title: Patient preferences of cosmesis for abdominal incisions in gynecologic surgery.
abstract: OBJECTIVE
  To estimate patient preferences insofar as the cosmetic appeal of abdominal incisions used for hysterectomy. We hypothesized that the laparoendoscopic single-site surgery (LESS) incision would be preferred cosmetically to traditional multiport laparoscopic incisions and open abdominal incisions via Pfannenstiel, vertical midline, or horizontal mini-laparotomy.
  
  
  METHODS
  Prospective comparative study (Canadian Task Force classification II-2).
  
  
  METHODS
  Two gynecology clinics at Duke University Medical Center in Durham, North Carolina.
  
  
  METHODS
  Seventy-three women including 50 consecutive women from a private specialty clinic and 23 consecutive women from a resident indigent care clinic.
  
  
  METHODS
  A brief questionnaire was distributed that assessed preferences via ranking and by using a visual analog scale. Patients were also asked to rate the importance of 4 factors in their decision making: size, location, and number of incisions, and perceived recovery time. Descriptive statistics, t tests, Wilcoxon rank-sum tests, and χ(2) tests were used to compare continuous or categorical values.
  
  
  RESULTS
  Overall, the LESS incision was the most preferred incision according to most common choice and visual analog scale scores. In the private clinic, the LESS incision was preferred most often, with 53% of women (39/73) ranking it as their first choice. In the resident clinic, the horizontal mini-laparotomy incision was preferred most often, with 27% of women (20/73) ranking it their first choice. Neither the demographic factors nor any of the factors in decision making explained the difference between the clinics.
  
  
  CONCLUSIONS
  The LESS incision was most preferred in this study. However, the horizontal mini-laparotomy incision and the traditional laparoscopic with low lateral incisions were also highly preferred. Patient perception of the "visibility" of abdominal incisions may be the distinguishing issue to explain the difference in the preferences between the clinics and the differences between the present study and previously published studies of cosmetic preferences.
authors: Department of Obstetrics, Gynecology, and Women's Health, Minimally Invasive Gynecologic Surgery, Saint Louis University, St. Louis, Missouri 63117, USA. yeungpjr.md@gmail.com
authors: Patrick P
authors: PP
authors: Yeung
authors: Carlos R
authors: CR
authors: Bolden
authors: Daniel
authors: D
authors: Westreich
authors: Craig
authors: C
authors: Sobolewski
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003357:Cosmetic Techniques; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009657:North Carolina; D010147:Pain Measurement; D057240:Patient Preference / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult