KMID : 0358420100530070633
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Korean Journal of Obstetrics and Gynecology 2010 Volume.53 No. 7 p.633 ~ p.639
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Evaluation of 110 cases of single-port access Laparoscopically assisted vaginal hysterectomy (SPA-LAVH) and comparison with multi-port access
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Park Byung-Joon
Kim Yong-Wook Ro Duck-Yeong Kim Tae-Eung Ryu Ki-Sung Kim Jang-Heub
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Abstract
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Objective: To evaluate the safety and feasibility of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) using conventional laparoscopic instruments compared to multi-port access laparoscopically assisted vaginal hysterectomy (MPA-LAVH).
Methods: We reviewed the medical records of 220 patients with uterine leiomyoma or adenomyosis who underwent 110 SPA-LAVH and 110 MPA-LAVH in Incheon St. Mary¡¯s Hospital between April 2007 and November 2009. We performed SPA-LAVH with conventional rigid straight laparoscopic instruments in all cases. We also performed a new vaginal cuff closure method, Kim¡¯s Vaginal Vault Suspension Method, named after the operator (Kim, YW) in both SPA-LAVH and MPA-LAVH.
Results: There was no significant difference in patients¡¯ age, operating time, uterine weight, hemoglobin change, frequency of blood transfusion, and incidence of postoperative fever between the two groups. The patients¡¯ mean age was 46.1¡¾7.0 years (SPA-LAVH) and 45.5¡¾6.3 years (MPA-LAVH). The mean operating time was 87.2¡¾21.0 minutes (SPA-LAVH) and 83.3¡¾20.3 minutes (MPA-LAVH). The mean uterine weight was 261.4¡¾139.7 g (SPA-LAVH) and 257.8¡¾132.9 g (MPA-LAVH). The mean hemoglobin change was 1.1¡¾0.7 g/dL (SPA-LAVH) and 1.2¡¾0.6 g/dL (MPA-LAVH). Neither bowel injury nor urinary tract injury occurred during the operation in the two groups. One of the SPA-LAVH and one of the MPA-LAVH cases were converted to abdominal total hysterectomy. The mean hospital stay time was shorter with SPA-LAVH (2.6¡¾0.6 days [SPA-LAVH] and 3.3¡¾0.7 days [MPA-LAVH], P<0.05).
Conclusion: SPA-LAVH using conventional rigid straight laparoscopic instruments can be offered as a safe and feasible alternative to MPA-LAVH.
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KEYWORD
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Single-port access, Multi-port access, Laparoscopically assisted vaginal hysterectomy, Conventional laparoscopic instruments
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