Single-incision laparoscopic hysterectomy using conventional laparoscopic instruments: initial experience with 25 cases

Purpose To evaluate the feasibility and safety of single-incision laparoscopic hysterectomy using conventional instruments. Methods Twenty-five patients undergoing single-incision laparoscopic hysterectomy (SI-LAH) using conventional instruments at West China Second University Hospital between July, 2017 and December, 2017 were selected for participation. Another 25 cases undergoing traditional multi-port laparoscopic hysterectomy (MP-LAH) matched with similar uterine size were selected as controls. Characteristics and clinical data of patients including operative time, estimated blood loss, hospital stay, catheter retention time, and intraoperative and postoperative complications were compared between the two groups. Results The baseline characteristics of the two groups were comparable. The estimated blood loss was less in SI-LAH with respect to MP-LAH (30 mL [range 20–50] vs 50 mL [range 10–200], P < 0.05), with no statistically significant difference in terms of decrease of hemoglobin level (17 g/dL [range 2–24] vs 18 g/dL [range 5–28], P > 0.05). There were no significant differences between the two groups in terms of operative time (150 min [range 85–225] vs 145 min [range 100–220], P > 0.05), intraoperative injury, catheter retention time, time to exhausting, postoperative hospital stay. In all cases, no additional port incision was needed and no conversion to laparotomy was necessary in two groups. No patient had development of intraoperative or postoperative complications. After a follow-up of 2 months, no incisional hernia occurred in all patients. Conclusions Single-incision laparoscopic hysterectomy using conventional instruments is a feasible and safe technique for patients with uterine size less than 12 weeks of pregnancy and no serious pelvic adhesion, requiring for more experienced skill of surgeons.