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Eom, Roh, Lee, Joo, Lee, You, and Yoo: Transumbilical single-port access laparoscopic surgery of ectopic pregnancy
Original Article
Korean Journal of Obstetrics and Gynecology

Korean Journal of Obstetrics and Gynecology 2010; 53(8): 720-726.

Published online: 19 August 2010

DOI: https://doi.org/10.0000/kjog.2010.53.8.720

Transumbilical single-port access laparoscopic surgery of ectopic pregnancy

Jeong Min Eom, M.D.1, Hyun Jin Roh, M.D.2, Soo Jeong Lee, M.D.2, Won Duk Joo, M.D.2, Mi Young Lee, M.D.1, Rae Mi You, M.D.1, Hang Jo Yoo, M.D.2

1Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

2Department of Obstetrics and Gynecology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Corresponding author (dryu0210@naver.com)

Received 12 April 2010       Accepted 16 July 2010

Copyright © 2010 Korean Society of Obstetrics and Gynecology

Abstract

Objective

To evaluate the effectiveness of transumbilical single-port access laparoscopic surgery of ectopic pregnancy.

Methods

Retrospective analysis was performed on six patients who underwent transumbilical single-port access laparoscopic management of ectopic pregnancies.

Results

The median age of 6 cases was 33.5 years (range, 32 to 36), and the median body mass index was 20.6 kg/m2 (range, 16.5 to 28.7). The median largest diameter of G-sac was 4.8 cm (range, 3.0 to 5.4). Intracorporeal rupture and hemoperitoneum were accompanied in all cases. The median time needed for the surgery was 77.5 minutes (range, 59 to 95). The median estimated blood loss was 40 mL (range, 20 to 50). The median postoperative hospital day was 2 days (range, 1 to 3). There were no complications on postoperative course and follow-up.

Conclusion

Transumbilical single-port access laparoscopic surgery for ectopic pregnancy was feasible and safe. This approach might be reasonable alternative to conventional laparoscopic surgery using 3 or 4 port in the management of ectopic pregnancy.

Keywords: Single-port access, Multi-channel port, Ectopic pregnancy, Laparoscopy

Figures and Tables

Fig. 1
(A) Preparation of single umbilical port. ① An ALEXIS® wound retractor XS was inserted through the umbilicus. ② The wrist portion of a 6 1/2 glove wrapped the retractor, and 3 trocars (5 mm, 10 mm, 5 mm) were inserted into the fingers of the glove and tied. (B), (C) 5 mm endoscope, suction irrigator and flexible instruments (Roticulator®, Covidien, Mansfield, MA; Real Hand®, Novare Surgical System, Cupertino, CA, USA) were inserted through single umbilical port.
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Fig. 2
Intraoperative view of transumbilical single port laparoscopic salpingectomy. (A) Left tubal pregnancy and hemoperitoneum. (B) Rupture of left tubal pregnancy was identified. (C) Left salpinx was being resected. (D) The left salpinx was surgically resected and the hematoma was evacuated.
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Fig. 3
Postoperative umbilical wound after two months later. It is hard to find skin incision scar in umbilicus.
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Table 1
Clinical Features of 6 Patients with ectopic pregnancy
kjog-53-720-i001

BMI: body mass index, EBL: estimated blood loss, LS: left salpingectomy, RS: right salpingectomy, Operation time: defined from skin to skin, Hemoglobin change: diminution of hemoglobin between preoperative and postoperative 1-day value.

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