Mini-Laparoscopic Surgery for Patients with Endometriosis

Yoko Nagayasu, Kiyoji Okuda, Satoshi Tsunetoh, Yoshihiro Nakamura, Yoko Yoshida, Atsushi Hayashi, Mika Hayashi, Yoshiki Yamashita, Yoshito Terai, Masahide Ohmichi
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2012 · vol. 28(2) , pp. 621–626 · doi:10.5180/jsgoe.28.621 · W2333622551
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-13 ⓘ

Mini-laparoscopic surgery for endometriosis patients showed decreased postoperative pain and improved cosmetic outcomes compared to conventional laparoscopy, though two cases required conversion due to adhesions.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This study compared mini-laparoscopic surgery (MLS) versus conventional laparoscopic surgery (CLS) for 24 endometrioma patients, assigning 13 to MLS and 11 to CLS, and evaluated operative findings, complications, postoperative analgesic use, and serum CRP levels. MLS used smaller ports (one 5-mm laparoscope port plus one 5-mm and two 2.3-mm working ports), while CLS used larger and more ports, and the groups had similar baseline disease severity based on r-ASRM scores. The total r-ASRM scores were not significantly different between groups, operating times were comparable, and while 2 MLS cases were converted to CLS due to severe tubal adhesions, no major postoperative complications occurred. Compared with CLS, MLS was associated with significantly lower early postoperative analgesic administration and lower serum CRP, and showed superior cosmetic outcomes; the study’s main limitation was the small sample size and lack of details on longer-term outcomes. This paper is centrally about endometriosis — it directly evaluates mini-laparoscopic surgical techniques for patients with endometriomas.

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Abstract

Introduction: In an attempt to reduce pain and improve cosmetic outcome in laparoscopic surgery, there has been a recent drive to reduce port sizes (mini-laparoscopic surgery: MLS) or port number (single-site laparoscopic surgery). We evaluated the safety and efficacy of MLS in the patients with endometriosis and compared its outcome with that of the conventional laparoscopic surgery (CLS).Methods: MLS was conducted with one 5-mm port for a 5-mm laparoscope as well as one 5-mm port and two 2.3-mm ports for the MiniLap Grasper. Conventional laparoscopic surgery (CLS) employs one 12-mm port for a 10-mm laparoscope and three 5-mm ports. A total of 24 patients with endometriomas underwent MLS (13) or CLS (11). We compared patient characteristics, operative findings, complications, postoperative pain medicine requirements, and serum CRP levels.Results: The total r-ASRM (Revised American Society for Reproductive Medicine classification of endometriosis) scores for patients with endometriomas were not significantly different between the MLS (56.5) and the CLS (52.9) groups. Two of 13 patients were converted from MLS to CLS because of severe tubal adhesions. However, no major postoperative complications were encountered. Median operating times were similar between MLS (123 minutes) and CLS (107 minutes). The mean frequency of analgesic administration and serum CRP levels were significantly lower following MLS than following CLS (Mean frequency 1.5±0.53 for MLS and 2.7±0.6, CRP 0.66±0.28 for MLS and 1.00±0.53 for CLS). Cosmetic outcomes were superior with MLS, compared to CLS.Conclusions: Compared to conventional laparoscopic surgery, the use of mini-laparoscopic techniques resulted in decreased incisional pain in the early postoperative period while improving cosmetic appearance.
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Abstract

Introduction: In an attempt to reduce pain and improve cosmetic outcome in laparoscopic surgery, there has been a recent drive to reduce port sizes (mini-laparoscopic surgery: MLS) or port number (single-site laparoscopic surgery). We evaluated the safety and efficacy of MLS in the patients with endometriosis and compared its outcome with that of the conventional laparoscopic surgery (CLS).

Methods

MLS was conducted with one 5-mm port for a 5-mm laparoscope as well as one 5-mm port and two 2.3-mm ports for the MiniLap Grasper. Conventional laparoscopic surgery (CLS) employs one 12-mm port for a 10-mm laparoscope and three 5-mm ports. A total of 24 patients with endometriomas underwent MLS (13) or CLS (11). We compared patient characteristics, operative findings, complications, postoperative pain medicine requirements, and serum CRP levels.

Results

The total r-ASRM (Revised American Society for Reproductive Medicine classification of endometriosis) scores for patients with endometriomas were not significantly different between the MLS (56.5) and the CLS (52.9) groups. Two of 13 patients were converted from MLS to CLS because of severe tubal adhesions. However, no major postoperative complications were encountered. Median operating times were similar between MLS (123 minutes) and CLS (107 minutes). The mean frequency of analgesic administration and serum CRP levels were significantly lower following MLS than following CLS (Mean frequency 1.5±0.53 for MLS and 2.7±0.6, CRP 0.66±0.28 for MLS and 1.00±0.53 for CLS). Cosmetic outcomes were superior with MLS, compared to CLS.

Conclusions

Compared to conventional laparoscopic surgery, the use of mini-laparoscopic techniques resulted in decreased incisional pain in the early postoperative period while improving cosmetic appearance.

Methods

MLS was conducted with one 5-mm port for a 5-mm laparoscope as well as one 5-mm port and two 2.3-mm ports for the MiniLap Grasper. Conventional laparoscopic surgery (CLS) employs one 12-mm port for a 10-mm laparoscope and three 5-mm ports. A total of 24 patients with endometriomas underwent MLS (13) or CLS (11). We compared patient characteristics, operative findings, complications, postoperative pain medicine requirements, and serum CRP levels.

Results

The total r-ASRM (Revised American Society for Reproductive Medicine classification of endometriosis) scores for patients with endometriomas were not significantly different between the MLS (56.5) and the CLS (52.9) groups. Two of 13 patients were converted from MLS to CLS because of severe tubal adhesions. However, no major postoperative complications were encountered. Median operating times were similar between MLS (123 minutes) and CLS (107 minutes). The mean frequency of analgesic administration and serum CRP levels were significantly lower following MLS than following CLS (Mean frequency 1.5±0.53 for MLS and 2.7±0.6, CRP 0.66±0.28 for MLS and 1.00±0.53 for CLS). Cosmetic outcomes were superior with MLS, compared to CLS.

Conclusions

Compared to conventional laparoscopic surgery, the use of mini-laparoscopic techniques resulted in decreased incisional pain in the early postoperative period while improving cosmetic appearance. © 2012 Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy Favorites & Alerts Recently viewed articles

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