Advantages of Single-Port Laparoscopic Myomectomy Compared with Conventional Laparoscopic Myomectomy: A Randomized Controlled Study

Kim, Seul Ki; Kim, Kidong; Lee, Jung Ryeol; Suh, Chang Suk; Kim, Seok Hyun

doi:10.1016/j.jmig.2017.08.651

Cited by 29 publications

(30 citation statements)

References 27 publications

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“…In our study, the mean number of myoma in a single patient was 3.84 ± 2.45, which is comparable to previous studies [18,19,[21][22][23][24][25] , which range from 1-5. However, in one patient in our study, 10 myomas were removed in the same operation, which we believe is the most reported in the literature in a single-port laparoscopic myomectomy.…”

Section: Discussionsupporting

confidence: 90%

“…Table 5. Comparison of surgical outcomes with previous published studies [18,19,[21][22][23][24] *Immediately arrive ward after operation; **24 hours later. VAS: visual analogue score…”

Section: Discussionmentioning

confidence: 94%

“…Its use in myomectomy is limited to advanced laparoscopic surgeons due to the difficulty of multiple suturing and tying [7] . However, there are more and more reports on the feasibility and safety of this difficult method [18][19][20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

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Single-port laparoscopic myomectomy in the virgin womb - a retrospective analysis of 31 consecutive cases

Tang¹

2020

MIS

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How to cite this article: Tang FH. Single-port laparoscopic myomectomy in the virgin womb -a retrospective analysis of 31 consecutive cases. Mini-invasive Surg 2020;4:24. http://dx. AbstractAim: We aimed to evaluate the feasibility of single-port laparoscopic myomectomy in the virgin womb. Methods:A retrospective chart review of 31 consecutive cases between November 2017 and October 2019 performed by a single surgeon was performed. Results:The mean age of patient was 50.10 ± 7.79 years old. The mean BMI was 23.55 ± 4.36 kg/m 2 . The mean number of myoma in single patient was 3.84 ± 2.45 pieces. The mean maximum diameter of myoma in single patient was 11.24 ± 3.27 cm. The mean operation time was 182.32 ± 52.39 min. The mean blood loss was 231.77 ± 238.90 mL. The Visual Analogue Score (VAS) of pain when immediately arriving at the ward after operation was 2.32 ± 1.60. The VAS after 24 h dropped to 1.23 ± 1.43. In total, 119 myomas were removed in our study. There were 15 (48.4%) women with more than four myomas. Fifteen (48.4%) women had more than two myomas that were > 5 cm. There were 58 (48.74%) intramural myomas, with mean diameter of 6.72 ± 4.41 cm. Fifty-two (43.70%) subserous type myoma were removed with mean diameter 2.58 ± 3.35 cm. Posterior myoma accounted for five (4.20%) pieces with mean diameter of 9.30 ± 4.49 cm. The broad ligament type myoma accounted for four pieces (3.36%), and the mean diameter was 3.74 ± 1.87 cm. There were 51 (42.9%) myomas > 5 cm in diameter. Among the different types of myoma, there were 36 (62.1%) intramural type and 6 (11.5%) subserous type, and all posterior and broad ligament type were > 5 cm in diameter. The blood loss and operation time showed no relationship to myoma number. There were differences in blood loss (P = 0.0359) and operation time (P = 0.0537) based on the maximum diameter of myoma. No learning curve was noted in the cumulative sum control chart analysis of the 31 consecutive cases. Conclusion:In our 31 consecutive cases, the operation time, blood loss, and postoperative VAS score were all comparable to the previously published literature for single-port laparoscopic myomectomy. It is feasible for virgin women with symptomatic myoma to receive single-port laparoscopic myomectomy.

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Section: Discussionsupporting

confidence: 90%

“…Table 5. Comparison of surgical outcomes with previous published studies [18,19,[21][22][23][24] *Immediately arrive ward after operation; **24 hours later. VAS: visual analogue score…”

Section: Discussionmentioning

confidence: 94%

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Single-port laparoscopic myomectomy in the virgin womb - a retrospective analysis of 31 consecutive cases

Tang¹

2020

MIS

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“…2 Especially for women who want to retain the uterus and fertility, if surgery is required, uterine myomectomy must be performed without removing the entire uterus. 3 Therefore, the laparoscopic myomectomy under general anesthesia is a preferred option for uterine myoma treatment instead of laparotomy. 4,5 Compared with laparotomy, laparoscopic surgery shows many advantages, such as lower perioperative morbidity, quicker recovery, and shorter hospital stay without reducing efficacy.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>Effects of Additional Intraoperative Administration of Sufentanil on Postoperative Pain, Stress and Inflammatory Responses in Patients Undergoing Laparoscopic Myomectomy: A Double-Blind, Randomized, Placebo-Controlled Trial</p>

Li¹,

Cao²,

Zhao³

et al. 2020

JPR

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Purpose: Although pain after laparoscopic surgery is assumed to be minor, many women still suffer from unexpected postoperative pain. Thus, we aimed to assess whether additional intraoperative administration of sufentanil could help to improve postoperative pain and related agitation, stress, and inflammation response in patients undergoing laparoscopic myomectomy. Patients and Methods: Forty female patients with uterine myoma scheduled for laparoscopic myomectomy under general anesthesia were randomized to receive sufentanil (group T, n=20) or normal saline (group C, n=20) 1h before the end of the surgery. The postoperative pain, agitation, stress, inflammation, and adverse effects were measured. Results: As the primary outcome, the visual analog scale (VAS) pain score was significantly reduced in group T as compared with group C at each measured time point in a postanesthesia care unit (PACU), VAS 5 min (31.5 ± 2.7 vs 40.6 ± 5.6) (P<0.001), VAS 30 min (36.5 ± 4.5 vs 46.0 ± 2.9) (P<0.001), VAS 1h (37.8 ± 4.0 vs 48.6 ± 5.5) (P<0.001). The secondary outcomes, including the sedation agitation scale (SAS) scores, plasma concentrations of epinephrine and norepinephrine, and the levels of plasma interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-α) in group T were remarkably lower than those in group C (P < 0.001). The cough cases in group T also showed a significant reduction in comparison with group C (P < 0.05). In addition, the anesthetic recovery time, including the spontaneous breathing recovery time and extubation time, were not significantly different between the two groups, as were the cases of respiratory depression and postoperative delirium (P > 0.05). Conclusion: For patients undergoing laparoscopic myomectomy, administration of sufentanil 1 h before the end of surgery shows excellent analgesic and sedative effects, alleviated postoperative stress and inflammatory responses, reduced incidence of cough, without prolonging anesthetic recovery time and increasing adverse reactions.

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Two-port robotic hysterectomy: a novel approach

2018

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The objective of the study was to demonstrate a novel technique for two-port robotic hysterectomy with a particular focus on the challenging portions of the procedure. The study is designed as a technical video, showing step-by-step a two-port robotic hysterectomy approach (Canadian Task Force classification level III). IRB approval was not required for this study. The benefits of minimally invasive surgery for gynecological pathology have been clearly documented in multiple studies. Patients had fewer medical and surgical complications postoperatively, better cosmesis and quality of life. Most gynecological surgeons require 3-5 ports for the standard gynecological procedure. Even though the minimally invasive multiport system provides an excellent safety profile, multiple incisions are associated with a greater risk for morbidity including infection, pain, and hernia. In the past decade, various new methods have emerged to minimize the number of ports used in gynecological surgery. The interventions employed were a two-port robotic hysterectomy, using a camera port plus one robotic arm, with a focus on salpingectomy and cuff closure. We describe a transvaginal and a transabdominal approach for salpingectomy and a novel method for cuff closure. The transvaginal and transabdominal techniques for salpingectomy for two-port robotic-assisted hysterectomy provide excellent tension and exposure for a safe procedure without the need for an extra port. We also describe a transvaginal technique to place the vaginal cuff on tension during closure. With the necessary set of skills on a carefully chosen patient, two-port robotic-assisted total laparoscopic hysterectomy is a feasible procedure.

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Advantages of Single-Port Laparoscopic Myomectomy Compared with Conventional Laparoscopic Myomectomy: A Randomized Controlled Study

Abstract: SP-LM is associated with more favorable cosmetic outcomes and better patient satisfaction compared with CLM. There were no differences in operative outcomes and complications between the 2 modalities.

Cited by 29 publications

References 27 publications

Single-port laparoscopic myomectomy in the virgin womb - a retrospective analysis of 31 consecutive cases

Single-port laparoscopic myomectomy in the virgin womb - a retrospective analysis of 31 consecutive cases

<p>Effects of Additional Intraoperative Administration of Sufentanil on Postoperative Pain, Stress and Inflammatory Responses in Patients Undergoing Laparoscopic Myomectomy: A Double-Blind, Randomized, Placebo-Controlled Trial</p>

Two-port robotic hysterectomy: a novel approach

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