Laparoendoscopic Single-Site Supracervical Hysterectomy with Manual Morcellation: A Retrospective Study.

Chang, Yu; Kay, Nari; Huang, Minpheus R; Huang, S Joseph; Tsai, Eing Mei

STUDY OBJECTIVE To evaluate the feasibility, efficiency, and safety of manual morcellation in laparoendoscopic single-site (LESS) supracervical hysterectomy. DESIGN Retrospective study (Canadian Task Force classification II-2). SETTING A teaching hospital. PATIENTS One hundred and ninety patients with symptomatic uterine leiomyomas and/or adenomyosis who underwent LESS supracervical hysterectomy. INTERVENTIONS Manual morcellation through the umbilical wound. MEASUREMENTS AND MAIN RESULTS Time of operation, blood loss volume, specimen weights, rate of morcellation, requirement for blood transfusion, hospital length of stay, and prevalence of postoperative cyclic spotting were recorded. The median weight of the uterine corpus was 245 g (range, 100-1960 g). The median total operation time was 69 minutes (range, 36-183 minutes). The median volume of blood loss was 50 mL (range, 10-850 mL). The median level of hemoglobin reduction was 1 g/dL (range, -1 to 3.2 g/dL). The incidence of intraoperative blood transfusion was 3.2%, and the mean manual morcellation rate was 38.9 ± 15 g/minute. The incidence of postoperative cyclic spotting was 10.5%. CONCLUSION Safe and effective LESS surgery requires a minimal surgical incision compared with conventional laparoscopic surgery and laparotomy. Manual morcellation was found to be effective and safe in removing solid tumors in this population.