Transumbilical single-port access versus conventional total laparoscopic hysterectomy: surgical outcomes

Am J Obstet Gynecol. 2010 Jul;203(1):26.e1-6. doi: 10.1016/j.ajog.2010.02.026. Epub 2010 Apr 24.

Abstract

Objective: The objective of the study was to compare surgical outcomes and postoperative pain between transumbilical single-port access total laparoscopic hysterectomy (SPA-TLH) and conventional 4-port total laparoscopic hysterectomy (TLH).

Study design: We retrospectively reviewed 157 patients who underwent SPA-TLH (n = 52) or conventional TLH (n = 105). A single-port access system consisted of a wound retractor, surgical glove, 2 5 mm trocars, and 1 10/11 mm trocar.

Results: The SPA-TLH group had less intraoperative blood loss (P < .001), shorter hospital stay (P = .001), and earlier diet intake (P < .001) compared with the conventional TLH group. There was no difference in perioperative complications. Immediate postoperative pain score was lower in the SPA-TLH group (P < .001). Postoperative pain after 6 and 24 hours was lower in SPA-TLH with marginal statistical significance.

Conclusion: SPA-TLH is a feasible method for hysterectomy with lower immediate postoperative pain and better surgical outcomes with respect to recovery time compared with conventional TLH.

MeSH terms

  • Female
  • Humans
  • Hysterectomy / methods*
  • Laparoscopy / methods*
  • Length of Stay
  • Pain, Postoperative
  • Retrospective Studies
  • Statistics, Nonparametric
  • Time Factors
  • Treatment Outcome