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Minimizing ancillary ports size in gynecologic laparoscopy: a randomized trial
Fabio Ghezzi1, Antonella Cromi, Giacomo Colombo
1Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy. fabio.ghezzi@uninsubria.it
Journal of Minimally Invasive Gynecology
|December 13, 2005
Summary
Minimally invasive gynecologic surgery using 3-mm ancillary trocars for adnexal masses is safe and effective. This approach reduces immediate postoperative pain compared to traditional 5-mm trocars.
Area of Science:
- Minimally invasive gynecologic surgery
- Surgical instrumentation innovation
Background:
- Laparoscopy is a common surgical approach for adnexal masses.
- Traditional ancillary trocars are typically 5-mm in diameter.
- Evaluating smaller instruments may improve patient outcomes.
Purpose of the Study:
- To assess the feasibility, safety, and impact on postoperative pain of using 3-mm ancillary trocars versus 5-mm trocars in laparoscopy for adnexal masses.
Main Methods:
- A randomized controlled trial was conducted with 102 women undergoing laparoscopy for benign adnexal masses.
- Participants were randomized to either 3-mm or 5-mm ancillary trocars.
- Postoperative pain was measured using a visual analog scale.
Main Results:
- No significant difference in intraoperative complications or operative time was observed between groups.
- Laparoscopy with 3-mm ancillary trocars resulted in significantly lower incisional pain 1 hour post-surgery.
- Analgesic requirements were similar between the 3-mm and 5-mm trocar groups.
Conclusions:
- Three-millimeter ancillary trocars are a safe and feasible alternative to 5-mm instruments for laparoscopic management of adnexal masses.
- Downsizing to 3-mm trocars reduces immediate postoperative pain without compromising surgical performance.
- This technique offers a potential benefit for patient recovery in gynecologic laparoscopy.