Laparoendoscopic single-site surgery for the treatment of benign adnexal diseases: a pilot study.
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.
Fagotti
Anna
A
Division of Gynecologic Oncology, Catholic University of the Sacred Heart, L.go A. Gemelli, 8, 00168 Rome, Italy. anna.fagotti@rm.unicatt.it
Fanfani
Francesco
F
Marocco
Francesco
F
Rossitto
Cristiano
C
Gallotta
Valerio
V
Marana
Elisabetta
E
Scambia
Giovanni
G
D000291:Adnexal Diseases / Q000601:surgery*; D000328:Adult; D000368:Aged; D004954:Esthetics; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D059032:Learning Curve; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D017060:Patient Satisfaction; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology; D014472:Umbilicus; D055815:Young Adult