Randomized controlled trial of postoperative pain and activity following microlaparoscopy and standard laparoscopy

Objective To compare postoperative pain and recovery of patients undergoing surgery with the 2‐mm microlaparosope and the 10‐mm standard laparoscope. Design A double‐blind prospective randomized clinical study to assess pain. Setting Monash Medical Centre Women's Health Program, Melbourne, Australia. Subjects 29 women of reproductive age (24–45 years) undergoing diagnostic procedures for fertility were randomly allocated to either microlaparoscopy (ML) or standard laparoscopy (SL). Interventions Of these patients 13 received a microlaparoscopy and 16 received standard laparoscopy. All patients agreed to complete the self‐administered Short‐Form McGill Pain Questionnaire (SF‐MPQ), immediately after surgery before any analgesia and at 48 h after surgery, in order to assess pain and recovery. Main outcome measures Pain intensity and recovery time for patients undergoing microlaparoscopy were compared with those for standard laparoscopy. Results There was no significant difference between the two groups when the affective, sensory and visual analogue scale (VAS) pain scores, immediately after recovery and at 48 h, were compared. However there was a significant difference in the time to return to normal activity as perceived by the patients, with the ML group scoring a quicker return to normal activity (mean ± SD, 3.6 ± 3.6 compared with the SL group (7.1 ± 3.3) ( P = 0.01). This was despite a significant difference in operating times between the two groups. The mean operating time for the ML group was 22.6 min (95% confidence interval (CI) 18.8–26.5), compared with a mean for the SL group of 16.4 min (95% CI, 13.9–18.8) ( P = 0.01). The ML group required no narcotic postoperative analgesia. Conclusion There was no significant difference in pain scores between groups in whom the microlaparoscope or the standard laparoscope were used. However the microlaparoscopy group experienced a quicker post‐surgical recovery, required less analgesia and were more satisfied with their scar.