1827 Laparoscopically Assisted Suprapubic Surgery for Adnexal Tumors Under Epidural Anesthesia

Abstract

Study Objective To evaluate the feasibility and safety of laparoscopically assisted surgery for benign ovarian tumors via a single suprapubic incision under epidural anesthesia. Design Forty-three patients underwent laparoscopically assisted surgery via a single suprapubic incision under epidural anesthesia. Types of surgery were classified as follows: type I – suprapubic incision surgery without laparoscopic support, type II – suprapubic incision surgery with laparoscopic support but without CO2 inflation; and type III – suprapubic incision surgery with laparoscopic support and CO2 inflation. Setting This study was performed in Pusan National University Hospital, Busan, Korea Patients or Participants Between April 2013 and November 2014, we performed 43 laparoscopically assisted extracorporeal surgeries for adnexal tumors via a single suprapubic incision, under epidural anesthesia, in the Department of Obstetrics and Gynecology of Pusan National University Hospital. Interventions Laparoscopically assisted surgery via a single suprapubic incision under epidural anesthesia. Measurements and Main Results Type I, II, and III procedures were performed on 16, 21, and six patients, respectively. Most patients (n = 35) were discharged on postoperative day 1 or 2. No surgical complication was encountered. Types of surgery exhibited different surgical characteristics. Type I was adopted for larger diameter tumors than types II or III (p = .016), whereas type III had a longer operative time (p = .024) than types I and II. Other characteristics, such as age, body mass index, and length of hospital stay, did not differ significantly among surgical types. Conclusion Laparoscopically assisted surgery for adnexal tumors via a single suprapubic incision under epidural anesthesia is feasible and safe and should be viewed as an alternative approach to conventional minimally invasive surgery.