1704 Application of “Chopstick Technique” In Laparoendoscopic Single-Site Radical Hysterectomy: Initial Single-Institutional Experience for Early Stage Cervical Cancer

Abstract

Study Objective This study aimed to describe the new “chopstick technique” in laparoendoscopic single-site radical hysterectomy (LESS-RH) and explore its feasibility, safety and perioperative outcomes in the treatment of early stage cervical cancer. Design Retrospective study. Setting The First Affiliated Hospital of Third Military Medical University, Chongqing, China. Patients or Participants Women with federation international of gynecology and obstetrics (FIGO) stage Ia1 with lymph vascular space invasion or stage Ia2-IIa2 cervical cancer. Interventions “Chopstick technique” was performed in LESS-RH and pelvic lymph node dissection. The demographic characteristics and perioperative efficacy of the patients were summarized and analyzed. Measurements and Main Results LESS-RH was attempted in 84 patients, and 83 (98%) patients underwent the procedure successfully. One patient underwent conversion to traditional laproscopic surgery secondary to phase IV endometriosis. “Chopstick technique” was used in all the 83 cases, wherein 40 cases used the single-incision three-channel laparoscopy platform, and 43 used the multichannel-tipped single port laparoscopy platform (HangT Port). The average operation time was 225.0±50.2min and the median intraoperative blood loss was 100mL. During the operations in the first 20 cases, 2 patients had intraoperative vascular injuries and 1 patient had bladder injury, and all were repaired under LESS. One case had ureterovaginal fistula 14 days after operation, and was successfully repaired by ureteroneocystostomy. The average number of pelvic lymph node dissections was 21, and the pathological examination of incisal edge was negative. Deep stromal invasion in 43 cases, LVSI in 16 cases,positive parametrium in 1 case, positive pelvic nodes in 15 cases. 33 patients were treated with postoperative chemotherapy and radiotherapy and 19 patients with intermediate risk factors were treated with radiotherapy postoperatively. Conclusion “Chopstick technique” under LESS was considered feasible for treating cervical cancer.