title: Minilaparoscopic versus conventional laparoscopic hysterectomy: results of a randomized trial.
abstract: OBJECTIVE
  To compare operative outcomes and postoperative pain of laparoscopic hysterectomy (LH) versus minilaparoscopic hysterectomy (MLH).
  
  
  METHODS
  Randomized controlled trial (Canadian Task Force Classification I).
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  Seventy-six women scheduled to undergo a hysterectomy for a supposed benign gynecologic condition.
  
  
  METHODS
  Participants were randomly assigned to LH (n = 38) or MLH (n = 38). MLH was performed with use of 3-mm ports. Both patients and assessors of the postoperative outcomes were blinded to the size of port used, and patients' wounds were concealed by standard-size nontransparent dressings.
  
  
  METHODS
  Primary outcome was postoperative pain (both rest and incident on coughing and abdominal pain, as well as shoulder pain) by use of a 100-mm visual analogue scale.
  
  
  RESULTS
  The two groups were similar in terms of operative outcomes. No intraoperative conversion from MLH to both LH and open surgery occurred. No significant difference in pain scores at 1, 3, 8, and 24 hours after surgery between groups was found. Rescue analgesic requirement was similar in the MLH and LH groups (21.1% vs 13.2%, p =.54).
  
  
  CONCLUSIONS
  Ports can safely be reduced in size without a negative impact on the surgeon's ability to perform LH. MLH appears to have no advantage over LH in terms of postoperative pain.
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy. fabio.ghezzi@uninsubria.it
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
authors.forename: Antonella
authors.initials: A
authors.lastname: Cromi
authors.forename: Gabriele
authors.initials: G
authors.lastname: Siesto
authors.forename: Stefano
authors.initials: S
authors.lastname: Uccella
authors.forename: Luigi
authors.initials: L
authors.lastname: Boni
authors.forename: Maurizio
authors.initials: M
authors.lastname: Serati
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Bolis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged