title: Single-port access laparoscopy-assisted vaginal hysterectomy: our initial experiences with 100 cases.
abstract: Objectives. To present our initial experiences with laparoscopically assisted vaginal hysterectomy performed using homemade transumbilical single-port system. Materials and Methods. We reviewed the medical records of one hundred patients who underwent single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH). SPA-LAVH was performed with homemade single port system and conventional rigid laparoscopic instruments. Results. All procedures were successfully completed through the single-port system and vagina without need for extraumbilical puncture or conversion to laparotomy. The median patient age was 48.2 ± 6.5 years. Thirty-three patients had history of past abdominopelvic surgery. The median total operative time, largest dimension of the uterus, and weight of the uterus were 73.1 ± 24.6 min, 10.5 ± 2.1 cm, and 300.8 ± 192.5 gram, respectively. The median decline in the hemoglobin from before surgery to postoperative day 1 was 1.8 ± 0.9 g/dL. Bladder injury in occurred one patient who was repaired through intraoperative laparoscopic suture. The postoperative course was uneventful in most patients except for three who had a transient paralytic ileus, five who had pelvic hematoma, but they were recovered following conservative managements. No port-related complications were noted, and the cosmetic results were excellent. Conclusions. SPA-LAVH is technically safe procedure, and the homemade single-port system offers reliable access for single-port surgery.
authors.affiliation: Department of Obstetrics and Gynecology, Eun Hospital, Duam-Dong, Buk-Gu, Kwang-Ju 500-101, Republic of Korea.
authors.forename: Young-Sam
authors.initials: YS
authors.lastname: Choi
authors.forename: Kwang-Sik
authors.initials: KS
authors.lastname: Shin
authors.forename: Jin
authors.initials: J
authors.lastname: Choi
authors.forename: Ji-No
authors.initials: JN
authors.lastname: Park
authors.forename: Yun-Sang
authors.initials: YS
authors.lastname: Oh
authors.forename: Tae-Eel
authors.initials: TE
authors.lastname: Rhee