Abstract
Study Objective: To describe our initial experience with single-port laparoscopic myomectomy (SP-LM) using transumbilical GelPort access and the surgical technique used, and to evaluate the safety and feasibility of this procedure. Design: A prospective observational study. Setting: University teaching hospital. Patients: Fifty patients with symptomatic subserosal or superficial intramural myoma (≤8 cm). Intervention: Single-port laparoscopic myomectomy (SP-LM) using transumbilical GelPort access. Measurements and Main Results: The mean age and body mass index were 35.0 ± 8.6 years and 22.6 ± 2.6 kg/m2. Two patients had a history of previous abdominal surgery, consisting of one and two Cesarean deliveries. The mean operating time, hemoglobin change, return of bowel activity, and length of hospital stay were 81 ± 21.5 minutes, 1.1 ± 0.5 g/dL, 34.3 ± 5.9 hours, and 3.1 ± 0.5 days, respectively. In one patient (6.7%), SP-LM was converted to two-port LM. There were no surgical or wound complications in any patient, and the histopathological result was leiomyoma in all cases.Tabled 1Clinical characteristics and operative resultsCharacteristicsMedian (range)/Number (%)Number of patients15Age (years)35.0 ± 8.6Parity0.6 ± 0.9Body mass index (kg/m2)22.6 ± 2.6Number of previous abdominal surgery0.6 ± 0.8Total number of removed myomas18Size of myomas (cm)5.5 ± 1.5Location of myomasAnterior8Posterior6Fundal2Lateral2Type of myomasSubserosal8Superficial intramural10Operating time (minutes)81 ± 21.5Hemoglobin change (g/dL)1.1 ± 0.5Return of bowel activity (hours)34.3 ± 5.9Hospital stay (days)3.1 ± 0.5Conversion rate to two-port access1 (6.7)Data are presented as mean ± SD Open table in a new tab Data are presented as mean ± SD Conclusion: SP-LM is feasible in selected patients with symptomatic myoma, to maximize the cosmetic benefits and to minimize wound-related morbidity. However, the development of especially designed advanced laparoscopic instruments and increased research regarding patient selection based on objective evidence are required if we are to perform SP-LM regularly in the future.
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