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Published in: Surgical Endoscopy 4/2011

01-04-2011

Laparoendoscopic single-site surgery for the treatment of benign adnexal diseases: a pilot study

Authors: Anna Fagotti, Francesco Fanfani, Francesco Marocco, Cristiano Rossitto, Valerio Gallotta, Elisabetta Marana, Giovanni Scambia

Published in: Surgical Endoscopy | Issue 4/2011

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Abstract

Background

This study aimed to validate the feasibility, efficacy, and safeness of laparoscopic treatment for benign adnexal diseases through a single transumbilical access in a prospective series of patients.

Methods

A prospective clinical trial including 30 women was conducted in our teaching and research division. Patients underwent different laparoscopic procedures by the laparoendoscopic single-site (LESS) approach using a multiport trocar, conventional laparoscopic instrumentation, and standardized surgical technique, with evaluation of the multiaccess conversion rate.

Results

The patients underwent different laparoscopic procedures (10 bilateral adnexectomies; 22 cystectomies, and 3 chromosalpingographies) by the LESS approach using a multiport trocar and conventional laparoscopic instrumentation with standardization of this innovative minimally invasive technique. The laparoscopic procedures were completed through a single access in 28 cases (93.4%). In two cases, at the end of the intervention, hemostasis required one additional sovra-pubic access. No major intra- or postoperative complications were observed. The mean hospital stay was 1.3 days.

Conclusions

The results of this study suggest the feasibility of the LESS approach in gynecologic surgery with a low conversion rate for multi-access laparoscopy, a rapid learning curve, limited complications, and good results in terms of cosmesis and postoperative pain. More clinical data are needed to confirm these advantages over standard laparoscopic technique.
Literature
1.
go back to reference Soble JJ, Gill IS (1998) Needlescopic urology: incorporating 2-mm instruments in laparoscopic surgery. Urology 52:187–194PubMedCrossRef Soble JJ, Gill IS (1998) Needlescopic urology: incorporating 2-mm instruments in laparoscopic surgery. Urology 52:187–194PubMedCrossRef
2.
go back to reference Mostafa G, Matthews BD, Sing RF, Kercher KW, Heniford BT (2001) Minilaparoscopic versus laparoscopic approach to appendectomy. BMC Surg 1:4PubMedCrossRef Mostafa G, Matthews BD, Sing RF, Kercher KW, Heniford BT (2001) Minilaparoscopic versus laparoscopic approach to appendectomy. BMC Surg 1:4PubMedCrossRef
3.
go back to reference Bisgaard T, Klarskov B, Trap R, Kehlet H, Rosenberg J (2002) Microlaparoscopic vs conventional laparoscopic cholecystectomy: a prospective randomized double-blind trial. Surg Endosc 16:458–464PubMedCrossRef Bisgaard T, Klarskov B, Trap R, Kehlet H, Rosenberg J (2002) Microlaparoscopic vs conventional laparoscopic cholecystectomy: a prospective randomized double-blind trial. Surg Endosc 16:458–464PubMedCrossRef
4.
go back to reference Kaouk JH, Haber GP, Goel RK, Desai MM, Aron M, Rackley RR, Moore C, Gill IS (2008) Single-port laparoscopic surgery in urology: initial experience. Urology 71:3–6PubMedCrossRef Kaouk JH, Haber GP, Goel RK, Desai MM, Aron M, Rackley RR, Moore C, Gill IS (2008) Single-port laparoscopic surgery in urology: initial experience. Urology 71:3–6PubMedCrossRef
6.
go back to reference Whiteford M, Denk P, Swanstrom L (2007) Feasibility of radical sigmoid colectomy performed as natural orifice translumenal endoscopic surgery (NOTES) using transanal endoscopic microsurgery. Surg Endosc 21:1870–1874PubMedCrossRef Whiteford M, Denk P, Swanstrom L (2007) Feasibility of radical sigmoid colectomy performed as natural orifice translumenal endoscopic surgery (NOTES) using transanal endoscopic microsurgery. Surg Endosc 21:1870–1874PubMedCrossRef
7.
go back to reference Bucher P, Pugin F, Morel P (2008) Minimally invasive necrosectomy for infected necrotizing pancreatitis. Pancreas 36:113–119PubMedCrossRef Bucher P, Pugin F, Morel P (2008) Minimally invasive necrosectomy for infected necrotizing pancreatitis. Pancreas 36:113–119PubMedCrossRef
8.
go back to reference Piskun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech Part A 9:361–364CrossRef Piskun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech Part A 9:361–364CrossRef
9.
go back to reference Kommu SS, Kaouk JH, Rané A (2009) Laparoendoscopic single-site surgery: preliminary advances in renal surgery. BJU Int 103:1034–1037PubMedCrossRef Kommu SS, Kaouk JH, Rané A (2009) Laparoendoscopic single-site surgery: preliminary advances in renal surgery. BJU Int 103:1034–1037PubMedCrossRef
10.
go back to reference Bessler M, Stevens PD, Milone L, Parikh M, Fowler D (2007) Transvaginal laparoscopically assisted endoscopic cholecystectomy: a hybrid approach to natural orifice surgery. Gastrointest Endosc 66:1243–1245PubMedCrossRef Bessler M, Stevens PD, Milone L, Parikh M, Fowler D (2007) Transvaginal laparoscopically assisted endoscopic cholecystectomy: a hybrid approach to natural orifice surgery. Gastrointest Endosc 66:1243–1245PubMedCrossRef
11.
go back to reference Inoue H, Takeshita K, Endo M (1994) Single-port laparoscopy-assisted appendectomy under local pneumoperitoneum condition. Surg Endosc 8:714–716PubMedCrossRef Inoue H, Takeshita K, Endo M (1994) Single-port laparoscopy-assisted appendectomy under local pneumoperitoneum condition. Surg Endosc 8:714–716PubMedCrossRef
12.
go back to reference Rao MM, Rao RK (2004) Two-port and single-port laparoscopic appendicectomy. J Indian Med Assoc 102:360–364PubMed Rao MM, Rao RK (2004) Two-port and single-port laparoscopic appendicectomy. J Indian Med Assoc 102:360–364PubMed
13.
go back to reference Novitsky YW, Kercher KW, Czerniach DR, Kaban GK, Khera S, Gallagher-Dorval KA, Callery MP, Litwin DE, Kelly JJ (2005) Advantages of minilaparoscopic vs conventional laparoscopic cholecystectomy: results of a prospective randomized trial. Arch Surg 140:1178–1183PubMedCrossRef Novitsky YW, Kercher KW, Czerniach DR, Kaban GK, Khera S, Gallagher-Dorval KA, Callery MP, Litwin DE, Kelly JJ (2005) Advantages of minilaparoscopic vs conventional laparoscopic cholecystectomy: results of a prospective randomized trial. Arch Surg 140:1178–1183PubMedCrossRef
14.
go back to reference Bucher P, Pugin F, Morel P (2008) Single-port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016PubMedCrossRef Bucher P, Pugin F, Morel P (2008) Single-port access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016PubMedCrossRef
15.
go back to reference Gumbs AA, Milone L, Sinha P, Bessler M (2009) Totally transumbilical laparoscopic cholecystectomy. J Gastrointest Surg 13:533–534PubMedCrossRef Gumbs AA, Milone L, Sinha P, Bessler M (2009) Totally transumbilical laparoscopic cholecystectomy. J Gastrointest Surg 13:533–534PubMedCrossRef
16.
go back to reference Bucher P, Pugin F, Buchs N, Ostermann S, Charara F, Morel P (2009) Single-port access laparoscopic cholecystectomy (with video). World J Surg 33:1015–1019PubMedCrossRef Bucher P, Pugin F, Buchs N, Ostermann S, Charara F, Morel P (2009) Single-port access laparoscopic cholecystectomy (with video). World J Surg 33:1015–1019PubMedCrossRef
17.
go back to reference Rané A, Rao P, Rao P (2008) Single-port-access nephrectomy and other laparoscopic urologic procedures using a novel laparoscopic port (R-port). Urology 72:260–263PubMedCrossRef Rané A, Rao P, Rao P (2008) Single-port-access nephrectomy and other laparoscopic urologic procedures using a novel laparoscopic port (R-port). Urology 72:260–263PubMedCrossRef
18.
go back to reference Fagotti A, Fanfani F, Marocco F, Rossitto C, Gallotta V, Scambia G (2009) Laparoendoscopic single-site surgery (LESS) for ovarian cyst enucleation: report of first 3 cases. Fertil Steril 92:1168.e13–1168.e16 Fagotti A, Fanfani F, Marocco F, Rossitto C, Gallotta V, Scambia G (2009) Laparoendoscopic single-site surgery (LESS) for ovarian cyst enucleation: report of first 3 cases. Fertil Steril 92:1168.e13–1168.e16
20.
go back to reference Ramirez PT (2009) Single-port laparoscopic surgery: is a single incision the next frontier in minimally invasive gynecologic surgery? Gynecol Oncol 114:143–144PubMedCrossRef Ramirez PT (2009) Single-port laparoscopic surgery: is a single incision the next frontier in minimally invasive gynecologic surgery? Gynecol Oncol 114:143–144PubMedCrossRef
21.
go back to reference Kolkman W, Wolterbeek R, Jansen FW (2006) Implementation of advanced laparoscopy into daily gynaecologic practice: difficulties and solutions. J Minin Invasive Gynecol 13:4–9CrossRef Kolkman W, Wolterbeek R, Jansen FW (2006) Implementation of advanced laparoscopy into daily gynaecologic practice: difficulties and solutions. J Minin Invasive Gynecol 13:4–9CrossRef
Metadata
Title
Laparoendoscopic single-site surgery for the treatment of benign adnexal diseases: a pilot study
Authors
Anna Fagotti
Francesco Fanfani
Francesco Marocco
Cristiano Rossitto
Valerio Gallotta
Elisabetta Marana
Giovanni Scambia
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 4/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1346-x

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