Surgical Outcomes of a New Approach to Laparoscopic Myomectomy: Single-Port and Modified Suture Technique

Abstract

Study ObjectiveTo introduce a new technique of laparoscopic myomectomy (LM) using single-port access and a modified suture technique. DesignRetrospective review of medical records. SettingUniversity medical center. PatientsFrom October 2011 through December 2012, 55 consecutive patients underwent single-port LM using a modified suture technique with Hem-o-lock ligation clips and myoma morcellation through the umbilical incision site (Choi's LM). As a historic control, patients who underwent conventional multi-port LM from January 2008 through November 2010 were included in the study. InterventionsMedical records for 157 patients (55 Choi's LM and 102 LM) were reviewed retrospectively. Inclusion criteria were <3 symptomatic myomas ≤10 cm. Outcomes measured were operative time, estimated blood loss, complications, length of postoperative hospital stay, and postoperative pain. Measurements and Main ResultsAge, symptoms resulting from myomas, location and type of dominant myomas, and number of myomas were similar in the 2 groups. There were no significant differences in mean diameter of the myomas between the groups (6.8 cm vs 7.0 cm; p = .40). The mean duration of the operation was shorter in the Choi's LM group compared with the conventional LM group (104 min vs 152 min; p < .001). Choi's LM also resulted in a statistically significant decrease in blood loss (139 mL vs 222 mL; p < .001). Postoperative pain scores were significantly lower in the Choi's LM group than in the conventional LM group at 1, 6, 12, and 24 hours after surgery. ConclusionChoi's LM with modified suture technique is associated with shorter operative time and less postoperative pain. A prospective trial is needed to confirm the results.