A prospective comparative study of cosmetic satisfaction for three different surgical approaches

To compare gynecologic patients' cosmetic satisfaction with surgical wounds after different approaches: laparoendoscopic single-site surgery (LESS), conventional laparoscopic surgery (CLS) and open surgery (OS).

This was a prospective study. The primary outcome was the cosmetic satisfaction after LESS, CLS, or OS, measured at 1 and 6 months post-surgery using the well-validated Cosmetic Scale. Multiple linear regression analysis was used to determine whether the surgical approach was independently associated with cosmetic satisfaction or not.

Of 294 patients enrolled, 84 (28.6%), 129 (43.9%), and 81 patients (27.3%) underwent LESS, CLS, and OS, respectively. Cosmetic Scale scores in the LESS group at 1 month post-surgery was about 7 higher than in the CLS group and 9 higher than in the OS group (P<0.001). This difference was maintained also at 6 months post-surgery (P<0.001). On multiple linear regression analysis, the surgical approach was independently associated with postoperative cosmetic satisfaction (P<0.001).

Our study found that cosmetic satisfaction after LESS was highest, followed by CLS, then OS. Therefore, physicians should more assertively discuss and consider LESS for gynecologic diseases.