title: Women's preferences for minimally invasive incisions.
abstract: OBJECTIVE
  To determine whether traditional, robotic, or single-site laparoscopic incisions are more appealing to women.
  
  
  METHODS
  Descriptive study using a survey (Canadian Task Force classification III).
  
  
  METHODS
  Single-specialty referral-based gynecology practice.
  
  
  METHODS
  All patients older than 18 years who came for care to the Newton-Wellesley Hospital Minimally Invasive Gynecological Surgery Center from April 2, 2010, to June 30, 2010.
  
  
  METHODS
  Three identical photos of an unscarred female abdomen were each marked with a black pen to indicate typical incision lengths and locations for robotic, single-site, and traditional laparoscopic surgery. Subjects were then asked to rank these incisions in order of preference. Additional demographic and surgical history questions were included in the survey.
  
  
  RESULTS
  Two-hundred fifty of 427 patients (58.5%) returned surveys, and of these, 241 completed critical survey elements. Preference for traditional laparoscopic incisions was 56.4% (95% confidence interval [CI], 50.1%-62.7%), for a single incision was 41.1% (95% CI, 34.8%-47.3%), and for robotic surgery was 2.5% (95% CI, 0.5%-4.5%). Two-sample test of proportion (Z test) showed the difference in preference for traditional over the other methods to be significant: p = .007 for a single incision and p <.001 for robotic surgery. Multivariatble analysis for factors influencing choice of single-site incision demonstrated that Latina/Hispanic ethnicity was the only significant factor (p = .02).
  
  
  CONCLUSIONS
  Women prefer both single-site and traditional laparoscopic incisions over robotic procedures. Inasmuch as aesthetics are an important consideration for many women and clinical outcomes are similar, during the informed-consent procedure, location and length of incisions should be included in the discussion of risks, benefits, and alternatives.
authors.affiliation: Swedish American Medical Group, Belvidere, IL 61008, USA. amanda.bush10@gmail.com
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Bush
authors.forename: Stephanie N
authors.initials: SN
authors.lastname: Morris
authors.forename: Frederick H
authors.initials: FH
authors.lastname: Millham
authors.forename: Keith B
authors.initials: KB
authors.lastname: Isaacson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D057240:Patient Preference; D012371:Robotics