Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jun;74(3):843-855.
doi: 10.1007/s13304-022-01248-y. Epub 2022 Apr 2.

Ultra-minimally invasive surgery in gynecological patients: a review of the literature

Marco La Verde  1 , Gaetano Riemma  2 , Alessandro Tropea  3 , Antonio Biondi  4 , Stefano Cianci  5
Affiliations
Review

Ultra-minimally invasive surgery in gynecological patients: a review of the literature

Marco La Verde et al. Updates Surg. 2022 Jun.

Abstract

In the last decade, Ultra-minimally invasive surgery (UMIS) including both minilaparoscopic (MH) and percutaneous (PH) endoscopic surgery achieved widespread use around the world. Despite UMIS has been reported as safe and feasible surgical procedure, most of the available data are drawn from retrospective studies, with a limited number of cases and heterogeneous surgical procedures included in the analysis. This literature review aimed to analyze the most methodologically valid studies concerning major gynecological surgeries performed in UMIS. A literature review was performed double blind from January to April 2021. The keywords 'minilaparoscopy'; 'ultra minimally invasive surgery'; '3 mm'; 'percutaneous'; and 'Hysterectomy' were selected in Pubmed, Medscape, Scopus, and Google scholar search engines. PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines were followed for the drafting of the systematic review. The systematic literature research provided 298 studies, of which 9 fell within the inclusion criteria. Two hundred ninety-six total patients were included, 148 for both PH and MH groups. Median age (48 years), BMI (24 kg/m2), OT (90 min), EBL (50 ml), time to discharge (1 day), self scar evaluation (10/10), and VAS (3/10) were reported. The most frequent intraoperative complication in both the PH and MH groups was surgical bleeding. The UMIS approaches were feasible and safe even for complex gynecological procedures. Operative times and complications were superimposable to the "classical" minimally invasive approaches reported in the literature. The reported results apply only to experienced surgeons.

Keywords: Endoscopic surgery; Minimally invasive surgery; Percutaneous approach; Ultra-minimally invasive.

PubMed Disclaimer

Conflict of interest statement

None of the authors have a conflict of interest to disclose.

Figures

Fig. 1
Fig. 1
Flow diagram of the study
Fig. 2
Fig. 2
Pooled analysis for laparotomic conversions
Fig. 3
Fig. 3
Pooled analysis for complications
See this image and copyright information in PMC

References

    1. Gallotta V, Conte C, Giudice MT, Nero C, Vizzielli G, Gueli Alletti S, et al. Secondary laparoscopic cytoreduction in recurrent ovarian cancer: a large, single-institution experience. J Minim Invasive Gynecol. 2018;25(4):644–650. doi: 10.1016/j.jmig.2017.10.024. - DOI - PubMed
    1. Fagotti A, Costantini B, Gallotta V, Cianci S, Ronsini C, Petrillo M, et al. Minimally invasive secondary cytoreduction plus HIPEC versus open surgery plus HIPEC in isolated relapse from ovarian cancer: a retrospective cohort study on perioperative outcomes. J Minim Invasive Gynecol. 2015;22(3):428–432. doi: 10.1016/j.jmig.2014.11.008. - DOI - PubMed
    1. Vitale SG. The biopsy snake grasper sec. VITALE: a new tool for office hysteroscopy. J Minim Invasive Gynecol. 2019 doi: 10.1016/j.jmig.2019.12.014. - DOI - PubMed
    1. Vitale SG, Lagana AS, Caruso S, Garzon S, Vecchio GM, La Rosa VL, et al. Comparison of three biopsy forceps for hysteroscopic endometrial biopsy in postmenopausal patients (HYGREB-1): a multicenter, single-blind randomized clinical trial. Int J Gynaecol Obstetr. 2021 doi: 10.1002/ijgo.13669. - DOI - PubMed
    1. Cianci S, Riemma G, Ronsini C, De Franciscis P, Torella M, Schiattarella A, et al. Hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer recurrence: systematic review and meta-analysis. Gland Surg. 2020;9(4):1140. doi: 10.21037/gs-20-335. - DOI - PMC - PubMed