Laparoendoscopic single-site myomectomy versus conventional laparoscopic myomectomy: a comparison of surgical outcomes

Abstract

Study objective: The objective of this study was to evaluate laparoendoscopic single-site myomectomy (LESS-M) for the surgical treatment of fibroids and to compare surgical outcomes and postoperative pain with conventional laparoscopic myomectomy (CLM).

Design: Retrospective study.

Setting: University-based hospital.

Patients: Data were obtained from medical records of patients who underwent LESS-M between August 2011 and June 2012. Considering the surgeon's learning curve for LESS-M, we collected the data after 100 LESS-M procedures were performed. The cases were compared with a historic cohort of patients who underwent CLM performed by the same surgeon between July 2008 and May 2009. A single experienced surgeon performed both procedures in all patients. A total of 118 patients who underwent LESS-M or CLM were included in the study (59 in the LESS-M group and 59 in the CLM group).

Interventions: None.

Measurements and main results: We analyzed and compared patient basal characteristics and surgical outcomes between the 2 groups. There were no statistically significant differences in basal characteristics (i.e., age, body mass index, number and size of myomas, and type of the largest myoma) between the 2 groups. The surgical outcomes (i.e., operative time, estimated blood loss, postoperative hemoglobin drop, postoperative hospital stay, and postoperative pain scores) were not different statistically between the 2 groups. Moreover, patients did not experience major intraoperative complications. Postoperative complications were wound infections that occurred in 3 patients (2 in the LESS-M and 1 in the CLM groups).

Conclusion: LESS-M is feasible for less than 5 myomas and offers comparable surgical outcomes with those of CLM after the surgeon's initial learning curve.

Keywords: Laparoendoscopic single-site surgery; Laparoscopic myomectomy; Myoma; Myomectomy; Single port.