Single incision laparoscopic surgery (SILS) in gynaecology: Feasibility and operative outcomes

Fariba Behnia-Willison, Fariba Behnia‐Willison, Leila Foroughinia, Maryam Sina, Phil McChesney
The Australian & New Zealand journal of obstetrics & gynaecology · 2012 · vol. 52(4) , pp. 366–370 · doi:10.1111/j.1479-828x.2012.01443.x · PMID:22548311 · W1993018532
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This study evaluated single incision laparoscopic surgery in 105 women, finding it a feasible and safe technique for various gynecological conditions with good cosmetic outcomes and reduced postoperative pain.

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Abstract

BACKGROUND: Single incision laparoscopic surgery (SILS) represents the latest advancement in minimally invasive surgery, combining the benefits of conventional laparoscopic surgery, such as less pain and faster recovery, with improved cosmesis. Although the successful use of this technique is well reported in general surgery and urology, there is a lack of studies on SILS in gynaecology. AIMS: To evaluate the feasibility, safety, cosmesis and outcome of SILS in gynaecology. METHODS: A prospective case series analysis of 105 women scheduled to undergo surgery by SILS from August 2010 to November 2011. Intra-operative data such as operative time, estimated blood loss, complications, additional ports and hospital stay were collected. Post-operative pain and cosmetic outcomes (scar size) were also recorded. RESULTS: Out of 105 women, SILS was performed for 84 (60 excisions of endometriosis, 13 divisions of adhesions, five hysterectomies, two mesh sacrohysteropexies and four ovarian cystectomies). SILS was not undertaken for 21 women because of a number of factors, including the lack of required equipment (eg bariatric scope, SILS port, roticulating instruments and diathermy leads). Four women required insertion of additional ports because of surgical difficulties. One intra-operative (uterine perforation) and seven post-operative complications (six wound infections and one vault haematoma) occurred. Mean operation times were as follows: mesh sacrohysteropexy - 60 min, excision of endometriosis - 55 min, hysterectomy - 150 min, laparoscopic division of adhesions - 62 min and ovarian cystectomy - 40 min. CONCLUSIONS: Our experience shows that SILS is a feasible and safe technique for the surgical management of various gynaecological conditions. Satisfaction is high because of improved cosmesis and reduced analgesic requirements post-operatively.

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Condition tags

endometriosis

MeSH descriptors

Cicatrix Gynecologic Surgical Procedures Laparoscopy Length of Stay Postoperative Complications Adolescent Adult Aged Aged, 80 and over Feasibility Studies Female Gynecologic Surgical Procedures Humans Laparoscopy Laparoscopy Length of Stay Middle Aged Prospective Studies Treatment Outcome Young Adult

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