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Obstet Gynecol Sci > Volume 55(1); 2012 > Article
Korean Journal of Obstetrics & Gynecology 2012;55(1):22-28.
DOI: https://doi.org/10.5468/KJOG.2012.55.1.22    Published online January 1, 2012.
A comparison of single-port laparoscopically assisted vaginal hysterectomy using transumbilical SILS port access and three-port laparoscopically assisted vaginal hysterectomy.
Seong Nam Park, Gi Youn Hong, Hoon Young Kim, Byoung Ryun Kim, Cheol Lee
1Department of Obstetrics and Gynecology, University of Wonkwang College of Medicine, Iksan, Korea. brkim21@lycos.co.kr
2Department of Anestheology and Pain Medicine, University of Wonkwang College of Medicine, Iksan, Korea.
The purpose of this study was to compare surgical outcomes and patients' satisfaction between single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) and conventional three-port access LAVH (TPA-LAVH) group. METHODS: A prospective analysis was performed in patients who underwent laparoscopically assisted vaginal hysterectomy at a Wonkwang University Hospital between April 2010 and May 2011, a total of 138 women were enrolled in this study. One of these procedures was chosen by patient and was performed with their consent. Sixty-five women underwent SPA-LAVH using transumbilical SILS port access (SPA-LAVH group), and 73 women underwent conventional three-port LAVH (TPA-LAVH group). RESULTS: There were no statistical differences between groups in the patients' demographic characteristics, mean operating time (93.4 +/- 20.2 minutes vs. 95.1 +/- 28.7 minutes, P = 0.696), postoperative changes in hemoglobin concentration (1.91 +/- 0.68 vs. 1.85 +/- 0.87 g/dL, P = 0.667), weight of the resected uterus (261.7 +/- 205.3 g vs. 311.8 +/- 268.3 g, P = 0.225), hospital stay (5.9 +/- 0.9 day vs. 6.4 +/- 1.6 day, P = 0.063), the rate of using an additional trocar (1.5% vs. 0%, P = 0.471), the rate of conversion to laparotomy (0% vs. 4.1%, P = 0.098) and postoperative pain scores (visual analogue scale) for 48 hours. However, patients' satisfaction after 6 weeks later was significantly greater in SPA-LAVH group than in conventional group, as evidenced by higher rate of fairly satisfactory (52.3% vs. 34.2%, P = 0.032) and very satisfactory (33.8% vs. 17.8%, P = 0.031). CONCLUSION: SPA-LAVH using transumbilical SILS port access is comparable with TPA-LAVH in women undergoing LAVH. However, SPA-LAVH is better than TPA-LAVH in terms of satisfaction of patient.
Key Words: Single-port access, Three-port access, Laparoscopically assisted vaginal hysterectomy, Patients' satisfaction

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