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Advantages of single-site laparoscopy in gynecological surgery
YANG Xu, ZHENG Ying
Chinese Journal of Practical Gynecology and Obstetrics ›› 2025, Vol. 41 ›› Issue (7) : 695-699.
PDF(901 KB)
PDF(901 KB)
Advantages of single-site laparoscopy in gynecological surgery
After years of development in gynecological surgery,laparoscopic minimally invasive surgery is now an important technology in the treatment of gynecological diseases. Compared with the traditional multi-port approach,laparoendoscopic single-site surgery,as the most cutting-edge minially invasive technology,has been attached great importance in gynecology not only for its minimal trauma,little pain,quick rehabilitation,and satisfying cosmetic effect,but also for its unique advantages in medical safety and surgical efficiency and it is developing rapidly. This paper provides an overview of the advantages of laparoendoscopic single-site surgery in gynecological field,share the technical difficults and operation skills of laparoendoscopic single-site surgery and discusses its present applications and future development directions.
minimally invasive surgery / single-site laparoscopic surgery / robotic single-site laparoscopic surgery
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There is scarcity of data about the long-term results such as port-site hernia, body image scale and cosmesis scale outcomes between laparoendoscopic single-site (LESS) surgery and conventional multiport laparoscopy (CMPL) for hysterectomy. Eighty women, who underwent total hysterectomy by the LESS ( = 40) and CMPL ( = 40) technique due to benign and malign gynecological disorders, were evaluated with a cosmesis and body image questionnaire in an age-matched cohort study.Median follow-up time was 25 (6-30) months in both groups. The mean age of the patients was 49.3 ± 6.3 years. The mean body image scale scores were 5.3 ± 0.6 and 5.5 ± 1.2 in the LESS and CMPL groups, respectively ( = 0.268). The mean cosmesis and scar scale scores were significantly higher in the LESS group compared to the CMPL group ( = .011 and < .001, respectively). Port-site hernia was detected in two patients in the LESS group, but not in the CMPL group. There was no cuff dehiscence in the LESS nor in the CMPL group. The LESS technique provides better cosmesis when compared with the CMPL technique. The body image perceptions in the two groups were similar. Women who wish to undergo the LESS surgery should be informed about the risk of incisional hernia.Impact statement Short-term results of LESS hysterectomy such as complication rates, additional port requirement, conversion to CMPL or laparotomy, pain score and analgesic use were evaluated in various studies. Several studies have been published on the safety and efficacy of single-port laparoscopic hysterectomy (LH); however, it has been unclear whether single-port LH offers benefits over multiport LH regarding long-term patient satisfaction and cosmetic satisfaction. In this prospective cohort study, we aimed to compare long-term results (at least six months) of abdominal incisional scar between LESS and CMPL surgery for hysterectomy. The LESS technique provides better cosmesis when compared with the CMPL technique, although, the body image perceptions in the two groups were similar. LESS technique can be offered as an option for hysterectomy since it provides better long-term cosmesis compared to CMPL.
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We aimed to evaluate the safety, efficiency and preferred indication for laparoendoscopic single-site surgery (LESS) compared with conventional laparoscopic (CL) surgery for benign ovarian masses.
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Hysterectomy is the most common surgical procedure in the field of gynaecology. The traditional multiport laparoscopy, transumbilical laparoendoscopic single-site surgery (TU-LESS) and transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy approaches have been implemented to varying degrees in clinical practice. At present, although their feasibility has been proven, there are no large randomised controlled studies on postoperative rehabilitation. This study aims to evaluate postoperative recovery and assess the safety and effectiveness of these three surgical approaches for total laparoscopic hysterectomy.
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Although single-port laparoscopy surgery has been evaluated for several years, it has not been widely adopted by gynecologic oncologists. The objective was to compare the perioperative outcomes and survival of endometrial cancer (EC) patients undergoing transumbilical laparoendoscopic single-site surgery (TU-LESS) with multi-port laparoscopic surgery (MLS).
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Transumbilical laparoendoscopic single-site surgery (TU-LESS) is a new and evolving surgical method suitable for gynecological diseases, because of its minimal invasion and good cosmetic results. However, since the incision required for this procedure is longer than that for traditional laparoscopy, it may be associated with a higher incidence of postoperative incision complications, such as umbilical hernia, infection, hematoma, and poor wound healing. Moreover, the patient may be left with a misshapen umbilicus because intensive surgery is performed through a single umbilical incision. To minimize the incisional complications and meet patients' cosmetic expectations, we designed a novel suturing technique, named "Zheng's anchor suture technique". This video demonstrates the specific steps and shows photographs of patients' umbilici that were sutured by this technique, taken after recovery from various operations.© 2022. The Author(s).
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Nowadays, lymphadenectomy could be performed by the transperitoneal or extraperitoneal approach. Nevertheless, each approach has its own advantages and disadvantages. Under these circumstances, we developed a transumbilical laparoendoscopic single-site (TU-LESS) extraperitoneal approach for lymphadenectomy. In this research, the primary goal is to demonstrate the feasibility of the novel approach in systematic lymphadenectomy and present the surgical process step-by-step.
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