title: Operative outcomes of single-port-access laparoscopy-assisted vaginal hysterectomy compared with single-port-access total laparoscopic hysterectomy.
abstract: OBJECTIVE
  This study aims to compare between operative outcomes of single-port-access laparoscopy-assisted vaginal hysterectomy (SPA-LAVH) and single-port-access total laparoscopic hysterectomy (SPA-TLH), further subdivided by vaginal cuff closure via laparoscopic suture (VCC-L) or via the vaginal route (VCC-V).
  
  
  METHODS
  A custom-made port was used for single-port laparoscopy in 111 patients who underwent SPA-LAVH (n = 33), SPA-TLH with VCC-L (n = 35), and SPA-TLH with VCC-V (n = 43) during October 2009-October 2010. Records were reviewed retrospectively.
  
  
  RESULTS
  A significant difference in the operating time was observed among the groups (p = 0.009). SPA-TLH with VCC-L took a significantly longer time to be performed (118.6 ± 41.8 minutes) than SPA-TLH with VCC-V (98.6 ± 21.3 minutes) or SPA-LAVH (102.0 ± 20.3 minutes). The decrease in hemoglobin level on the 1(st) day postsurgery was significantly smaller in case of SPA-LAVH (1.56 ± 0.97 g/dL, p = 0.005) compared with that in case of SPA-TLH with VCC-L (2.19 ± 0.95 g/dL) and SPA-TLH with VCC-V (2.24 ± 0.95 g/dL). No significant differences in other surgical outcomes were found.
  
  
  CONCLUSIONS
  SPA-TLH with laparoscopic vaginal suture required the longest operating time, and hemoglobin changes were smaller in the SPA-LAVH group than in the other groups. In patients undergoing SPA laparoscopy, we recommend the SPA-LAVH procedure.
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Republic of Korea.
authors.forename: Bo Sung
authors.initials: BS
authors.lastname: Yoon
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Republic of Korea. Electronic address: sjseong@cha.ac.kr.
authors.forename: Seok Ju
authors.initials: SJ
authors.lastname: Seong
authors.affiliation: Department of Obstetrics and Gynecology, CHA Daegu Medical Center, CHA University, Seoul, Republic of Korea.
authors.forename: In Hyun
authors.initials: IH
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Taejong
authors.initials: T
authors.lastname: Song
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Republic of Korea.
authors.forename: Mi-La
authors.initials: ML
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Republic of Korea.
authors.forename: Mi Kyoung
authors.initials: MK
authors.lastname: Kim
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D013536:Suture Techniques; D014621:Vagina / Q000601:surgery
keywords: laparoscopic hysterectomy; laparoscopy-assisted vaginal hysterectomy; single port; total laparoscopic hysterectomy; vaginal cuff suture