Laparoendoscopic Single-Site Hysterectomy: A Novel Method with New Medical Instruments

Abstract

Objective: The aim of this research was to demonstrate the feasibility and safety of laparoendoscopic single-site surgery (LESS) for total laparoscopic hysterectomy (TLH). A laparoscope was used with a work channel and modified conventional laparoscopic instruments. Design: This was a prospective study. Materials and Methods: Between April 2010 and December 2014, LESS-TLH was performed in 80 patients with benign gynecologic conditions at the department of laparoscopic and endoscopic surgery, at the National Center for Minimal Access Surgery, in Havana, Cuba. Results: The mean age of the patients was 45 years (range 30–76 years), mean uterus weight was 225 g (100–482 g), mean operative time was 82 minutes (50–200 minutes), and mean blood loss 54 mL (10–400 mL). The postoperative hospital stay was <1 day. One patient experienced an intraoperative complication (bladder injury). There were two postoperative complications: 1 patient with a vault abscess 2 weeks after surgery and 1 patient with endometriosis had a ureter injury. No patients required transfusion during or after the laparoscopic procedure and there were two conversions to conventional TLH. Conclusions: This LESS-TLH technique proposed in this article seems to be a feasible and safe approach, with similar operative time, and without the disadvantages of loss of triangulation and clashing of instruments, compared with other LESS hysterectomy techniques. (J GYNECOL SURG 32:91)