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. 2020 Oct-Dec;24(4):e2020.00045.
doi: 10.4293/JSLS.2020.00045.

Single-Port vs. Conventional Multi-Port Laparoscopic Lymph Node Biopsy

Marco Casaccia  1 , Rosario Fornaro  1 , Francesco Saverio Papadia  1 , Tommaso Testa  1 , Matteo Mascherini  1 , Adalberto Ibatici  2 , Chiara Ghiggi  2 , Stefania Bregante  2 , Franco De Cian  1
Affiliations

Single-Port vs. Conventional Multi-Port Laparoscopic Lymph Node Biopsy

Marco Casaccia et al. JSLS. 2020 Oct-Dec.

Abstract

Background and objectives: The purpose of the investigation was to compare clinical results and diagnostic accuracy for conventional multiport laparoscopic lymph node biopsy (MPLB) and single-port laparoscopic lymph node biopsy (SPLB) operations at a single institution.

Methods: A set of 20 SPLB patients operated on from October 2016 to May 2019 were compared to an historical series of 35 MPLB patients. Primary endpoints were the time of surgery, estimated blood loss, surgical conversion, length of stay and morbidity. The secondary endpoint was the diagnostic accuracy of the technique.

Results: SPLB was completed laparoscopically in all cases. Two MPLB patients (5.7%) experienced a surgical conversion due to intraoperative difficulties. Duration of surgery was similar in SPLB and MPLB groups respectively (84 ± 31.7 min vs. 81.1 ± 22.2; P = .455). A shorter duration of hospital stay was shown for patients operated on by SPLB compared to the MPLB group (1.7 ± 0.9 days vs. 2.1 ± 1.2 days; P = .133). The postoperative course was uneventful in both groups. In 95% of the SPLB and 97.1% of the MPLB cases respectively, LLB achieved the necessary information for the diagnosis.

Conclusion: SPLB has shown good procedural and postoperative outcomes as well as a high diagnostic yield, comparable to traditional MPLB. Therefore, our results show that this approach is safe and effective and can be an equally valid option to MPLB to obtain a diagnosis or to follow the progression of a lymphoproliferative disease. Further studies are necessary to support these results before its widespread adoption.

Keywords: Abdominal biopsy; Laparoscopy; Lymph node; Lymphoma.

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Conflict of interest statement

Conflicts of Interest: The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Intra-operative view. Gastric suspension through trans abdominal sutures passed on the greater curvature, according to the “puppeteering technique”.
Figure 2.
Figure 2.
The four-channel Unimax single-port device positioned at the umbilicus for a laparoscopic procedure in case of submesocolic lymphadenopathy.
See this image and copyright information in PMC

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