2859 Single-Port Laparoscopic Hysterectomy in Patients with Myoma Uteri

Abstract

Study Objective The aim of this study is to compare surgical outcomes of single – port laparoscopic hysterectomy (SPL-H), conventional laparoscopic hysterectomy (LH) and robot-assisted hysterectomy (RH) in patients with uterine fibroids. Design Retro and prospective study. Setting City Hospital #40, The Swiss University clinic. Patients or Participants 117 patients entered the study between 2012 and 2018. 39 patients had single – port laparoscopic hysterectomy (SPL-H), 41 patients - conventional laparoscopic hysterectomy (LH), and 37 patients - robot-assisted hysterectomy (RH) for myoma uteri. Interventions single – port laparoscopic hysterectomy (SPL-H), conventional laparoscopic hysterectomy (LH), robot-assisted hysterectomy (RH). Measurements and Main Results Patient characteristics, operating time, estimated blood loss, length of hospital stay, rate of complications, postoperative pain scores and cosmesis were compared. Mean operating time (min) in the group of SPL-H was 109,1±24,8 (95% CI: 101,1-117,2 min), in comparison with LH -104,8±26,2 min (95% CI: 96,5-113,0 min), р=0,847. The total duration of surgery in the group of robot-assisted laparoscopy was 185.1±50.5 min. Estimated blood loss (ml) did not differ statistically in the group of single - port and conventional laparoscopic hysterectomy (Me 80 ml, p=0,083). The hospital stay (days) in a group of SPL-H was significantly lower compared to both groups robotic and conventional laparoscopy (p=0.018 and p=0.034, respectively), while the differences in this two groups were insignificant (p=0.777). There were no conversions to abdominal hysterectomy. In one case of single-port hysterectomy (2.56%), an additional trocar was required due to the atypical localization of the myoma. There were 2 cases with complications in the group of SPL-H who had required relaparoscopy, in the group of RH - 1 case. In the group of traditional laparoscopy there were no complications. All complications in SPL-H group were at the stage of development of the method. Conclusion Single-port hysterectomy is a feasible and safe technique, with no major complications compared to conventional and robotic access.