Management of benign ovarian cysts by a novel, gasless, single-incision laparoscopic technique: keyless abdominal rope-lifting surgery (KARS).
BACKGROUND
To find the most efficacious method to minimize the side effects and maximize the advantages of laparoscopic surgery, this study aimed to define and document a gasless, single-incision abdominal access technique for the management of benign ovarian cysts.


METHODS
During a 1½ year period, 55 women underwent surgery for a benign ovarian cyst. Conventional carbon dioxide (CO(2)) laparoscopy was used for 33 of the women, and 22 of the women underwent a novel, gasless, single-incision laparoscopic surgery. An abdominal access pathway through a single intraabdominal incision was used to place transabdominal sutures that elevated the abdominal wall, and the operations were performed through the intra-umbilical entry without the use of trocars. Thus, the new technique was called keyless abdominal rope-lifting surgery (KARS). Two operative groups were compared to assess the feasibility of the new technique.


RESULTS
All the operations could be performed by KARS without conversion to CO(2) laparoscopy or laparotomy. However, for two patients in the conventional laparoscopy group, minilaparotomy had to be performed for tissue retrieval. Although the two techniques had many similar results, the total operative times and the abdominal access times in the KARS group were significantly longer than in the conventional laparoscopy group (p < 0.05). Simple oral analgesics were adequate for postoperative pain relief in both groups.


CONCLUSIONS
The KARS technique is a gasless, single-incision laparoscopic procedure that can be performed safely and effectively in terms of cosmesis, postoperative pain, and fertility preservation for the management of benign adnexal pathologies.
Department of Obstetrics and Gynecology, Kafkas University Medical Faculty, Kars, Turkey. kahramanulker@hotmail.com
Kahraman
K
Ülker
Ürfettin
Ü
Hüseyinoğlu
Nergiz
N
Kılıç
D034861:Abdominal Wall / Q000601:surgery; D058107:Abdominal Wound Closure Techniques; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000379:methods; D010048:Ovarian Cysts / Q000601:surgery*; D011028:Pneumoperitoneum, Artificial; D013536:Suture Techniques; D000267:Tissue Adhesions / Q000209:etiology