title: Laparoendoscopic single-site surgery for management of ovarian endometriomas.
abstract: OBJECTIVE
  To compare our initial experience in laparoscopic surgery for ovarian endometriomas performed through an umbilical incision using a single 3-channel port and flexible laparoscopic instrumentation versus traditional laparoscopy.
  
  
  METHODS
  This study was conducted in 3 tertiary care referral centers. Since September 2009, we have performed laparoendoscopic single-site surgery in 24 patients diagnosed with ovarian endometriomas. A control group of patients with similar diagnoses who underwent traditional operative laparoscopy during the same period was included (n = 28). In the laparoendoscopic single-site surgery group, a multichannel port was inserted into the peritoneum through a 1.5- to 2.0-cm umbilical incision.
  
  
  RESULTS
  Patients in the laparoendoscopic single-site surgery group were significantly older (P = .04) and had a higher body mass index (P = .005). Both groups were comparable regarding history of abdominal surgery, lateral pelvic side wall involvement, and cul-de-sac involvement. After we controlled for age and body mass index, the size of the resected endometriomas, duration of surgery, and amount of operative blood loss were comparable in both groups. When required, an additional 5-mm port was inserted in the right or left lower quadrant in the laparoendoscopic single-site surgery group to allow the use of a third instrument for additional tissue retraction or manipulation (10 of 24 patients, 41.6%). However, adhesiolysis was performed more frequently in the conventional laparoscopy group. The duration of hospital stay was <24 hours in both groups. No intraoperative complications were encountered. All incisions healed and were cosmetically satisfactory.
  
  
  CONCLUSIONS
  The laparoendoscopic single-site surgery technique is a reasonable initial approach for the treatment of endometriomas. In our experience, an additional side port is usually needed to treat pelvic side wall and cul-de-sac endometriosis that often accompanies endometriomas.
authors: University Hospitals Case Medical Center, Case Western Reserve University, OH, USA; Department of Obstetrics and Gynecology, Faculty of Medicine, The University of British Columbia D415A4500 Oak Street Vancouver, BC V6H 3N1, Canada. bedaiwymmm@yahoo.com.
authors: Mohamed A
authors: MA
authors: Bedaiwy
authors: University Hospitals Case Medical Center, Case Western Reserve University, OH, USA.
authors: Tarek
authors: T
authors: Farghaly
authors: University Hospitals Case Medical Center, Case Western Reserve University, OH, USA.
authors: William
authors: W
authors: Hurd
authors: University Hospitals Case Medical Center, Case Western Reserve University, OH, USA.
authors: James
authors: J
authors: Liu
authors: University Hospitals Case Medical Center, Case Western Reserve University, OH, USA.
authors: Gihan
authors: G
authors: Mansour
authors: Department of Gynecology, Greater Baltimore Medical Center and Johns Hopkins Hospital, Baltimore, MD, USA.
authors: Amanda Nickles
authors: AN
authors: Fader
authors: Department of OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA.
authors: Pedro
authors: P
authors: Escobar
mesh_terms: D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D010049:Ovarian Diseases / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult