| 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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Seong Nam Park, Gi Youn Hong, Hoon Young Kim, Byoung Ryun Kim, Cheol Lee |
1Department of Obstetrics and Gynecology, University of Wonkwang College of Medicine, Iksan, Korea. brkim21@lycos.co.kr
2Department of Anestheology and Pain Medicine, University of Wonkwang College of Medicine, Iksan, Korea. |
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| Abstract |
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. |
| Key Words:
Single-port access, Three-port access, Laparoscopically assisted vaginal hysterectomy, Patients' satisfaction |
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