Laparoendoscopic single-site (LESS) surgery in patients with benign adnexal disease

被引:84
作者
Escobar, Pedro F. [1 ,2 ]
Bedaiwy, Mohamed A. [2 ,3 ]
Fader, Amanda Nickles [2 ,4 ,5 ]
Falcone, Tommaso [2 ]
机构
[1] Cleveland Clin, Gynecol Oncol Sect, Dept OB Gyn, Cleveland, OH 44195 USA
[2] Cleveland Clin, Womens Hlth Inst, Cleveland, OH 44195 USA
[3] Case Western Reserve Univ, Univ Hosp Case Med Ctr, Cleveland, OH 44106 USA
[4] Greater Baltimore Med Ctr, Gynecol Oncol Sect, Baltimore, MD USA
[5] Johns Hopkins Med Inst, Baltimore, MD 21205 USA
关键词
LESS; single-port laparoscopy; adnexectomy; endometriosis;
D O I
10.1016/j.fertnstert.2009.11.034
中图分类号
R71 [妇产科学];
学科分类号
100211 [妇产科学];
摘要
Objective: To present our initial experience in laparoscopic surgery for benign adnexal disease performed exclusively through an umbilical incision using a single three-channel port and flexible laparoscopic instrumentation. Design: Case report. Setting: Tertiary-care referral center. Patient(s): Since November, 2008, we have performed single-port laparoscopic surgery in nine patients diagnosed with benign adnexal disease. Patients with adnexal masses or endometriosis and a body mass index of <35 kg/m(2) were selected. Intervention(s): Laparoendoscopic single-site (LESS) surgery. In each case, a multichannel port was inserted into the peritoneum through a 1.5-2.0-centimeter umbilical incision. Main Outcome Measures: Feasibility, postoperative pain score, age, BMI, estimated blood loss. Result(s): Eight of nine cases were completed successfully, without conversion to a standard laparoscopic approach or to laparotomy. An additional 3 mm extraumbilical port was required in one patient with stage 4 endometriosis. Seven out of nine patients had earlier abdominal surgery. The operative blood loss ranged from minimal to 75 mL. Duration of hospital stay was <24 hours in all cases. Minimal use of postoperative narcotics was required, and no intraoperative complications occurred. Conclusion(s): The LESS surgery for benign adnexal disease is feasible in patients with or without earlier surgery. Additional investigation is needed to evaluate the safety and long-term outcomes of this new approach. (Fertil Steril (R) 2010;93:2074.e7-e10. (C) 2010 by American Society for Reproductive Medicine.)
引用
收藏
页码:2074.e7 / 2074.e10
页数:4
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