title: Laparoendoscopic single site (LESS) surgery in benign gynecology: perioperative and late complications of 515 cases.
abstract: OBJECTIVE
  To present 515 LESS surgeries and report the perioperative outcomes and late complications according to the Clavien-Dindo classification.
  
  
  METHODS
  We performed a prospective single-center study (Canadian Task Force classification II-2). One surgeon trained in minimally invasive surgery performed 515 cases of LESS surgery from May 2008 to September 2011.
  
  
  RESULTS
  LESS gynecological surgery was performed on 515 patients (274 total hysterectomies; 26 subtotal hysterectomies; 87 adnexectomies including oophorectomy, salpingectomy, and salpingo-oophorectomy; 100 ovarian cystectomies; 17 myomectomies; 11 others). The median age and body mass index of the patients were 45 years and 22.6 kg/m², respectively. LESS surgery was successfully completed in 493 patients (95.7%) without the need for one or more ancillary ports or conversion to laparotomy. Twenty patients needed one or more additional ports and two cases were converted to laparotomy. One or more additional ports were required most frequently in ovarian cystectomy procedures (12/100, 12%). Thirty-six patients (7.0%) required intraoperative and/or postoperative transfusions. Each of these patients underwent hysterectomy (33/274, 12.0%) or subtotal hysterectomy (3/26, 11.5%). Perioperative complications (<30 postoperative days), excluding transfusions, occurred in 8 patients (1.6%) and included one case each of vault bleeding, vault abscess, stump watery discharge, rectal injury, and vesicovaginal fistula, and three cases of urinary tract injury. Late complications occurred in three patients (0.6%) and included two umbilical hernias and one vault evisceration. The overall complication rate, excluding transfusions, was 2.1% (11/515).
  
  
  CONCLUSIONS
  The rate of late postoperative complications, including umbilical port site hernia and vault evisceration, was not increased in this study, as compared to previous reports of single-port and conventional laparoscopic surgeries.
authors: Department of Obstetrics & Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors: Jin-Young
authors: JY
authors: Park
authors: Tae-Joong
authors: TJ
authors: Kim
authors: Hyo-Jeong
authors: HJ
authors: Kang
authors: Yoo-young
authors: YY
authors: Lee
authors: Chel Hun
authors: CH
authors: Choi
authors: Jeong-Won
authors: JW
authors: Lee
authors: Duk-Soo
authors: DS
authors: Bae
authors: Byoung-Gie
authors: BG
authors: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005831:Genital Diseases, Female / Q000601:surgery*; D006554:Hernia, Umbilical / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D010388:Pelvis / Q000601:surgery*; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D011184:Postoperative Period; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D014472:Umbilicus; D055815:Young Adult