title: Single-port access laparoscopic surgery in gynecologic oncology: outcomes and feasibility.
abstract: OBJECTIVE
  Single-port access laparoscopic surgery (SPALS) is supposed to simplify and improve the outcomes of current multiport laparoscopic procedures. This retrospective study was performed to assess the actual outcomes of SPALS in 2 simple gynecological oncology procedures, namely, diagnostic laparoscopy and bilateral adnexectomy.
  
  
  METHODS
  We conducted a retrospective monocentric study. Case files of only those women who underwent bilateral adnexectomies and diagnostic and/or staging laparoscopy were studied with respect to the operative room time, intraoperative and postoperative complications, postoperative pain, and lengths of hospital stays. The main objective was to assess the feasibility and utility of SPALS surgery in gynecology. The secondary objective was to compare this group with a cohort of patients with multiport conventional laparoscopic surgery (MPCLS) performed during the same period.
  
  
  RESULTS
  From December 2009 to March 2013, there were 134 patients who underwent these 2 procedures. Eighty adnexectomies were performed, 41 by SPALS and 39 by MPCLS. Fifty-four diagnostic laparoscopies were performed, with 27 patients in each group. In the group of adnexectomies, operative time was significantly lower in SPALS compared with MPCLS (36 vs 59 minutes, P < 10) and also compared with the postoperative stay (1 vs 2.2 nights, P < 10). By contrast, no significant difference was observed between the 2 methods of access in all the parameters studied in the group of diagnostic laparoscopies.
  
  
  CONCLUSIONS
  Our experience demonstrates that SPALS is feasible and safe for simple gynecological procedures. This approach may result in a smooth postoperative course and shorter hospital stay and can thus be promoted to a day care procedure.
authors.affiliation: Department of Gynecologic Oncology, Oscar Lambret Center, Lille, France.
authors.forename: Justine
authors.initials: J
authors.lastname: Figurelli
authors.forename: Lucie
authors.initials: L
authors.lastname: Bresson
authors.forename: Fabrice
authors.initials: F
authors.lastname: Narducci
authors.forename: Ninad
authors.initials: N
authors.lastname: Katdare
authors.forename: Pascale
authors.initials: P
authors.lastname: Coulon
authors.forename: Charles
authors.initials: C
authors.lastname: Fournier
authors.forename: Eric
authors.initials: E
authors.lastname: Leblanc
mesh_terms: D000291:Adnexal Diseases / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000601:surgery*; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies