Retroperitoneal Approach in Single-Port Laparoscopic Hysterectomy.
JSLS
; 20(2)2016.
Article
em En
| MEDLINE
| ID: mdl-27186067
BACKGROUND AND OBJECTIVES: In single-port laparoscopic hysterectomy(SP-LH), ligation of the uterine artery is a fundamental step. We analyzed the effectiveness and safety of 2 different surgical approaches to ligate the uterine artery in SP-LH for women with uterine myomas or adenomyosis. METHODS: A single surgeon (TJ Kim) performed 36 retroperitoneal single-port laparoscopic hysterectomies (SP-rH) from September 1st 2012 to April 30th 2013. We compared these cases with 36 cases of conventional single-port laparoscopic abdominal hysterectomy (SP-aH) performed by the same surgeon from November 1st 2011 to July 31th 2012 (historic control). In the SP-rH cases, the retroperitoneal space was developed to identify the uterine artery; then, it was ligated where it originates from the internal iliac artery. RESULTS: Estimated blood loss (EBL) was decreased in the SP-rH group compared with the SP-aH group (100 mL vs 200 mL; P = .023). The median total operative time was shorter in the SP-rH group (75 minutes vs 93 minutes; P < .05). The operative time of the Scope I phase, including ligation of the utero-ovarian (or infundibulopelvic) ligament, round ligament, uterine artery, and detachment of the bladder, was longer in the SP-rH group compared with that in the SP-aH group (26.0 minutes vs 24 minutes; P = .043). However, the operative time of the Scope II phase, including detachment of the uterosacral-cardinal ligament, vaginal cutting, and uterus removal, was shorter in the SP-rH group (19.5 minutes vs 30 minutes; P < .05). Operative complications were not significantly different between the groups (P = .374). CONCLUSION: Although SP-rH may be considered technically difficult, it can be performed safely and efficiently with surgical outcomes comparable to those of SP-aH.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Uterinas
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Laparoscopia
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Artéria Uterina
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Histerectomia
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
Limite:
Adult
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
JSLS
Ano de publicação:
2016
Tipo de documento:
Article
País de publicação:
Estados Unidos