Single-port laparoscopic surgery for benign salpingo-ovarian pathology: a single-center experience from Saudi Arabia

Abstract

BACKGROUND: There are limited data and few solid conclusions on the use of single-port laparoscopic surgery (SPLS) in gynecologic procedures. OBJECTIVE: The objective of our descriptive study was to review our single-center experience with benign salpingo-ovarian conditions (feasibility, safety and surgical outcomes). DESIGN: A retrospective cross-sectional study from January-2012 to October-2014. SETTING: King Faisal Specialist Hospital & Research Center—a referral tertiary healthcare center. PATIENTS AND METHODS: All gynecologic patients who underwent SPLS procedures for benign adnexal pathologies were analyzed for pre-, intra- and postoperative details. SPLS was done using a single multi-port trocar and standard laparoscopic instruments. MAIN OUTCOME MEASURES: Perioperative complications and conversion rate. RESULTS: Eighty (n=80) patients underwent SPLS interventions. The median age and BMI were 37 years and 24.6 kg/m2, respectively. Thirty-one patients (38.8%) had ≥1 previous abdominopelvic surgeries. Of 104 SPLS procedures conducted, the three most common procedures were unilateral ovarian cystectomy (n=21/104; 20.2%), bilateral ovarian transposition (n=20/104; 19.2%), and unilateral salpingo-oophorectomy (n=16/104; 15.4%). No patient required addition of extra ports or conversion to conventional multi-port laparoscopy or laparotomy. The median operative time, estimated blood loss and hospital stay were 66 min, 10 mL and 1 day, respectively. No patient experienced major intraoperative or postoperative complications. The median postoperative pain grade using the visual analogue scale was 2 (examined in 74 of 80 patients). At six-weeks postoperatively, the median wound scar length (measured at outpatient clinic) was 1.2 cm. CONCLUSION: SPLS in the management of benign salpingo-ovarian conditions is generally feasible, potentially safe, and associated with satisfactory operative and postoperative outcomes. LIMITATIONS: Retrospective and non-comparative design. Single-center experience. Subjective scores of the patients' self-reported satisfaction about post-operative pain, subject to recall bias.