Laparoendoscopic single-site (LESS) surgery in patients with benign adnexal disease

Pedro F. Escobar, Escobar PF, Mohamed A. Bedaiwy, Amanda N. Fader, Fader AN, Amanda Nickles Fader, Tommaso Falcone, Falcone T
Fertility and sterility · 2010 · vol. 93(6) , pp. 2074.e7–2074.e10 · doi:10.1016/j.fertnstert.2009.11.034 · PMID:20100614 · W1998484895
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This paper reports on the outcomes and feasibility of laparoendoscopic single-site (LESS) surgery for benign adnexal disease.

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Abstract

OBJECTIVE: To present our initial experience in laparoscopic surgery for benign adnexal disease performed exclusively through an umbilical incision using a single three-channel port and flexible laparoscopic instrumentation. DESIGN: Case report. SETTING: Tertiary-care referral center. PATIENT(S): Since November, 2008, we have performed single-port laparoscopic surgery in nine patients diagnosed with benign adnexal disease. Patients with adnexal masses or endometriosis and a body mass index of <35 kg/m(2) were selected. INTERVENTION(S): Laparoendoscopic single-site (LESS) surgery. In each case, a multichannel port was inserted into the peritoneum through a 1.5-2.0-centimeter umbilical incision. MAIN OUTCOME MEASURES: Feasibility, postoperative pain score, age, BMI, estimated blood loss. RESULT(S): Eight of nine cases were completed successfully, without conversion to a standard laparoscopic approach or to laparotomy. An additional 3 mm extraumbilical port was required in one patient with stage 4 endometriosis. Seven out of nine patients had earlier abdominal surgery. The operative blood loss ranged from minimal to 75 mL. Duration of hospital stay was <24 hours in all cases. Minimal use of postoperative narcotics was required, and no intraoperative complications occurred. CONCLUSION(S): The LESS surgery for benign adnexal disease is feasible in patients with or without earlier surgery. Additional investigation is needed to evaluate the safety and long-term outcomes of this new approach.

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MeSH descriptors

Adnexal Diseases Endoscopy Laparoscopy Abdomen Abdomen Abdomen Adnexal Diseases Adnexal Diseases Adult Adult Aged Aged Endoscopy Endoscopy Endoscopy Feasibility Studies Feasibility Studies Female Female Follow-Up Studies

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License: CC0 · commercial use OK