Single-port access (SPA) laparoscopic surgery in gynecology: a surgeon's experience with an initial 200 cases.

Park, Hwang Shin; Kim, Tae-Joong; Song, Taejong; Kim, Min Kyu; Lee, Yoo-Young; Choi, Chel Hun; Lee, Jeong-Won; Kim, Byoung-Gie; Bae, Duk-Soo

OBJECTIVE To report our initial two hundred single-port access (SPA) gynecologic surgeries and present the perioperative outcomes. STUDY DESIGN This is a prospective single-center study (Canadian Task Force classification II-2). Two hundred selected patients with gynecological disease were recruited for the study from May 2008 through December 2009 at Samsung Medical Center. RESULTS Two hundred patients underwent SPA gynecological surgery (105 a total hysterectomy; 11 a subtotal hysterectomy; 43 an oophorectomy; 31 an ovarian cystectomy; 5 a salpingectomy; 2 a myomectomy; 3 adhesiolysis only). The median age and body mass index were 45.5 and 22.9 kg/m(2), respectively. SPA surgery was successfully completed in 187 patients, without the need for ancillary ports (93.5%). Two cases required a conventional multiport, and nine cases needed one additional port. Two patients were converted to a laparotomy. One intra- and five post-operative complications occurred. The complication rate was 3.2% (6/187). The median operative time was 120 min (54-250) for a total hysterectomy, 180 (150-345) for a subtotal hysterectomy, 60 (27-245) for an oophorectomy, 105 (50-185) for a cystectomy, and 60 (30-115) for a salpingectomy. CONCLUSION Single-port surgery was safe and feasible for gynecological indications. Further study of single-port surgery is required to determine whether it has significant benefits compared to conventional techniques.