Transumbilical single-incision laparoscopic surgery: application to laparoscopically assisted vaginal hysterectomy.

Koyanagi, Takahiro; Motomura, Satoru

PURPOSE Transumbilical single-incision laparoscopic surgery has been used more frequently in general surgery to reduce the invasiveness of traditional laparoscopy. However, few reports of single-incision laparoscopic surgery have been described in the field of gynecology. We used single-incision laparoscopic surgery to laparoscopically assisted vaginal hysterectomy (LAVH). We performed single-incision LAVH in ten patients and compared the operative results with the conventional multiport, multi-incision LAVH. METHODS We began applying single-incision LAVH in July 2009 and completed this method for uterine myoma in ten cases. Operative time, weight of resected uterus, and body mass index (BMI) were recorded and compared to those of conventional multiport LAVH. RESULTS Comparative outcomes of single-incision LAVH versus conventional multiport LAVH were as follows. The mean operative time was 76 ± 15.5 versus 71.4 ± 21.7 min (P = 0.57). The mean weight of resected uterus was 366.3 ± 144 versus 354 ± 95.5 g (P = 0.85). BMI was 23.3 ± 2.75 versus 22.2 ± 3.76 kg/m(2) (P = 0.52). No significant difference was observed between single incision and conventional LAVH. CONCLUSIONS Single-incision LAVH can be undertaken safely and with similar operative results to conventional multiport LAVH. We consider that it is a promising alternative method for the treatment of some patients with uterine myomas as incision-free gynecological operation.