Single port access laparoscopic adnexal surgery

Abstract

Study objective: To estimate the feasibility, safety, and operative outcomes for the management of adnexal masses by single port access (SPA) laparoscopy with a wound retractor and a surgical glove.

Design: A prospective single-center study (Canadian Task Force classification III).

Setting: University hospital.

Patients: Twenty-four well selected patients with adnexal masses on imaging scans recruited from June 2008 through January 2009.

Interventions: Single port access laparoscopic adnexal surgery.

Measurements and main results: Single port access laparoscopic adnexal surgery was successfully completed in 22 of 24 patients. The median age of the patients was 45 years (range 23-63 years), and the median body mass index was 22 (range 18-29). The median tumor size was 5 cm (range 3-12 cm). The median operative time was 70 minutes (range 40-128 minutes). The estimated blood loss was minimal (range 10-100mL). The postoperative course was uneventful in all patients. The median postoperative hospital stay was 1 day (range 1-3 days). No postoperative complications were observed at follow-up. The 2 failed cases were as follow: 1 required an additional trocar for adequate adhesiolysis, and the other a staging laparotomy because of the finding of a borderline ovarian malignancy on frozen section pathologic study.

Conclusion: The single port access laparoscopic adnexal surgery was safe and feasible and provided almost no visual scar.