Is single-port laparoscopy for benign adnexal disease less painful than conventional laparoscopy? A single-center randomized controlled trial

Objective: To determine whether laparo-endoscopic single-site surgery (LESS) results in less postoperative pain and a better cosmetic surgical scar compared with conventional laparoscopy. Design: Prospective randomized controlled trial. Setting: A county hospital in Norway. Patient(s): Forty women with benign adnexal disease or a hereditary cancer risk scheduled for laparoscopic adnexal surgery. Intervention(s): LESS or conventional laparoscopy. Main Outcome Measure(s): Postoperative pain 24 hours after surgery. Result(s): There was no difference in pain at 24 hours after surgery, with a mean score of 3.0 (SD 2.1) in the LESS group and 2.5 (SD 1.5) in the conventional laparoscopy group. Significantly more shoulder tip pain was reported by women undergoing LESS compared with those having conventional surgery at 6 and 24 hours after surgery. A high satisfaction with the cosmetic result was reported in both groups, with no significant difference in the Manchester scar scale score. Conclusion(s): Although similar levels of postoperative pain are experienced by women having LESS and conventional laparoscopic surgery, women having LESS report significantly more shoulder tip pain compared to those having conventional laparoscopic surgery. This may relate to a significantly longer operation time in the LESS group. Clinical Trial Registration Number: NCT01288599. (Fertil Steril (R) 2012;98:973-9. (C)2012 by American Society for Reproductive Medicine.)