A prospective comparison of single-port laparoscopically assisted vaginal hysterectomy using transumbilical GelPort access and multiport laparoscopically assisted vaginal hysterectomy

Objective

To evaluate the feasibility and safety of single-port laparoscopically assisted vaginal hysterectomy (SP-LAVH) using transumbilical GelPort access.

Study design

A prospective case–control study was performed at a University teaching hospital between January 2009 and March 2010, a total of 242 women with a uterus ≤16 weeks gestational size were enrolled in the study. Eighty women underwent SP-LAVH using transumbilical GelPort access (SP-LAVH group), and 162 women underwent conventional multiport LAVH (conventional LAVH group).

Results

There were no statistical differences between groups in the patients’ demographic characteristics, median operating time (92.5 vs. 90 min; P = 0.479), postoperative changes in hemoglobin concentration (1.4 vs. 1.4 g/dL; P = 0.290), weight of the resected uterus (246 vs. 256 g; P = 0.098), return of bowel activity (37.1 vs. 39.8 h; P = 0.103), hospital stay (3 vs. 3 days; P = 0.554), complication rate (3.8 vs. 4.3%; P = 1.000), and the rate of using an additional trocar or conversion to laparotomy (1.3 vs. 0.6%; P = 0.553).

Conclusions

SP-LAVH using transumbilical GelPort access is feasible and safe in women with a uterus ≤16 weeks gestational size. However, a large prospective randomized study is needed to confirm this conclusion and to establish guidelines for the use of SP-LAVH.