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Vol. 75, No. 1, 2013
Issue release date: January 2013
Gynecol Obstet Invest 2013;75:16–20

Single-Port Access Total Laparoscopic Hysterectomy for Large Uterus

Song T. · Lee Y. · Kim M.-L. · Yoon B.S. · Joo W.-D. · Seong S.J. · Kim I.H.
Department of Obstetrics and Gynecology,aCHA Gangnam Medical Center and bCHA Daegu Women’s Medical Center, CHA University, Seoul, Korea

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Background/Aims: To evaluate the feasibility and safety of single-port access total laparoscopic hysterectomy (SPA-TLH) for large uterus (>500 g). Methods: A prospective data collection was performed in 21 consecutive patients in March 2010 and August 2011. Surgical outcome including operative time (OT) and estimated blood loss (EBL) were analyzed. Results: SPA-TLH procedures were successfully performed in 16 cases (76.2%). Of the 5 failed cases, 4 were converted to multiport TLH because of distorted uterine contours and pelvic adhesions and 1 was converted to laparotomy for bleeding control. The median OT, uterine weight, and EBL were 110 (65–165) min, 600 (502–980) g, and 200 (100–800) ml, respectively. Spearman’s correlation analysis demonstrated that OT and blood loss increased with increasing uterine weight (p = 0.003 and p = 0.033, respectively). No operative complications were observed during the hospital stay and 3-month follow-up following discharge. Conclusion: SPA-TLH for large uterus is a feasible and safe technique.

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  1. Nieboer TE, Johnson N, Lethaby A, Tavender E, Curr E, Garry R, van Voorst S, Mol BW, Kluivers KB: Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev 2009:CD003677.
  2. Jung YW, Kim YT, Lee DW, Hwang YI, Nam EJ, Kim JH, Kim SW: The feasibility of scarless single-port transumbilical total laparoscopic hysterectomy: initial clinical experience. Surg Endosc 2010;24:1686–1692.
  3. Langebrekke A, Qvigstad E: Total laparoscopic hysterectomy with single-port access without vaginal surgery. J Minim Invasive Gynecol 2009;16:609–611.
  4. Jung YW, Lee M, Yim GW, Lee SH, Paek JH, Kwon HY, Nam EJ, Kim SW, Kim YT: A randomized prospective study of single-port and four-port approaches for hysterectomy in terms of postoperative pain. Surg Endosc 2011;25:2462–2469.
  5. Yim GW, Jung YW, Paek J, Lee SH, Kwon HY, Nam EJ, Kim S, Kim JH, Kim YT, Kim SW: Transumbilical single-port access versus conventional total laparoscopic hysterectomy: surgical outcomes. Am J Obstet Gynecol 2010;203:26. e1–e6.
  6. Fiaccavento A, Landi S, Barbieri F, Zaccoletti R, Tricolore C, Ceccaroni M, Pomini P, Bruni F, Soriano D, Stepniewska A, Selvaggi L, Zanolla L, Minelli L: Total laparoscopic hysterectomy in cases of very large uteri: a retrospective comparative study. J Minim Invasive Gynecol 2007;14:559–563.
  7. O’Hanlan KA, McCutcheon SP, McCutcheon JG: Laparoscopic hysterectomy: impact of uterine size. J Minim Invasive Gynecol 2011;18:85–91.
  8. Fader AN, Cohen S, Escobar PF, Gunderson C: Laparoendoscopic single-site surgery in gynecology. Curr Opin Obstet Gynecol 2010;22:331–338.
  9. Phongnarisorn C, Chinthakanan O: Transumbilical single-incision laparoscopic hysterectomy with conventional laparoscopic instruments in patients with symptomatic leiomyoma and/or adenomyosis. Arch Gynecol Obstet 2011;284:893–900.
  10. Sinha R, Sundaram M, Mahajan C, Raje S, Kadam P, Rao G, Shitut P: Single-incision total laparoscopic hysterectomy. J Minim Access Surg 2011;7:78–82.

    External Resources

  11. Yoon BS, Park H, Seong SJ, Park CT, Jun HS, Kim IH: Single-port versus conventional laparoscopic salpingectomy in tubal pregnancy: a comparison of surgical outcomes. Eur J Obstet Gynecol Reprod Biol 2011;159:190–193.
  12. Fagotti A, Bottoni C, Vizzielli G, Alletti SG, Scambia G, Marana E, Fanfani F: Postoperative pain after conventional laparoscopy and laparoendoscopic single site surgery (LESS) for benign adnexal disease: a randomized trial. Fertil Steril 2011;96:255–259. e2.
  13. Chen YJ, Wang PH, Ocampo EJ, Twu NF, Yen MS, Chao KC: Single-port compared with conventional laparoscopic-assisted vaginal hysterectomy. Obstet Gynecol 2011;117:906–912.
  14. Yoon A, Kim TJ, Lee WS, Kim BG, Bae DS: Single-port access laparoscopic staging operation for a borderline ovarian tumor. J Gynecol Oncol 2011;22:127–130.
  15. Ark C, Gungorduk K, Celebi I, Celikkol O: Experience with laparoscopic-assisted vaginal hysterectomy for the enlarged uterus. Arch Gynecol Obstet 2009;280:425–430.
  16. Wattiez A: Total laparoscopic hysterectomy for very enlarged uteri. J Am Assoc Gynecol Laparosc 2002;9:125–130.
  17. Song T, Kim TJ, Kim MK, Park H, Kim JS, Lee YY, Kim CJ, Choi CH, Lee JW, Kim BG, Bae DS: Single port access laparoscopic-assisted vaginal hysterectomy for large uterus weighing exceeding 500 g: technique and initial report. J Minim Invasive Gynecol 2010;17:456–460.
  18. Kim TJ, Lee YY, Cha HH, Kim CJ, Choi CH, Lee JW, Bae DS, Lee JH, Kim BG: Single-port-access laparoscopic-assisted vaginal hysterectomy versus conventional laparoscopic-assisted vaginal hysterectomy: a comparison of perioperative outcomes. Surg Endosc 2010;24:2248–2252.

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