Two-port access staging laparoscopy for gynecologic cancers: a pilot study

The aims of this work were to introduce a two-port access (TPA) staging laparoscopy in gynecologic cancers and evaluate the feasibility and surgical outcomes of this operation.

We performed 12 cases of TPA staging laparoscopy. The TPA system consisted of a single multichannel port at the umbilicus and an ancillary 5-mm port in the suprapubic area. Patient status was estimated in terms of operative morbidity and surgical outcomes.

All operations were completed laparoscopically, with no conversions to conventional laparoscopy or laparotomy. Procedures included endometrial cancer staging (n = 6), ovarian cancer staging (n = 3), 2 cases of type III radical hysterectomy, and 1 type II radical hysterectomy. Median patient age and body mass index were 48 years and 20.4 kg/m(2), respectively. Median operation duration was 241 minutes (range, 188-360). Median estimated blood loss was 175 mL. Median number of lymph nodes obtained was 30 (range, 14-49). Median postoperative hospital stay was 8 days. There were no perioperative complications.

TPA staging laparoscopy, using the single multichannel port system, could be a feasible procedure in selected gynecologic cancer patients, with only minimal skin incisions. Prospective, randomized trials will permit the evaluation of potential benefits of this minimally invasive surgical technique.