Feasibility of laparoscopically assisted extracorporeal cystectomy via single suprapubic incision, using an adjustable-view laparoscope to treat large benign ovarian cysts: comparison with conventional procedure

Objective: To demonstrate the feasibility of minimally invasive surgery using a novel optical device to treat large benign ovarian cysts and to compare the safety of the procedure with that of conventional laparoscopically assisted multiport extracorporeal cystectomy. Study design: Twenty-one patients with large benign ovarian cysts underwent laparoscopically assisted extracorporeal ovarian cystectomy via a single suprapubic incision using a novel 10-mm rigid laparoscope with an adjustable direction of view and a multiport device, between October 2010 and July 2012. The surgical outcomes were retrospectively compared between these patients (Group A) and 32 patients who underwent the conventional 3-port laparoscopically assisted extracorporeal procedure between January 2009 and September 2010 (Group B). Data were statistically analyzed using the Mann-Whitney U-test or Fisher's exact test. Results: None of Group A required conversion to conventional multiport laparoscopy. The total duration of surgery, elapsed time between skin incision and the start of pneumoperitoneum, and time required for intra- and extra-corporeal manipulations did not significantly differ between the groups. The time required for skin closure, however, was significantly decreased in Group A compared with Group B (13.0 +/- 3.5 vs. 20.2 +/- 4.8 min, P = 0.005). The volume of blood loss and postoperative blood findings were similar to those associated with the conventional procedure. Postoperative visual analog pain scales at 3 h were significantly lower in Group A than in Group B (3.7 +/- 2.6 vs. 4.8 +/- 2.0, P = 0.04). Postoperative complications did not arise after either procedure. Conclusion: Laparoscopically assisted extracorporeal cystectomy via a single suprapubic incision is a feasible and safe alternative to conventional multiport cystectomy for treating large benign ovarian cysts. (C) 2013 Elsevier Ireland Ltd. All rights reserved.