Single Port Access Laparoscopic Adnexal Surgery

Study Objective: To estimate the feasibility, safety, and operative outcomes for the management of adnexal masses by single port access (SPA) laparoscopy with a wound retractor and a surgical glove. Design: A prospective single-center study (Canadian Task Force classification III). Setting: University hospital. Patients: Twenty-four well selected patients with adnexal masses on imaging scans recruited from June 2008 through January 2009. Interventions: Single port access laparoscopic adnexal surgery. Measurements and Main Results: Single port access laparoscopic adnexal surgery was successfully completed in 22 of 24 patients. The median age of the patients was 45 years (range 23-63 years), and the median body mass index was 22 (range 1829). The median tumor size was 5 cm (range 3-12 cm). The median operative time was 70 minutes (range 40-128 minutes). The estimated blood loss was minimal (range 10-100 mL). The postoperative course was uneventful in all patients. The median postoperative hospital stay was I day (range 1-3 days). No postoperative complications were observed at follow-up. The 2 failed cases were as follow: I required an additional trocar for adequate adhesiolysis, and the other a staging laparotomy because of the finding of a borderline ovarian malignancy on frozen section pathologic study. Conclusion: The single port access laparoscopic adnexal surgery was safe and feasible and provided almost no visual scar. Journal of Minimally Invasive Gynecology (2009) 16, 612-615 (C) 2009 AAGL. All rights reserved.