction in perioperative morbidity.
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Kaya C, Alay I, Eren E, Helvacioglu O. Laparoscopy-assisted suprapubic salpingectomy 'Kaya technic' - a low-cost treatment of ectopic pregnancy. J OBSTET GYNAECOL 2019; 39:1164-1168. [PMID: 31334680 DOI: 10.1080/01443615.2019.1604641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We aimed to demonstrate the feasibility and total cost of laparoscopy-assisted suprapubic salpingectomy (LASS), which utilises conventional open surgery equipment without any sealing or coagulation devices and reduces port sites compared to conventional laparoscopy (CL). Fifty-seven consecutive, age-matched patients presenting with a tubal pregnancy were enrolled. In the LASS group, a 10 mm reusable umbilical optical trocar and a 10 mm suprapubic trocar was used. The other 30 patients were managed with multiport CL. All of the patients were asked to use the visual analogue scale and Patient and Observer Scar Assessment Scale to evaluate their cosmetic satisfaction. The duration of surgery was 21.19 ± 2.33 minutes for the LASS group and 36.9 ± 4.9 minutes for the CL group (p < .001). The postoperative 6th-hour VAS score was 2.44 ± 0.5 for the LASS group and 3.03 ± 0.8 for the CL group (p: .005). All of the PSAS and OSAS parameter scores were significantly lower in LASS group than CL group. In conclusion, the LASS procedure is a feasible method for treating ectopic pregnancies with a shorter surgical duration, lower VAS scores, and better cosmetic scores than CL. Impact statement What is already known on this subject? Laparoscopy or laparotomy may be performed for the surgical management of ectopic pregnancy. Conventional laparoscopy has some advantages such as shorter hospital stay and recovery time and the better cosmetic results. However, the equipment used in conventional laparoscopy and single incision laparoscopy are more expensive than conventional open surgery equipment. What the results of this study add? Laparoscopy-assisted suprapubic salpingectomy (LASS) method has shorter operation time, lower VAS scores, better cosmetic scores and cheaper than conventional laparoscopy. What the implications are of these findings for clinical practice and/or further research? The LASS procedure looks like a feasible method for treating ectopic pregnancies and the feasibility of this procedure should be confirmed by a larger series of patients and randomised trials.
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Affiliation(s)
- Cihan Kaya
- Department of Obstetrics and Gynaecology, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital , Istanbul , Turkey
| | - Ismail Alay
- Department of Obstetrics and Gynaecology, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital , Istanbul , Turkey
| | - Ecem Eren
- Department of Obstetrics and Gynaecology, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital , Istanbul , Turkey
| | - Ozlem Helvacioglu
- Department of Dermatology, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital , Istanbul , Turkey
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Karasu Y, Akselim B. Feasibility of single-incision laparoscopy for ruptured ectopic pregnancies with hemoperitoneum. MINIM INVASIV THER 2018; 28:46-50. [PMID: 29741420 DOI: 10.1080/13645706.2018.1470538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND The aim of this study was to compare single-incision laparoscopic surgery (SILS) and conventional laparoscopy in ectopic pregnancies accompanied by severe hemoperitoneum. MATERIAL AND METHODS The main outcome measures were duration of surgery, intraoperative bleeding quantity, complications, post-operative pain scores, additional analgesic requirements, and length of hospital stay. RESULTS A total of 53 women, 28 in the conventional laparoscopy group and 25 in the SILS group, participated in the study. There were no differences in demographic characteristics between the two groups. There were no differences in terms of variables including gestational week, beta human chorionic gonadotropin (βhCG) levels, and operation time. No intraoperative complications were observed in either group. The groups exhibited no significant differences regarding additional analgesic requirements or postoperative pain scores. However, pain at the sixth postoperative hour was lower in the SILS group. This effect was not observed at 12 and 24 hours. CONCLUSION SILS appears to be effective and safe for the treatment of ruptured ectopic pregnancies accompanied by hemoperitoneum.
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Affiliation(s)
- Yetkin Karasu
- a Obstetrics and Gynecology , Ankara Training and Research Hospital , Ankara , Turkey
| | - Burak Akselim
- a Obstetrics and Gynecology , Ankara Training and Research Hospital , Ankara , Turkey
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Gasparri ML, Mueller MD, Taghavi K, Papadia A. Conventional versus Single Port Laparoscopy for the Surgical Treatment of Ectopic Pregnancy: A Meta-Analysis. Gynecol Obstet Invest 2018; 83:329-337. [PMID: 29669329 DOI: 10.1159/000487944] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 02/22/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND/AIMS A new minimally invasive laparoscopic approach for ectopic pregnancy, the laparo-endoscopic single site surgery (LESS), has recently been introduced. The aim of this study is to compare the surgical outcome of this approach with conventional laparoscopy for ectopic pregnancy. METHOD A review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement was performed. Electronic databases PubMed, MEDLINE, and Scopus were searched in December 2017 by searching the terms "single port laparoscopy" or "laparoendoscopic single site-surgery" or "single site laparoscopy" or "single-incision laparoscopic surgery" and "ectopic pregnancy." Studies comparing the 2 techniques and reporting surgical outcome were selected. Endpoints included comparison of length of operative time (OT), hemoglobin drop, length of hospitalization, number of patients requiring packed red blood cells (PRBC) transfusion, intra- and post-operative complication rates between patients undergoing conventional laparoscopy and those undergoing LESS. RESULTS A total of 56 studies were retrieved of which 5 studies including 460 patients met selection criteria. No differences were found between conventional laparoscopy and LESS with regards to length of OT time (even after stratification for presence of hemoperitoneum and/or adhesions), length of hospitalization, mean hemoglobin drop, number of patients requiring transfusions of PRBC, and intra- and post-operative complications. CONCLUSION The management of ectopic pregnancies with LESS does not seem to be superior to conventional laparoscopy.
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Affiliation(s)
- Maria Luisa Gasparri
- Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland.,Department of Gynecology Obstetrics and Urology, Sapienza Univeristy of Rome, Rome, Italy.,Surgical and Medical Department of Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - Michael D Mueller
- Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland
| | - Katayoun Taghavi
- Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland
| | - Andrea Papadia
- Department of Obstetrics and Gynecology, University Hospital of Berne and University of Berne, Berne, Switzerland
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Schmitt A, Crochet P, Baumstark K, Tourette C, Poizac S, Pivano A, Boubli L, Cravello L, Agostini A. Effect of laparoscopy by single-port endoscopic access in benign adnexal surgery: study protocol for a randomized controlled trial. Trials 2018; 19:38. [PMID: 29335017 PMCID: PMC5769507 DOI: 10.1186/s13063-017-2429-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/08/2017] [Indexed: 11/17/2022] Open
Abstract
Background Laparoscopic surgery has become the preferred surgical approach due to a reduction in postoperative pain, better recovery, shorter hospitalization, and improved esthetic outcomes. Laparoscopic surgery with single-port laparoscopy (SPL) is a laparoscopic surgery technique that is based on making a single parietal incision using a single trocar specifically designed to allow introduction of several instruments. The level of evidence regarding the advantages of SPL in terms of postoperative pain has remained low despite several randomized studies. Adult patients exhibiting a surgical indication for an a priori benign ovarian pathology or for prophylactic purposes that can be performed by laparoscopy will be randomized to receive conventional laparoscopy (CL) or SPL. The aim of our study is to evaluate whether SPL offers advantages over CL in benign adnexal surgery. Methods The patients will be evaluated preoperatively to confirm their eligibility. The perioperative data up to 24 h after the intervention, as well as the postoperative data at day 7 and at one month from the intervention will be collected. The primary outcome for the study will be the postoperative pain at 24 h ± 2 h after the intervention. The pain will be assessed by a numeric rating scale of 0–10. Other outcomes will also be assessed, such as pain at other times, the consumption of analgesics, the operative time, perioperative bleeding, the number of additional trocars in the two groups, the incidence of laparoconversion, the esthetic criteria of the scar at one month, the incidence of complications, and the quality of life at one month. Discussion If our hypothesis is confirmed, this study will provide evidence that the use of SPL can decrease postoperative pain in adnexal surgery. The standard surgical treatment of this condition would thus be modified. Trial registration ClinicalTrials.gov, NCT02739724. Registered on 12 April 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2429-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andy Schmitt
- Pôle de gynécologie-obstétrique et reproduction, Gynepôle, AP-HM Hôpital de la Conception, 147 bd Baille, 13005, Marseille, France
| | - Patrice Crochet
- Pôle de gynécologie-obstétrique et reproduction, Gynepôle, AP-HM Hôpital de la Conception, 147 bd Baille, 13005, Marseille, France
| | - Karine Baumstark
- Clinical Research Platform, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Claire Tourette
- Pôle de gynécologie-obstétrique et reproduction, Gynepôle, AP-HM Hôpital de la Conception, 147 bd Baille, 13005, Marseille, France
| | - Sabine Poizac
- Pôle de gynécologie-obstétrique et reproduction, Gynepôle, AP-HM Hôpital de la Conception, 147 bd Baille, 13005, Marseille, France
| | - Audrey Pivano
- Pôle de gynécologie-obstétrique et reproduction, Gynepôle, AP-HM Hôpital de la Conception, 147 bd Baille, 13005, Marseille, France
| | - Léon Boubli
- Pôle de gynécologie-obstétrique et reproduction, Gynepôle, AP-HM Hôpital de la Conception, 147 bd Baille, 13005, Marseille, France
| | - Ludovic Cravello
- Pôle de gynécologie-obstétrique et reproduction, Gynepôle, AP-HM Hôpital de la Conception, 147 bd Baille, 13005, Marseille, France
| | - Aubert Agostini
- Pôle de gynécologie-obstétrique et reproduction, Gynepôle, AP-HM Hôpital de la Conception, 147 bd Baille, 13005, Marseille, France.
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Single-Port Laparoscopy vs Conventional Laparoscopy in Benign Adnexal Diseases: A Systematic Review and Meta-Analysis. J Minim Invasive Gynecol 2017; 24:1083-1095. [DOI: 10.1016/j.jmig.2017.07.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/26/2017] [Accepted: 07/03/2017] [Indexed: 12/20/2022]
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Loh AZH, Torrizo MP, Ng YW. Single Incision Laparoscopic Surgery for Surgical Treatment of Tubal Ectopic Pregnancy: A Feasible Alternative to Conventional Laparoscopy. J Gynecol Surg 2017. [DOI: 10.1089/gyn.2016.0103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Alvona Zi Hui Loh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Marbee P. Torrizo
- Department of Obstetrics and Gynaecology, Chong Hua Hospital, Cebu City, Philippines
| | - Ying Woo Ng
- Department of Obstetrics and Gynaecology, Division of Benign Gynaecology, National University Hospital, Singapore, Singapore
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Poizac S, Ménager N, Tourette C, Gnisci A, Estrade JP, Agostini A. [Influencing factors on surgical duration of ovarian cystectomy by single-port access]. ACTA ACUST UNITED AC 2014; 44:78-82. [PMID: 25063484 DOI: 10.1016/j.jgyn.2014.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 06/09/2014] [Accepted: 06/18/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To evaluate the factors influencing the operative duration of ovarian cystectomy by single-port access (SPA). MATERIALS AND METHODS Observational monocentric study from June 2010 to September 2012. Inclusive patients were patients with an indication of ovarian cystectomy may be done by laparoscopy. The procedures were performed by the SPA system LESS®. Factors evaluated were BMI of the patient, histological nature and size of the cyst. RESULTS We performed 54 cystectomy in 49 patients. SPA surgery was successfully completed in 53 patients. The median operative time was statistically longer for endometriotic cysts than dermoid cysts or serous-mucinous cysts (P=0.003). Cases exceeding 60minutes were significantly higher in the endometriosis group (P=0.005). There wasn't correlation found between the BMI of the patient and operative time (P=0.5). The operating time wasn't increased according to the size of the cyst (P=0.9). CONCLUSION Endometriotic cysts nature appears to be the only limiting factor of cystectomy by SPA. Further studies are needed to evaluate the factors that may limit the SPA actions.
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Affiliation(s)
- S Poizac
- Service de gynécologie obstétrique, hôpital de la Conception, université Aix-Marseille-II, boulevard Baille, 13005 Marseille, France
| | - N Ménager
- Service de gynécologie obstétrique, hôpital de la Conception, université Aix-Marseille-II, boulevard Baille, 13005 Marseille, France
| | - C Tourette
- Service de gynécologie obstétrique, hôpital de la Conception, université Aix-Marseille-II, boulevard Baille, 13005 Marseille, France
| | - A Gnisci
- Service de gynécologie obstétrique, hôpital de la Conception, université Aix-Marseille-II, boulevard Baille, 13005 Marseille, France
| | - J-P Estrade
- Service de gynécologie obstétrique, hôpital de la Conception, université Aix-Marseille-II, boulevard Baille, 13005 Marseille, France
| | - A Agostini
- Service de gynécologie obstétrique, hôpital de la Conception, université Aix-Marseille-II, boulevard Baille, 13005 Marseille, France.
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Rabischong B, Compan C, Savary D, Bourdel N, Canis M, Mage G, Botchorishvili R. La laparoscopie par incision unique en gynécologie : état des lieux en 2013. ACTA ACUST UNITED AC 2013; 42:445-57. [DOI: 10.1016/j.jgyn.2013.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 03/26/2013] [Accepted: 03/27/2013] [Indexed: 11/16/2022]
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Single-incision laparoscopy in gynecologic surgery: a systematic review and meta-analysis. Obstet Gynecol 2013; 121:819-828. [PMID: 23635683 DOI: 10.1097/aog.0b013e318288828c] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate surgical outcomes for gynecologic surgery performed by single-incision laparoscopy compared with conventional multi-incision laparoscopy. DATA SOURCES We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and clinicaltrials.gov through August 2012. We also screened reference lists of retrieved articles and manually searched abstracts from conference proceedings. METHODS OF STUDY SELECTION We included randomized control trials (RCTs) and high-quality observational studies that compared outcomes for single-incision laparoscopy and conventional laparoscopy for gynecologic surgery in patients. Included studies met predefined quality criteria and reported, at minimum, on complications, conversions, and operative time. TABULATION, INTEGRATION, RESULTS: Six RCTs and 15 observational studies met inclusion criteria, with a total of 2,085 patients (899 single-incision laparoscopies and 1,186 conventional laparoscopies). In the pooled analysis, there was no significant difference in the risk of total complications between single-incision laparoscopy and conventional laparoscopy groups (relative risk 1.01, 95% confidence interval [CI] 0.72-1.40; P=.97, random effects model). The meta-analysis was powered to detect a 5% difference in complications (power=0.8, alpha=0.05). Mean operative time for adnexal surgery performed by single-incision laparoscopy was 6.97 minutes longer than conventional laparoscopy (95% CI 0.16-13.77; P=.045; I=47.2; random effects based on three RCTs). There was no significant difference in mean operative time for hysterectomy procedures performed by single-incision laparoscopy (8.29 minutes, 95% CI -5.85 to 22.43; P=.251; I=83.6; random effects based on three RCTs). Clinical outcomes of postoperative pain, change in hemoglobin, length of hospital stay, and scar cosmesis could not be pooled because of paucity of data and lack of uniform reporting. CONCLUSION There was no difference in the risk of complications between single-incision laparoscopy and conventional laparoscopy approaches in gynecologic surgery. Studies with imprecise effect sizes suggest that single-incision laparoscopy may have longer operative time for adnexal surgery, but not for hysterectomy. Effects on other surgical outcomes remain uncertain.
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de Poncheville L, Smirnoff A, Ménard J, Corbineau G, Vié-Buret V, Nohra O, Leyre S, Drapier E. [Feasibility of laparoendoscopic single-site surgery in gynecology with conventional laparoscopic instruments]. ACTA ACUST UNITED AC 2012; 40:729-33. [PMID: 23165226 DOI: 10.1016/j.gyobfe.2012.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Accepted: 08/09/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To describe the safety and efficacy of single-port access for laparoscopic surgery in gynecology with conventional laparoscopic instruments. PATIENTS AND METHODS In this prospective study, we report our experience with 90 patients who underwent Single Port Access (SPA) laparoscopic surgery for gynecologic pathology with the use of the SILS(®) Port Multiple Instrument Access Port (Covidien(®), Mansfield, MA). RESULTS We realised 15 ovarian cystectomies, 30 salpingo-oophrectomies with 14 one side, 9 lysis of adhesions, 7 distal tubal repairs, 6 salpingectomy, 8 other procedures. The mean surgical time is 47 min (25-120). One conversion to conventional laparoscopy and one in laparotomy were performed. The mean duration stay is 2 days [1-3]. DISCUSSION AND CONCLUSION SPA in gynecology is feasible with conventional laparoscopic instruments. SPA surgery represents the newest frontier in minimally invasive surgery.
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Affiliation(s)
- L de Poncheville
- Clinique du Mail Capio, 96, allée du Mail, 17000 La Rochelle, France.
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