Feasibility of laparoscopically assisted extracorporeal cystectomy via single suprapubic incision using an adjustable-view laparoscope to treat large benign ovarian cysts: comparison with conventional procedure.
OBJECTIVE
To demonstrate the feasibility of minimally invasive surgery using a novel optical device to treat large benign ovarian cysts and to compare the safety of the procedure with that of conventional laparoscopically assisted multiport extracorporeal cystectomy.


METHODS
Twenty-one patients with large benign ovarian cysts underwent laparoscopically assisted extracorporeal ovarian cystectomy via a single suprapubic incision using a novel 10-mm rigid laparoscope with an adjustable direction of view and a multiport device, between October 2010 and July 2012. The surgical outcomes were retrospectively compared between these patients (Group A) and 32 patients who underwent the conventional 3-port laparoscopically assisted extracorporeal procedure between January 2009 and September 2010 (Group B). Data were statistically analyzed using the Mann-Whitney U-test or Fisher's exact test.


RESULTS
None of Group A required conversion to conventional multiport laparoscopy. The total duration of surgery, elapsed time between skin incision and the start of pneumoperitoneum, and time required for intra- and extra-corporeal manipulations did not significantly differ between the groups. The time required for skin closure, however, was significantly decreased in Group A compared with Group B (13.0 ± 3.5 vs. 20.2 ± 4.8 min, P=0.005). The volume of blood loss and postoperative blood findings were similar to those associated with the conventional procedure. Postoperative visual analog pain scales at 3h were significantly lower in Group A than in Group B (3.7 ± 2.6 vs. 4.8 ± 2.0, P=0.04). Postoperative complications did not arise after either procedure.


CONCLUSIONS
Laparoscopically assisted extracorporeal cystectomy via a single suprapubic incision is a feasible and safe alternative to conventional multiport cystectomy for treating large benign ovarian cysts.
Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan. kumakiri@juntendo.ac.jp
Jun
J
Kumakiri
Iwaho
I
Kikuchi
Rie
R
Ozaki
Makoto
M
Jinushi
Ayako
A
Kono
Satoru
S
Takeda
D000293:Adolescent; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D010048:Ovarian Cysts / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome