Laparoscopic Single-Port versus Mini-Laparoscopic Hysterectomy: An International Study.

Area of Science:

• Minimally Invasive Gynecological Surgery
• Surgical Technology Comparison
• Benign Gynecological Pathology

Background:

• Laparoendoscopic single-site surgery (LESS) and mini-laparoscopic surgery (Mini-LPS) offer alternatives to conventional laparoscopy for hysterectomy.
• Limited comparative data exists between LESS and Mini-LPS for hysterectomy in benign conditions.

Purpose of the Study:

• To compare the outcomes of LESS versus Mini-LPS hysterectomy for benign pathology.
• Key outcomes evaluated include surgical time, postoperative pain, and hospital stay.

Main Methods:

• Retrospective international multicenter study involving 5 centers (2 Spanish, 3 Italian).
• Data from 161 patients undergoing hysterectomy for benign pathology between 2010-2015 were analyzed.
• Comparison groups: LESS (n=104) and Mini-LPS (n=57), with procedure choice based on surgeon/center expertise.

Main Results:

• Surgical time was significantly longer in the LESS group (120 min) versus Mini-LPS (75 min) (p < 0.001).
• Hospital stay was also significantly longer in the LESS group (48 h) compared to Mini-LPS (36 h) (p < 0.001).
• Conversion to conventional laparoscopy occurred in 4 (2.5%) patients, exclusively in the Mini-LPS group (p = 0.015).

Conclusions:

• Mini-LPS hysterectomy demonstrated shorter surgical duration and hospital stay than LESS.
• Intraoperative complications, specifically instrumentation flaws requiring conversion, were higher in the Mini-LPS group.
• Both techniques are considered safe for benign hysterectomy, highlighting the need for surgical training and adaptation.