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Park, Hong, Kim, Kim, and Lee: A comparison of single-port laparoscopically assisted vaginal hysterectomy using transumbilical SILS port access and three-port laparoscopically assisted vaginal hysterectomy
Original Article
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2012; 55(1): 22-28.

Published online: 16 January 2012

DOI: https://doi.org/10.5468/KJOG.2012.55.1.22

A comparison of single-port laparoscopically assisted vaginal hysterectomy using transumbilical SILS port access and three-port laparoscopically assisted vaginal hysterectomy

Seong Nam Park, MD1, Gi Youn Hong, MD1, Hoon Young Kim, MD1, Byoung Ryun Kim, MD1, Cheol Lee, MD2

1Department of Obstetrics and Gynecology, University of Wonkwang College of Medicine, Iksan, Korea.

2Department of Anestheology and Pain Medicine, University of Wonkwang College of Medicine, Iksan, Korea.

Corresponding author: Byoung Ryun Kim, MD. Department of Obstetrics and Gynecology, University of Wonkwang College of Medicine, 344-2 Sinyong-dong, Iksan 570-749, Korea. Tel: +82-10-9425-3103, Fax: +82-63-852-7520, brkim21@lycos.co.kr

Received 12 August 2011       Revised 24 November 2011       Accepted 9 December 2011

Copyright © 2012. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Single-port access, Three-port access, Laparoscopically assisted vaginal hysterectomy, Patients' satisfaction

Figures and Tables

Fig. 1
(A) SILS port was placed in the umbilicus. (B) Photograph of umbilicus after skin suture.
kjog-55-22-g001
Table 1
Patient characteristics
kjog-55-22-i001

Values are presented as mean±standard deviation or number (%).

SPA-LAVH, single-port access laparoscopic assisted vaginal hysterectomy; TPA-LAVH, three-port access laparoscopic assisted vaginal hysterectomy; BMI, body mass index.

Table 2
Operative results
kjog-55-22-i002

Value are presented as mean±standard deviation or number (%).

SPA-LAVH, single-port access laparoscopically assisted vaginal hysterectomy; TPA-LAVH, three-port access laparoscopically assisted vaginal hysterectomy; OC, ovarian cystectomy.

Table 3
Postoperative pain
kjog-55-22-i003

Value are presented as mean±standard deviation.

VAS, visual analog scale; SPA-LAVH, single-port access laparoscopically assisted vaginal hysterectomy; TPA-LAVH, three-port access laparoscopically assisted vaginal hysterectomy.

Table 4
Patients' satisfaction
kjog-55-22-i004

Values are presented as number (%).

SPA-LAVH, single-port access laparoscopically assisted vaginal hysterectomy; TPA-LAVH, three-port access laparoscopically assisted vaginal hysterectomy.

aBy the chi-square test.

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