Laparoendoscopic Single-Site Surgery for Management of Ovarian Endometriomas

被引:11
作者
Bedaiwy, Mohamed A. [1 ]
Farghaly, Tarek [1 ]
Hurd, William [1 ]
Liu, James [1 ]
Mansour, Gihan [1 ]
Fader, Amanda Nickles [2 ,3 ]
Escobar, Pedro [4 ,5 ]
机构
[1] Case Western Reserve Univ, Univ Hosp, Case Med Ctr, Cleveland, OH 44106 USA
[2] Greater Baltimore Med Ctr, Dept Gynecol, Baltimore, MD USA
[3] Johns Hopkins Univ Hosp, Baltimore, MD 21287 USA
[4] Cleveland Clin, Dept OB GYN, Cleveland, OH 44106 USA
[5] Cleveland Clin, Womens Hlth Inst, Cleveland, OH 44106 USA
关键词
LESS; Endometrioma; Ovarian cystectomy; Laparoscopy; CONVENTIONAL LAPAROSCOPY; LESS PAINFUL; EVOLUTION; CANCER; RISK;
D O I
10.4293/108680813X13794522666284
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background and Objectives: To compare our initial experience in laparoscopic surgery for ovarian endometriomas performed through an umbilical incision using a single 3-channel port and flexible laparoscopic instrumentation versus traditional laparoscopy. Methods: This study was conducted in 3 tertiary care referral centers. Since September 2009, we have performed laparoendoscopic single-site surgery in 24 patients diagnosed with ovarian endometriomas. A control group of patients with similar diagnoses who underwent traditional operative laparoscopy during the same period was included (n = 28). In the laparoendoscopic single-site surgery group, a multichannel port was inserted into the peritoneum through a 1.5- to 2.0-cm umbilical incision. Results: Patients in the laparoendoscopic single-site surgery group were significantly older (P = .04) and had a higher body mass index (P = .005). Both groups were comparable regarding history of abdominal surgery, lateral pelvic side wall involvement, and cul-de-sac involvement. After we controlled for age and body mass index, the size of the resected endometriomas, duration of surgery, and amount of operative blood loss were comparable in both groups. When required, an additional 5-mm port was inserted in the right or left lower quadrant in the laparoendoscopic single-site surgery group to allow the use of a third instrument for additional tissue retraction or manipulation ( 10 of 24 patients, 41.6%). However, adhesiolysis was performed more frequently in the conventional laparoscopy group. The duration of hospital stay was <24 hours in both groups. No intraoperative complications were encountered. All incisions healed and were cosmetically satisfactory. Conclusion: The laparoendoscopic single-site surgery technique is a reasonable initial approach for the treatment of endometriomas. In our experience, an additional side port is usually needed to treat pelvic side wall and cul-de-sac endometriosis that often accompanies endometriomas.
引用
收藏
页码:191 / 196
页数:6
相关论文
共 30 条
[1]  
American Congress of Obstetricians and Gynecologists, 2007, ACOG PRACTICE B
[2]   Laparoendoscopic Single-Site Surgery in Patients with Benign Adnexal Disease: A Comparative Study [J].
Bedaiwy, Mohamed A. ;
Starks, David ;
Hurd, William ;
Escobar, Pedro F. .
GYNECOLOGIC AND OBSTETRIC INVESTIGATION, 2012, 73 (04) :294-298
[3]   Female population perception of conventional laparoscopy, transumbilical LESS, and transvaginal NOTES for cholecystectomy [J].
Bucher, Pascal ;
Ostermann, Sandrine ;
Pugin, Francois ;
Morel, Philippe .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2011, 25 (07) :2308-2315
[4]   Transumbilical Single-Port Surgery: Evolution and Current Status [J].
Canes, David ;
Desai, Mihir M. ;
Aron, Monish ;
Haber, Georges-Pascal ;
Goel, Raj K. ;
Stein, Robert J. ;
Kaouk, Jihad H. ;
Gill, Inderbir S. .
EUROPEAN UROLOGY, 2008, 54 (05) :1020-1030
[5]   Laparo-Endoscopic Single Site (LESS) versus Standard Laparoscopic Left Donor Nephrectomy: Matched-pair Comparison [J].
Canes, David ;
Berger, Andre ;
Aron, Monish ;
Brandina, Ricardo ;
Goldfarb, David A. ;
Shoskes, Daniel ;
Desai, Mihir M. ;
Gill, Inderbir S. .
EUROPEAN UROLOGY, 2010, 57 (01) :95-101
[6]   Laparoscopic management of early uterine cancer: 10-year experience in Asan Medical Center [J].
Cho, Yun-Hyun ;
Kim, Dae-Yeon ;
Kim, Jong-Hyeok ;
Kim, Yong-Man ;
Kim, Young-Tak ;
Nam, Joo-Hyun .
GYNECOLOGIC ONCOLOGY, 2007, 106 (03) :585-590
[7]   Laparoendoscopic single-site (LESS) surgery in patients with benign adnexal disease [J].
Escobar, Pedro F. ;
Bedaiwy, Mohamed A. ;
Fader, Amanda Nickles ;
Falcone, Tommaso .
FERTILITY AND STERILITY, 2010, 93 (06) :2074.e7-2074.e10
[8]   Single-port risk-reducing salpingo-oophorectomy with and without hysterectomy: Surgical outcomes and learning curve analysis [J].
Escobar, Pedro F. ;
Starks, David C. ;
Fader, Amanda Nickles ;
Barber, Matthew ;
Rojas-Espalliat, Luis .
GYNECOLOGIC ONCOLOGY, 2010, 119 (01) :43-47
[9]   Robotic-Assisted Laparoendoscopic Single-Site Surgery in Gynecology: Initial Report and Technique [J].
Escobar, Pedro F. ;
Fader, Amanda Nickles ;
Paraiso, Marie Fidel ;
Kaouk, Jihad H. ;
Falcone, Tommaso .
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, 2009, 16 (05) :589-591
[10]   Laparoendoscopic single-site surgery (LESS) in gynecologic oncology: Technique and initial report [J].
Fader, Amanda Nickles ;
Escobar, Pedro F. .
GYNECOLOGIC ONCOLOGY, 2009, 114 (02) :157-161