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Laparoendoscopic single-site surgery for the treatment of benign adnexal disease: a prospective trial.

Fagotti A, Fanfani F, Rossitto C, Marocco F, Gallotta V, Romano F, Scambia G - Diagn Ther Endosc (2010)

Bottom Line: No major intra- or postoperative complications were observed.Mean hospital stay was 1.3 days.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Division of Gynecologic Oncology, Catholic University of the Sacred Heart, 00168 Rome, Italy.

ABSTRACT
Background. To validate feasibility, efficacy, and safeness of laparoscopic treatment of benign adnexal diseases through a single transumbilical access (LESS) in a prospective series of patients. Methods. A prospective clinical trial including 30 women has been conducted at the Division of Gynecology of Catholic University of Sacred Hearth of Rome. Patients underwent different laparoscopic procedures by LESS utilizing a multiport trocar and conventional straight laparoscopic instrumentation. Intra and perioperative outcome has been reported. Results. Ten mono/bilateral adnexectomies and 20 cystectomies have been performed by LESS approach. Laparoscopic procedures were completed through a single access in 28 cases (93.4%). No major intra- or postoperative complications were observed. Mean hospital stay was 1.3 days. Conclusions. LESS approach is feasible to treat benign adnexal disease with a very low conversion rate and no early or late complications. More clinical data are needed to confirm these advantages compared to standard laparoscopic technique.

No MeSH data available.


Related in: MedlinePlus

(a) Positioning of the trocar at the beginning of the procedure. (b) Postoperative umbilical scar's outcome.
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fig1: (a) Positioning of the trocar at the beginning of the procedure. (b) Postoperative umbilical scar's outcome.

Mentions: Surgical procedures were performed throughout a single multiport trocar (Laparo-Endoscopic Single-Site Surgery, Olympus Winter & IBE GMBH, Hamburg, Germany), inserted in the umbilicus, as shown in Figure 1(a). The trocar is made of a doubled-over cylindrical sleeve of pliable film material which is fixed to the proximal ring and flows down around the distal ring and back up and out. To introduce the trocar, the distal ring is passed into the abdominal cavity utilizing the introducer, by an open access: a 1.5–2.0 cm longitudinal transumbilical skin incision is made, then the subcutaneous fat is opened, with exposure and consequent cold-knife incision of the abdominal fascia for approximately 1,5 cm. The parietal peritoneum is smoothly dissected with blunt scissors achieving access into the peritoneal cavity, then the introducer with the trocar distal ring is entered. Pulling on the sleeve up, the distal and the proximal ring pairs off: the procedure creates a retracting tension inside the sleeve between the rings. The valve is then positioned to fix the system, maintaining the retraction of the sleeve. This trocar is a multi-instrument access port that allows up to three laparoscopic instruments (three 5-mm cannulas or two 5-mm and one 12-mm cannula) to be used simultaneously through separate flexible channels. The cannula positions are adjustable within the flexible port, and a separate channel is available for CO2 insufflation. An intrauterine device (Uterus manipulator, Olympus Winter & IBE GMBH, Hamburg, Germany) is always utilized.


Laparoendoscopic single-site surgery for the treatment of benign adnexal disease: a prospective trial.

Fagotti A, Fanfani F, Rossitto C, Marocco F, Gallotta V, Romano F, Scambia G - Diagn Ther Endosc (2010)

(a) Positioning of the trocar at the beginning of the procedure. (b) Postoperative umbilical scar's outcome.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2821631&req=5

fig1: (a) Positioning of the trocar at the beginning of the procedure. (b) Postoperative umbilical scar's outcome.
Mentions: Surgical procedures were performed throughout a single multiport trocar (Laparo-Endoscopic Single-Site Surgery, Olympus Winter & IBE GMBH, Hamburg, Germany), inserted in the umbilicus, as shown in Figure 1(a). The trocar is made of a doubled-over cylindrical sleeve of pliable film material which is fixed to the proximal ring and flows down around the distal ring and back up and out. To introduce the trocar, the distal ring is passed into the abdominal cavity utilizing the introducer, by an open access: a 1.5–2.0 cm longitudinal transumbilical skin incision is made, then the subcutaneous fat is opened, with exposure and consequent cold-knife incision of the abdominal fascia for approximately 1,5 cm. The parietal peritoneum is smoothly dissected with blunt scissors achieving access into the peritoneal cavity, then the introducer with the trocar distal ring is entered. Pulling on the sleeve up, the distal and the proximal ring pairs off: the procedure creates a retracting tension inside the sleeve between the rings. The valve is then positioned to fix the system, maintaining the retraction of the sleeve. This trocar is a multi-instrument access port that allows up to three laparoscopic instruments (three 5-mm cannulas or two 5-mm and one 12-mm cannula) to be used simultaneously through separate flexible channels. The cannula positions are adjustable within the flexible port, and a separate channel is available for CO2 insufflation. An intrauterine device (Uterus manipulator, Olympus Winter & IBE GMBH, Hamburg, Germany) is always utilized.

Bottom Line: No major intra- or postoperative complications were observed.Mean hospital stay was 1.3 days.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Division of Gynecologic Oncology, Catholic University of the Sacred Heart, 00168 Rome, Italy.

ABSTRACT
Background. To validate feasibility, efficacy, and safeness of laparoscopic treatment of benign adnexal diseases through a single transumbilical access (LESS) in a prospective series of patients. Methods. A prospective clinical trial including 30 women has been conducted at the Division of Gynecology of Catholic University of Sacred Hearth of Rome. Patients underwent different laparoscopic procedures by LESS utilizing a multiport trocar and conventional straight laparoscopic instrumentation. Intra and perioperative outcome has been reported. Results. Ten mono/bilateral adnexectomies and 20 cystectomies have been performed by LESS approach. Laparoscopic procedures were completed through a single access in 28 cases (93.4%). No major intra- or postoperative complications were observed. Mean hospital stay was 1.3 days. Conclusions. LESS approach is feasible to treat benign adnexal disease with a very low conversion rate and no early or late complications. More clinical data are needed to confirm these advantages compared to standard laparoscopic technique.

No MeSH data available.


Related in: MedlinePlus