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. 2015 Sep 15;8(9):14992-8.
eCollection 2015.

Single-incision multiport laparoscopy versus multichannel-tipped single port laparoscopy in gynecologic surgery: outcomes and benefits

Mingzhi Zhao  1 , Jing Zhao  1 , Keqin Hua  1 , Zhiling Zhu  1 , Changdong Hu  1
Affiliations

Single-incision multiport laparoscopy versus multichannel-tipped single port laparoscopy in gynecologic surgery: outcomes and benefits

Mingzhi Zhao et al. Int J Clin Exp Med. .

Abstract

Objective: To estimate the feasibility and safety of single-incision multiport laparoscopy (SIMPL) used in patients who underwent laparoendoscopic single-site surgery (LESS) for gynecologic disease, and the cosmetic outcome and economic benefit compared with multichannel-tipped single port laparoscopy (MSPL).

Intervention: We underwent LESS via a single 2.5- to 3.0-cm umbilical incision with the Single-Incision Multiport Laparoscopic Surgery Trocar available on the market, briefly named MSPL. Since January 2014, we improved the procedure and named SIMPL. In SIMPL group, two traditional laparoscopic trocar (diameter=5 mm) and one mini-laparoscopic trocar (diameter =3 mm) were inserted into the peritoneum separately through a single 1.5- to 1.8-cm umbilical transcutaneous incision. Subject demographics and clinical variables were collected and perioperative outcomes analyzed. In addition, the size of umbilicus was measured in all patients prior to the operation and the levels of cosmetic satisfaction were evaluated at 4 weeks after surgery.

Measurements and main results: From January 2014 to December 2014, there were 32 patients who underwent SIMPL for ovarian cystectomy. Hospital cost was significantly lower in SIMPL group compared with MSPL group (RMB 10207.0 vs 17973.7 yuan), P<0.001. Compared with MSPL group, the SIMPL group reported significantly higher cosmetic satisfaction at 4 weeks afer surgery (P<0.1). Besides, the SIMPL procedures performed in benign gynecologic surgery were myomectomy (n=8), salpingpoophorectomy (n=2), salpingectomy (n=5), adhesiolysis and fimbrioplasty (n=32), ovarian drilling (n=3), salpingotomy for ectopic pregnancy (n=3). All surgeries were completed successfully without conversion to the traditional laparoscopic approach. Two postoperative complications occurred were delay healing of umbilicus incision after myomectomy. The cosmetic satisfactory rate was 100%.

Conclusion: According to our experience, SIMPL is safe and efficient for simple gynecologic operation, with lower cost and better cosmetic results than MSPL. Beyond cosmetic and economic results, further randomized studies are needed to identify a possible benefit.

Keywords: Laparoendoscopic single-site surgery (LESS); benign gynecologic disease; multichannel-tipped single port laparoscopy (MSPL); single-incision multiport laparoscopy (SIMPL).

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Figures

Figure 1
Figure 1
MSPL Trocar (Innovex Medical C0., Ltd.).
Figure 2
Figure 2
Single-Incision Multiport for SIMPL.
Figure 3
Figure 3
Postoperative Scar of MSPL.
Figure 4
Figure 4
Postoperative Scar of SIMPL.
Figure 5
Figure 5
Endotracheal Tube.
Figure 6
Figure 6
The balloon part of the endotracheal tube as an external element.
See this image and copyright information in PMC

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