Laparoendoscopic Single-Site Surgery Versus Conventional Laparoscopic Surgery in Ovarian Cystectomy: A Meta-Analysis

Background/Objectives: To systematically compare the effectiveness and safety of laparoendoscopic single-site surgery (LESS) versus conventional multi-port laparoscopic surgery (CLS) for ovarian cystectomy in women with benign ovarian cysts, focusing on operative outcomes, postoperative pain, and recovery parameters. Methods: A comprehensive search was conducted in PubMed, Cochrane Library, Web of Science, ClinicalTrials.gov, and SCOPUS from inception to 1 June 2024. Randomized controlled trials and observational studies directly comparing LESS with CLS for benign ovarian cystectomy (excluding adnexectomy) were included. Primary outcomes were operative time, blood loss, hospital stay, postoperative pain, and complications. Data were pooled using mean differences (MD) or risk ratios with 95% confidence intervals in fixed- or random-effects models according to heterogeneity. Results: Nine studies (1 randomized trial, 8 observational; total n = 1368 patients: 702 LESS, 666 CLS) were included. LESS was associated with longer operative time (MD 9.42 min, 95% CI 3.47-15.37, p = 0.002) but shorter hospital stay (MD -0.26 days, 95% CI -0.39 to -0.14, p < 0.001). No significant differences were found in blood loss, postoperative analgesic requirements, hemoglobin drop, or complication rates. Postoperative pain scores at 6 and 24 h were similar, although adjusted analysis suggested marginally lower pain at 24 h with LESS (MD -0.20, p = 0.05). Conclusions: Laparoendoscopic single-site ovarian cystectomy is a safe and reliable alternative to conventional multi-port laparoscopy, offering the advantage of shorter hospital stay despite slightly longer operative time, with equivalent safety profile and postoperative pain. LESS expands minimally invasive options in benign gynecologic surgery 1.1 s.