title: Single incision laparoscopic surgery (SILS) in gynaecology: feasibility and operative outcomes.
abstract: BACKGROUND
  Single incision laparoscopic surgery (SILS) represents the latest advancement in minimally invasive surgery, combining the benefits of conventional laparoscopic surgery, such as less pain and faster recovery, with improved cosmesis. Although the successful use of this technique is well reported in general surgery and urology, there is a lack of studies on SILS in gynaecology.
  
  
  OBJECTIVE
  To evaluate the feasibility, safety, cosmesis and outcome of SILS in gynaecology.
  
  
  METHODS
  A prospective case series analysis of 105 women scheduled to undergo surgery by SILS from August 2010 to November 2011. Intra-operative data such as operative time, estimated blood loss, complications, additional ports and hospital stay were collected. Post-operative pain and cosmetic outcomes (scar size) were also recorded.
  
  
  RESULTS
  Out of 105 women, SILS was performed for 84 (60 excisions of endometriosis, 13 divisions of adhesions, five hysterectomies, two mesh sacrohysteropexies and four ovarian cystectomies). SILS was not undertaken for 21 women because of a number of factors, including the lack of required equipment (eg bariatric scope, SILS port, roticulating instruments and diathermy leads). Four women required insertion of additional ports because of surgical difficulties. One intra-operative (uterine perforation) and seven post-operative complications (six wound infections and one vault haematoma) occurred. Mean operation times were as follows: mesh sacrohysteropexy - 60 min, excision of endometriosis - 55 min, hysterectomy - 150 min, laparoscopic division of adhesions - 62 min and ovarian cystectomy - 40 min.
  
  
  CONCLUSIONS
  Our experience shows that SILS is a feasible and safe technique for the surgical management of various gynaecological conditions. Satisfaction is high because of improved cosmesis and reduced analgesic requirements post-operatively.
authors.affiliation: Obstetrics & Gynaecology, Flinders Medical Centre, Adelaide, South Australia, Australia. fbw@fbwgynplus.com
authors.forename: Fariba
authors.initials: F
authors.lastname: Behnia-Willison
authors.forename: Leila
authors.initials: L
authors.lastname: Foroughinia
authors.forename: Maryam
authors.initials: M
authors.lastname: Sina
authors.forename: Phil
authors.initials: P
authors.lastname: McChesney
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002921:Cicatrix; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult