Single port access laparoscopic adnexal surgery versus conventional laparoscopic adnexal surgery: a comparison of peri-operative outcomes.
OBJECTIVE
The objective of the study was to compare the peri-operative outcomes of single port access (SPA) laparoscopic adnexal surgery and conventional laparoscopic adnexal surgery.


METHODS
This is a retrospective case-control study matched by body mass index (BMI; kg/m(2)). A single surgeon (T-JK) performed 17 SPA laparoscopic adnexal surgeries (cases) consecutively between December 2008 and March 2009; 34 conventional laparoscopic adnexal surgeries (controls) were performed by another surgeon who had similar surgical skill at our hospital during the same time period. Data on the SPA laparoscopic adnexal surgery cases were collected prospectively into our data registry after Institutional Review Board (IRB) approval and we reviewed the data on the controls from the electronic medical records with IRB approval.


RESULTS
In both groups all procedures were performed without failure. Among preoperative baseline characteristics there was no difference between the two groups including preoperative size of ovarian tumor and bilaterality. The pathology findings were similar; a mature cystic teratoma was the most common pathological feature in both groups. The two groups were comparable with regard to operative outcomes according the surgery type. There were no differences between SPA and conventional groups in median operation time (64 min vs. 57.5 min, p=0.252), the number of patients that requested additional parenteral non-steroidal anti-inflammatory drugs (7 patients vs. 19 patients, p=0.597), and the absolute decrease (1.3mg/dl vs. 1.1mg/dl, p=0.640) from preoperative hemoglobin to postoperative day 1 measurements. No patient from either cohort required a blood transfusion. There were no complications in either group including umbilical incision complications in the SPA group.


CONCLUSIONS
Our study demonstrated that SPA laparoscopic adnexal surgery had comparable operative outcomes to conventional laparoscopic adnexal surgery. A prospective comparison is needed for confirmation and to define the role of SPA in gynecological adnexal surgery.
Lee
Yoo-Young
YY
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea.
Kim
Tae-Joong
TJ
Kim
Chul-Jung
CJ
Park
Hwang Shin
HS
Choi
Chel Hun
CH
Lee
Jeong-Won
JW
Lee
Je-ho
JH
Bae
Duk-Soo
DS
Kim
Byoung-Gie
BG
D000291:Adnexal Diseases / Q000097:blood / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D059035:Perioperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome
D006454:Hemoglobins