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Laparoendoscopic single-site surgery (LESS) for treatment of benign adnexal disease: single-center experience over
Anna Fagotti1, Carolina Bottoni, Giuseppe Vizzielli
1Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy. anna.fagotti@rm.unicatt.it
Study Objective:
To describe the effects of laparoendoscopic single-site (LESS) surgery performed over 3 consecutive years to treat adnexal disease and to report patient perioperative outcomes.
Design:
Retrospective clinical study (Canadian Task Force classification III).
Setting:
Tertiary care academic medical center.
Patients:
Women undergoing LESS because of a benign gynecologic indication, from January 2009 through December 2011.
Interventions:
Women with benign adnexal disease ≤10 cm underwent LESS surgery through a single 1.5- to 2.0-cm umbilical incision. Intraoperative and postoperative outcomes were carefully recorded, including the need for postoperative rescue analgesia.
Measurements And Main Results:
One hundred twenty-five patients were enrolled. Median patient age was 49 years, and median body mass index was 23. Surgical procedures included unilateral or bilateral salpingo-oophorectomy and unilateral or bilateral cyst enucleation. Median operative time was 48 minutes. Pain control was optimal, with an average visual analog score of 4/10. Both patients and surgeons were highly satisfied with the cosmetic result, and the cosmetic visual analog score was 9/10 at discharge and at 30 days after surgery. The number of women who underwent unilateral or bilateral salpingo-oophorectomy increased progressively and significantly yearly over the study period (16 vs 23 vs 40; p = .001). Median operative time for unilateral or bilateral salpingo-oophorectomy increased significantly from 2009 to 2010 and 2011 (34 vs 45 and 44 minutes; p = .001), together with median BMI (23 vs 23 vs 25; p = .04).
Conclusion:
LESS is a desirable surgical approach in patients with simple adnexal disease.
