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KMID : 0358420120550010022
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Korean Journal of Obstetrics and Gynecology
2012 Volume.55 No. 1 p.22 ~ p.28
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A comparison of single-port laparoscopically assisted vaginal hysterectomy using transumbilical SILS port access and three-port laparoscopically assisted vaginal hysterectomy
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Park Seong-Nam
Hong Kee-Yeon
Kim Hun-Young
Kim Byoung-Ryun
Lee Cheol
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Abstract
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Objective: The purpose of this study was to compare surgical outcomes and patients’ satisfaction between single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) and conventional three-port access LAVH (TPA-LAVH) group.
Methods: A prospective analysis was performed in patients who underwent laparoscopically assisted vaginal hysterectomy at a Wonkwang University Hospital between April 2010 and May 2011, a total of 138 women were enrolled in this study. One of these procedures was chosen by patient and was performed with their consent. Sixty-five women underwent SPA-LAVH using transumbilical SILS port access (SPA-LAVH group), and 73 women underwent conventional three-port LAVH (TPA-LAVH group).
Results: There were no statistical differences between groups in the patients’ demographic characteristics, mean operating time (93.4 ± 20.2 minutes vs. 95.1 ± 28.7 minutes, P = 0.696), postoperative changes in hemoglobin concentration (1.91 ± 0.68 vs. 1.85 ± 0.87 g/dL, P = 0.667), weight of the resected uterus (261.7 ± 205.3 g vs. 311.8 ± 268.3 g, P = 0.225), hospital stay (5.9±0.9 day vs. 6.4±1.6 day, P = 0.063), the rate of using an additional trocar (1.5% vs. 0%, P = 0.471), the rate of conversion to laparotomy (0% vs. 4.1%, P = 0.098) and postoperative pain scores (visual analogue scale) for 48 hours. However, patients’ satisfaction after 6 weeks later was significantly greater in SPA-LAVH group than in conventional group, as evidenced by higher rate of fairly satisfactory (52.3% vs. 34.2%, P = 0.032) and very satisfactory (33.8% vs. 17.8%, P = 0.031).
Conclusion: SPA-LAVH using transumbilical SILS port access is comparable with TPA-LAVH in women undergoing LAVH. However, SPA-LAVH is better than TPA-LAVH in terms of satisfaction of patient.
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KEYWORD
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Single-port access, Three-port access, Laparoscopically assisted vaginal hysterectomy, Patients’ satisfaction
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