Single-port Laparoscopic Group Research Articles

Comparison of Single-Port Laparoscopy with Other Surgical Approaches in Endometrial Cancer Surgical Staging: Propensity-Score-Matched Analysis.

This single-institution, retrospective study aimed to compare the surgical outcomes of single-port, multi-port, and robot-assisted laparoscopy, as well as laparotomy, in patients with endometrial cancer who underwent surgical staging between January 2006 and December 2017. This study evaluated various parameters, including disease-free survival (DFS), overall survival (OS), recurrence rate (RR), recurrence site, and intra- and postoperative complications. Propensity score matching was performed to account for baseline characteristics, and a total of 881 patients were included in the analysis. The 3-year DFS of single-port laparoscopy was similar to that of the other groups, but laparotomy exhibited a lower 3-year DFS compared to multi-port (p = 0.001) and robot-assisted (p = 0.031) laparoscopy. Single-port laparoscopy resulted in a significantly higher 3-year OS than laparotomy (p = 0.013). After propensity score matching, the four groups demonstrated similar survival outcomes (3-year DFS: p = 0.533; 3-year OS: p = 0.328) and recurrence rates (10.3%, 12.1%, 10.3%, and 15.9% in the single-port, multi-port, and robot-assisted laparoscopy and laparotomy groups, respectively, p = 0.552). Recurrence most commonly occurred in distant organs. The single-port laparoscopy group had the longest operative time (205.1 ± 76.9 min) but the least blood loss (69.5 ± 90.8 mL) and the shortest postoperative hospital stay (5.2 ± 2.3 days). In contrast, the laparotomy group had the shortest operative time (163.4 ± 51.0 min) but the highest blood loss (368.3 ± 326.4 mL) and the longest postoperative hospital stay (10.3 ± 4.6 days). The transfusion rate was 0% in the single-port laparoscopy group and 3.7% in the laparotomy group. Notably, the laparotomy group had the highest wound complication rate (p = 0.001), whereas no wound hernias were observed in the three minimally invasive approaches. In conclusion, the survival outcomes were comparable between the methods, with the benefit of lower blood loss and shorter hospital stay observed in the single-port laparoscopy group. This study suggests that single-port laparoscopy is a feasible approach for endometrial cancer surgical staging.

Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery versus single-port laparoscopy: Comparison of early outcomes.

The study objective was to compare intraoperative and early postoperative outcomes among patients who underwent hysterectomy via transvaginal natural orifice transluminal endoscopic surgery (and single-port lararoscopy for presumed benign gynecologic disorders). We retrospectively reviewed 40 patients who underwent single-port laparoscopic hysterectomy and 20 patients who underwent hysterectomy via natural orifice transluminal endoscopic surgery. Patients' age, body mass index, history of previous delivery and surgery, total operation time (from skin incision to closure), intraoperative and postoperative complications conversion to another surgical procedure, drop of hemoglobin level, postoperative pain at 1 and 18 h, average hospital stay, and clinical outcomes were analyzed. Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery was superior to single-port hysterectomy concerning the length of hospitalization (p < 0.001) and visual analog scale at 1h (p=0.024) and 18 h (p < 0.001). In transvaginal natural orifice transluminal endoscopic group, postoperative complications were lower than single-port laparoscopy group (p=0.023). In transvaginal natural orifice transluminal endoscopy, group conversion to a standard vaginal hysterectomy occurred in two cases (10%). Four patients in the single-port laparoscopic hysterectomy group had umbilical herniation, three had port-site infections, and two patients had vaginal cuff hematoma. These patients required rehospitalization. Despite hysterectomy via transvaginal natural orifice transluminal surgery has not yet found its place in routine practice in gynecology departments, it could be a prominent alternative approach to other minimally invasive surgical procedures in selected patients with many advantages including lesser pain and lower complication rates compared with single-port laparoscopic hysterectomy.

1891 A Prospective, Controlled Study Comparing Single Port Laparoscopic Sacrospinous Fixation and Transvaginal Sacrospinous Fixation in the Treatment of Pelvic Organ Prolapse

Study Objective The objective of the study was to compare operative time, intraoperative blood loss, recurrence and complication rates for single port laparoscopic sacrospinous fixation SSF and transvaginal (SSF) for the primary treatment of pelvic organ prolapse. Design Patients undergoing surgery for pelvic organ prolapse were included in a randomized, controlled study comparing single port laparoscopic SSF or transvaginal sacrospinous fixation. The examination included operative time, intraoperative blood loss, operative complication, and pelvic organ prolapse quantification, urodynamics, ultrasound, and quality-of-life (QoL) questionnaires before and 3 and 12 months after surgery. Setting trendelenburg. Patients or Participants Of 20 randomized patients in Zhongnan Hospital of Wuhan University, from Jan.2018 to Mar.2019. Interventions 10 patients underwent single port laparoscopic SSF and 10 patients underwent transvaginal SSF. Measurements and Main Results All the operations were completed successfully. The operative time in the single port laparoscopic group (117.0±20.0 min) was longer than the transvaginal group (75.2±24.3 min). The intraoperative blood loss (54.9±24.1 ml) was less than the transvaginal group (87.6±12.3 min). The incidence of operative complications in the single port laparoscopic group (30.0%) was lower than transvaginal group (50.0%). There were no difference between the single port laparoscopic group and the transvaginal group in prolapse recurrence after 12 months occurred (P >0.05). No difference in QoL improvement as well as of de novo stress urinary incontinence and overactive bladder onset was found. Conclusion Single port laparoscopic sacrospinous fixation is safe and feasible in the treatment of pelvic organ prolapse. The objective of the study was to compare operative time, intraoperative blood loss, recurrence and complication rates for single port laparoscopic sacrospinous fixation SSF and transvaginal (SSF) for the primary treatment of pelvic organ prolapse. Patients undergoing surgery for pelvic organ prolapse were included in a randomized, controlled study comparing single port laparoscopic SSF or transvaginal sacrospinous fixation. The examination included operative time, intraoperative blood loss, operative complication, and pelvic organ prolapse quantification, urodynamics, ultrasound, and quality-of-life (QoL) questionnaires before and 3 and 12 months after surgery. trendelenburg. Of 20 randomized patients in Zhongnan Hospital of Wuhan University, from Jan.2018 to Mar.2019. 10 patients underwent single port laparoscopic SSF and 10 patients underwent transvaginal SSF. All the operations were completed successfully. The operative time in the single port laparoscopic group (117.0±20.0 min) was longer than the transvaginal group (75.2±24.3 min). The intraoperative blood loss (54.9±24.1 ml) was less than the transvaginal group (87.6±12.3 min). The incidence of operative complications in the single port laparoscopic group (30.0%) was lower than transvaginal group (50.0%). There were no difference between the single port laparoscopic group and the transvaginal group in prolapse recurrence after 12 months occurred (P >0.05). No difference in QoL improvement as well as of de novo stress urinary incontinence and overactive bladder onset was found. Single port laparoscopic sacrospinous fixation is safe and feasible in the treatment of pelvic organ prolapse.

Comparison of clinical efficacy of subinguinal microsurgical and single-port laparoscopic high ligation in the treatment of varicocele

Objective To compare the clinical efficacy of subinguinal microsurgical and single-port laparoscopic high ligation in the treatment of varicocele. Methods 218 patients with varicocele were enrolled in this study.According to the digital table, they were randomly divided into two group.148 cases were treated by subinguinal microscopic varicocelectomy(microscopic group), 70 cases were treated by single-port laparoscopic high ligation varicocele(single-port laparoscopic group). Postoperative follow up was 3-24months.The operative duration, length of hospital stay, hospitalization expense, postoperative complications and semen quality parameters were compared between the two groups. Results There were statistically significant differences in operative duration and hospitalization expense between the two groups(all P 0.05). In the 218 followed-up patients, the sperm concentration and motility (grade a + b sperm) all significantly improved, which of the microscopic group and single-port laparoscopic group preoperation were (19.1±8.2)×106/mL, (18.2±7.9)×106/mL and (22.7±7.8)%, (21.6±8.9)% respectively, which at 3-6 months after operation were (56.2±10.8)×106/mL, (45.8±12.9)×106/mL and (58.8±9.7)%, (44.6±10.7)%, there were statistically significant differences compared with preoperation(t=6.227, 9.579, all P<0.05). Conclusion The surgical methods in the treatment of varicocele can improve the quality of patients, but microscopic group is obviously better than single-port laparoscopic group in improvement of semen quality parameters, safety, patient-based compliance and economy. Key words: Varicocele; Microscopic; Laparoscopy