Effect of Umbilical Port and Endoscope Size on Discharge Times and Postoperative Recovery After Total Laparoscopic Hysterectomy: A Retrospective Review

Abstract

Background: Laparoscopy is increasingly replacing open surgery as the preferred treatment option in most patients across disciplines. In addition, as technological improvements have occurred, minilaparoscopic instruments have been designed to reduce surgical trauma further and minimize invasiveness. Several studies in the literature have shown that using minilaparoscopic instruments does not increase complication rates and may improve patient recovery. There are no data examining the use of smaller incisions for the endoscope. Objective: This review was conducted to determine differences in discharge times and postoperative recovery when using a 5-mm trocar, compared to a 10-mm trocar, when making umbilical incisions. Materials and Methods: This retrospective review of a single surgeon series of 328 consecutive cases examined the implications (discharge times and postoperative recovery) of using a 5-mm umbilical incision and endoscope, compared with the conventional 10-mm incision and endoscope. Results: The 5-mm incision and endoscope decreased length of stay and was a safe alternative to the 10-mm incision and endoscope. Conclusions: The 5-mm incision and trocar should be used rather than the 10-mm incision and trocar when performing a total laparoscopic hysterectomy. (J GYNECOL SURG 30:273)