{"paper_id":"7d2a4d0e-477f-44fb-88fb-3d50fe4b52bc","body_text":"Abstract\nTo assess the feasibility and the safety of the ultra-minimally invasive (U-MIS) approaches in gynecology, we compared our experience in percutaneous assisted hysterectomy (PSS-H) with a series of 3 mm mini-laparoscopy hysterectomy (m-LPS-H). 126 patients affected by benign and malignant gynecological conditions were considered eligible for minimally invasive hysterectomy: 80 patients received PSS approach and 46 m-LPS approach. For both groups, we evaluated intra and perioperative outcomes, post-operative pain and cosmetic outcomes. The baseline characteristics were comparable between the two study groups. As well, no differences were reported in the clinical indications for hysterectomy, principally fibroids/adenomyosis, endometrial hyperplasia and early stage endometrial cancer. The median operative time was 88.5 (40–190) minutes for PSS-H group and 95.0 (42–231) minutes in m-LPS-H group (p = 0.131). No differences were detected in median estimated blood loss (p = 0.104) as well, in the uterine manipulator usage (p = 0.127) between the two different surgical approaches. Only 1 (2.2%) conversion to standard laparoscopy occurred in m-LPS-H group (p = 0.691). One intra-operative complication was recorded 1 (1.3%) in the PSS-H group (p = 0.367). The post-operative early complication was recorded in five cases of PSS-H group (p = 0.158), none for m-LPS-H procedures. The results in post-operative pain detection was statistically significant after 4 h in favor of m-LPS-H group (p = 0.001). After 30 days no differences in cosmetic satisfaction were detected between the two groups (p = 0.206). PSS-H and m-LPS-H are two valid U-MIS alternatives for benign gynecological conditions and low/intermediate risk endometrial cancer.\nSimilar content being viewed by others\nReferences\nGueli Alletti S, Cianci S, Perrone E, Fanfani F, Vascone C, Uccella S, Gallotta V, Vizzielli G, Fagotti A, Monterossi G, Scambia G, Rossitto C (2019) Technological innovation and personalized surgical treatment for early-stage endometrial cancer patients: a prospective multicenter Italian experience to evaluate the novel percutaneous approach. 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Biomed Res Int 2018:5727165. https://doi.org/10.1155/2018/5727165\nFunding\nThe work was not supported by any fund/grant.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nConflict of interest\nThe authors declare that they have no conflict of interest.\nResearch involving human participants and/or animals\nAll procedures performed in studies involving animals were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.\nInformed consent\nInformed consent was obtained from all subjects.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nCianci, S., Perrone, E., Rossitto, C. et al. Percutaneous-assisted vs mini-laparoscopic hysterectomy: comparison of ultra-minimally invasive approaches. Updates Surg 73, 2347–2354 (2021). https://doi.org/10.1007/s13304-020-00893-5\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s13304-020-00893-5","source_license":"public-domain-us","license_restricted":false}