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Single-port Access Subtotal Laparoscopic Hysterectomy: A Prospective Case-Control Study.

Stefano Angioni1, Alessandro Pontis1, Adolfo Pisanu1

  • 1Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.

Journal of Minimally Invasive Gynecology
|March 23, 2015
PubMed
Summary

Single-port access laparoscopic subtotal hysterectomy (SPAL-SH) is a safe and feasible alternative to multiport surgery, offering reduced pain and improved cosmetic satisfaction. While operative times are longer, SPAL-SH leads to shorter hospital stays for selected patients.

Keywords:
Laparoscopic subtotal hysterectomySPALSingle-port access laparoscopy

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Area of Science:

  • Minimally Invasive Gynecologic Surgery
  • Surgical Outcomes Research
  • Laparoscopic Procedures

Background:

  • Conventional multiport access laparoscopic subtotal hysterectomy (MPAL-SH) is a standard surgical approach.
  • Assessing novel techniques like single-port access laparoscopic subtotal hysterectomy (SPAL-SH) is crucial for improving patient care.
  • Patient acceptance and cosmetic outcomes are increasingly important factors in surgical procedure selection.

Purpose of the Study:

  • To compare the perioperative outcomes, safety, and patient acceptance of SPAL-SH versus MPAL-SH.
  • To evaluate the feasibility of SPAL-SH as an alternative to conventional laparoscopic hysterectomy.
  • To assess patient satisfaction regarding cosmesis and postoperative pain.

Main Methods:

  • A case-control study was conducted involving 61 women with gynecologic conditions requiring subtotal hysterectomy.
  • Patients were divided into two groups: 31 undergoing SPAL-SH and 30 undergoing MPAL-SH.
  • Data on operative time, hospital stay, postoperative pain, and cosmetic satisfaction were collected and analyzed.

Main Results:

  • SPAL-SH was associated with longer operative times but significantly shorter hospital stays compared to MPAL-SH (p < .001).
  • Patients in the SPAL-SH group experienced significantly lower postoperative pain at all measured time points (p < .001).
  • Cosmetic satisfaction was notably higher in the SPAL-SH group at 1, 4, and 24 weeks post-surgery (p < .01).

Conclusions:

  • SPAL-SH is a safe and feasible alternative to MPAL-SH for selected patients undergoing subtotal hysterectomy.
  • The technique offers significant benefits in terms of reduced postoperative pain and enhanced cosmetic outcomes.
  • Further refinement of SPAL-SH techniques and instrumentation may broaden its application in gynecologic surgery.