Evaluation of 110 cases of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) and comparison with multi-port access

Byung-Joon Park, Yong Wook Kim, Duck-Yeong Ro, Tae-Eung Kim, Ki-Sung Ryu, Jang-Heup Kim
In: Korean Journal of Obstetrics and Gynecology · 2010 · vol. 53(7) , pp. 633 · doi:10.5468/kjog.2010.53.7.633 · W1982466083
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-11 ⓘ

Single-port access laparoscopically assisted vaginal hysterectomy using conventional instruments demonstrated similar operative outcomes and safety to multi-port access but resulted in shorter hospital stays.

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This retrospective study evaluated the safety and feasibility of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) using conventional rigid straight laparoscopic instruments by reviewing 220 patients with uterine leiomyoma or adenomyosis who underwent either SPA-LAVH (n=110) or multi-port access LAVH (MPA-LAVH; n=110) from April 2007 to November 2009. The authors compared outcomes including operative time, uterine weight, hemoglobin change, blood transfusion rates, postoperative fever, hospital stay, and intraoperative injuries, and reported no significant between-group differences in most perioperative measures, with bowel and urinary tract injuries absent in both groups. Hospital stay was shorter in the SPA-LAVH group (mean 2.6 vs 3.3 days, P<0.05), and there were conversions to abdominal total hysterectomy in one case in each group. The paper’s main limitation is its retrospective medical-record review design rather than a randomized comparison. Relevance to endometriosis: adenomyosis is included in the study population as an eligible uterine condition, though the paper’s main focus is comparing SPA-LAVH versus MPA-LAVH surgical approaches rather than endometriosis or adenomyosis mechanisms.

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Abstract

Objective: To evaluate the safety and feasibility of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) using conventional laparoscopic instruments compared to multi-port access laparoscopically assisted vaginal hysterectomy (MPA-LAVH). Methods: We reviewed the medical records of 220 patients with uterine leiomyoma or adenomyosis who underwent 110 SPA-LAVH and 110 MPA-LAVH in Incheon St. Mary's Hospital between April 2007 and November 2009. We performed SPA-LAVH with conventional rigid straight laparoscopic instruments in all cases. We also performed a new vaginal cuff closure method, Kim’s Vaginal Vault Suspension Method, named after the operator (Kim, YW) in both SPA-LAVH and MPA-LAVH. Results: There was no significant difference in patients' age, operating time, uterine weight, hemoglobin change, frequency of blood transfusion, and incidence of postoperative fever between the two groups. The patients' mean age was 46.1±7.0 years (SPA-LAVH) and 45.5±6.3 years (MPA-LAVH). The mean operating time was 87.2±21.0 minutes (SPA-LAVH) and 83.3±20.3 minutes (MPA-LAVH). The mean uterine weight was 261.4±139.7 g (SPA-LAVH) and 257.8±132.9 g (MPA-LAVH). The mean hemoglobin change was 1.1±0.7 g/dL (SPA-LAVH) and 1.2±0.6 g/dL (MPA-LAVH). Neither bowel injury nor urinary tract injury occurred during the operation in the two groups. One of the SPA-LAVH and one of the MPA-LAVH cases were converted to abdominal total hysterectomy. The mean hospital stay time was shorter with SPA-LAVH (2.6±0.6 days [SPA-LAVH] and 3.3±0.7 days [MPA-LAVH], P<0.05). Conclusion: SPA-LAVH using conventional rigid straight laparoscopic instruments can be offered as a safe and feasible alternative to MPA-LAVH.
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| Evaluation of 110 cases of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) and comparison with multi-port access. | | Byung Joon Park, Yong Wook Kim, Duck Yeong Ro, Tae Eung Kim, Ki Sung Ryu, Jang Heup Kim | | Department of Obstetrics and Gynecology, The Catholic University of Korea, Incheon, Korea. [email protected] | | | | Abstract | OBJECTIVE To evaluate the safety and feasibility of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) using conventional laparoscopic instruments compared to multi-port access laparoscopically assisted vaginal hysterectomy (MPA-LAVH). METHODS: We reviewed the medical records of 220 patients with uterine leiomyoma or adenomyosis who underwent 110 SPA-LAVH and 110 MPA-LAVH in Incheon St. Mary's Hospital between April 2007 and November 2009. We performed SPA-LAVH with conventional rigid straight laparoscopic instruments in all cases. We also performed a new vaginal cuff closure method, Kim's Vaginal Vault Suspension Method, named after the operator (Kim, YW) in both SPA-LAVH and MPA-LAVH. RESULTS: There was no significant difference in patients' age, operating time, uterine weight, hemoglobin change, frequency of blood transfusion, and incidence of postoperative fever between the two groups. The patients' mean age was 46.1+/-7.0 years (SPA-LAVH) and 45.5+/-6.3 years (MPA-LAVH). The mean operating time was 87.2+/-21.0 minutes (SPA-LAVH) and 83.3+/-20.3 minutes (MPA-LAVH). The mean uterine weight was 261.4+/-139.7 g (SPA-LAVH) and 257.8+/-132.9 g (MPA-LAVH). The mean hemoglobin change was 1.1+/-0.7 g/dL (SPA-LAVH) and 1.2+/-0.6 g/dL (MPA-LAVH). Neither bowel injury nor urinary tract injury occurred during the operation in the two groups. One of the SPA-LAVH and one of the MPA-LAVH cases were converted to abdominal total hysterectomy. The mean hospital stay time was shorter with SPA-LAVH (2.6+/-0.6 days [SPA-LAVH] and 3.3+/-0.7 days [MPA-LAVH], P<0.05). CONCLUSION: SPA-LAVH using conventional rigid straight laparoscopic instruments can be offered as a safe and feasible alternative to MPA-LAVH. | | Keywords: Single-port access; Multi-port access; Laparoscopically assisted vaginal hysterectomy; Conventional laparoscopic instruments | |

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