Surgical outcomes of a new approach to laparoscopic myomectomy: single-port and modified suture technique

Abstract

Study objective: To introduce a new technique of laparoscopic myomectomy (LM) using single-port access and a modified suture technique.

Design: Retrospective review of medical records.

Setting: University medical center.

Patients: From 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.

Interventions: Medical 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 results: Age, 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.

Conclusion: Choi'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.

Keywords: Laparoscopic myomectomy; Myoma; Single-port myomectomy.