Laparoendoscopic single-site surgery in patients with benign adnexal disease: a comparative study.

Bedaiwy, Mohamed A; Starks, David; Hurd, William; Escobar, Pedro F

BACKGROUND Laparoendoscopic single-site surgery (LESS) is becoming increasingly popular in different disciplines. Evidence is scarce about its utility in gynecologic surgery. AIM To compare our initial experience using LESS for benign adnexal disease to traditional laparoscopy. METHODS Since November 2008, we have performed LESS in 28 patients diagnosed with benign adnexal disease (group I). Patients with adnexal masses and a body mass index <35 were selected. An age-matched control group of patients with similar diagnoses who underwent traditional operative laparoscopy was included (n = 50; group II). RESULTS Both groups were comparable with regard to age, body mass index, preoperative diagnosis, indication of surgery and history of previous abdominal surgery. The operative blood loss ranged from minimal to <50 ml for both groups. The mean ± SD duration of surgery in group I (45 ± 19.5 min) was comparable to that of group II (46.4 ± 18.3 min). The duration of hospital stay was <24 h in both groups. Minimal use of postoperative narcotics was required in study subjects and no intraoperative complications occurred. CONCLUSIONS LESS for benign adnexal disease is feasible in patients with or without previous surgery and is comparable to traditional laparoscopic surgery. Additional investigation is needed to evaluate the safety, cost-effectiveness and long-term outcomes of this new approach.