Objective: To compare the perioperative outcomes of three laparoscopic approaches for performing ovarian cyst enucleation. Methods: A total of 148 patients underwent laparoscopic cyst enucleation at the CHA Gangnam Medical Center between September 2010 and May 2011. We reviewed retrospectively the medical records including patient demographics, operative outcomes and complications. Results: We assigned the 148 patients into three groups: single-port (group A: 40), 2-port (group B: 30) and 4-port (group C: 78). There were no statistically significant differences in patient characteristics. The operation times were 90.4 ± 43.6, 74.7 ± 22.0 and 63.8 ± 30.5 min, and the estimated blood loss was 179.3 ± 253.9, 73 ± 75.2 and 89.9 ± 106.7 ml, respectively. Mean operation time was longer (p < 0.001) and estimated blood loss was higher (p = 0.005) in group A than in the other groups. There was no statistical difference in perioperative complications among the three groups. In group A, additional port insertion rate was higher than in groups B and C (p < 0.001). Conclusion: Single-port surgery required longer operation time, had a higher estimated blood loss and used additional ports more frequently during the operation than the other groups. However, 2-port surgery had no significant differences from 4-port surgery in the surgical outcomes. Therefore, 2-port surgery can be an alternative surgical option for 4-port surgery in ovarian cyst enucleation.

1.
Fanfani F, Fagotti A, Scambia G: Laparoendoscopic single-site surgery for total hysterectomy. Int J Gynaecol Obstet 2010;109:76-77.
2.
Langebrekke A, Qvigstad E: Total laparoscopic hysterectomy with single-port access without vaginal surgery. J Minim Invasive Gynecol 2009;16:609-611.
3.
Paek JH, Kim SW, Lee SH, Lee M, Yim GW, Nam EJ: Kim YT. Learning curve and surgical outcome for single-port access total laparoscopic hysterectomy in 100 consecutive cases. Gynecol Obstet Invest 2011;72:227-233.
4.
Lee YY, Kim TJ, Kim CJ, Kang H, Choi CH, Lee JW, Kim BG, Bae DS: Single-port access laparoscopic-assisted vaginal hysterectomy: a novel method with a wound retractor and a glove. J Minim Invasive Gynecol 2009;16:450-453.
5.
Yoon G, Kim TJ, Lee YY, Kim CJ, Choi CH, Lee JW, Kim BG, Bae DS: Single-port access subtotal hysterectomy with transcervical morcellation: a pilot study. J Minim Invasive Gynecol 2010;17:78-81.
6.
Yoon BS, Park H, Seong SJ, Park CT, Park SW, Lee KJ: Single-port laparoscopic salpingectomy for the surgical treatment of ectopic pregnancy. J Minim Invasive Gynecol 2010;17:26-29.
7.
Kim TJ, Lee YY, Kim MJ, Kim CJ, Kang H, Choi CH, Lee JW, Kim BG, Bae DS: Single port access laparoscopic adnexal surgery. J Minim Invasive Gynecol 2009;16:612-615.
8.
Fagotti A, Fanfani F, Marocco F, Rossitto C, Gallotta V, Scambia G: Laparoendoscopic single-site surgery (LESS) for ovarian cyst enucleation: report of first 3 cases. Fertil Steril 2009;92:1168.e13-e16.
9.
Escobar PF, Bedaiwy M, Fader AN, Falcone T: Laparoendoscopic single-site (LESS) surgery in patients with benign adnexal disease. Fertil Steril 2010;93:2074.e7-e10.
10.
Yoshiki N, Okawa T, Kubota T: Single-incision laparoscopic myomectomy with intracorporeal suturing. Fertil Steril 2011;95:2426-2428.
11.
Paek J, Nam EJ, Jung YW, Lee SH, Kim JH, Kim YT, Kim SW: Two-port access staging laparoscopy for gynecologic cancers: a pilot study. J Laparoendosc Adv Surg Tech A 2010;20:347-353.
12.
Paek J, Nam EJ, Kim YT, Kim SW: Overcoming technical difficulties with single-port access laparoscopic surgery in gynecology: using conventional laparoscopic instruments. J Laparoendosc Adv Surg Tech A 2011;21:137-141.
13.
Fader AN, Escobar PF: Laparoendoscopic single-site surgery (LESS) in gynecologic oncology: technique and initial report. Gynecol Oncol 2009;114:157-161.
14.
Lee YY, Kim TJ, Kim CJ, Park HS, Choi CH, Lee JW, Lee JH, Bae DS, Kim BG: Single port access laparoscopic adnexal surgery versus conventional laparoscopic adnexal surgery: a comparison of peri-operative outcomes. Eur J Obstet Gynecol Reprod Biol 2010;151:181-184.
15.
Fagotti A, Battoni C, Vizzielli G, Alletti SG, Scambia G, Marana E, Fanfani F: Postperative pain after conventional laparoscopy and laparoendoscopic single site surgery (LESS) for benign adnexal disease: a randomized trial. Fertil Steril 2011;96:255-259.e2.
16.
Bedaiwy MA, Starks D, Hurd W, Escobar PF: Laparoendoscopic single-site surgery in patients with benign adnexal disease: a comparative study. Gynecol Obstet Invest 2012;73:294-298.
17.
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.
18.
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.
19.
Park HS, Kim TJ, Song T, Kim MK, Lee YY, Choi CH, Lee JW, Kim BG, Bae DS: Single-port access (SPA) laparoscopic surgery in gynecology: a surgeon's experience with an initial 200 cases. Eur J Obstet Gynecol Reprod Biol 2011;154:81-84.
20.
Yi SW: Two-port laparoscopic adnexal surgery with a multichannel port using a wound retractor: is it safe and minimally scarring? J Laparoendosc Adv Surg Tech A 2009;19:781-786.
21.
Kim WC, Lee JE, Kwon YS, Koo YJ, Lee IH, Lim KT: Laparoendoscopic single-site surgery (LESS) for adnexal tumors: one surgeon's initial experience over a one-year period. Eur J Obstet Gynecol Reprod Biol 2011;158:265-268.
22.
Poon CM, Chan KW, Lee DW, Chan KC, Ko CW, Cheung HY, Lee KW: Two-port versus four-port laparoscopic cholecystectomy. Surg Endosc 2003;17:1624-1627.
23.
Yagnik VD, Rathod JB, Phatak AG: A retrospective study of two-port appendectomy and its comparison with open appendectomy and three-port appendectomy. Saudi J Gastroenterol 2010;16:268-271.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.