Objectives During the last decade endoscopic surgical procedures have been constantly evolving. The latest innovation in ultra-minimally invasive surgery (MIS) is the percutaneous technology (Percuvanceâ¢ Percutaneous Surgical System (PSS), Teleflex Inc., USA). We compared surgical outcome of hysterectomy, in a retrospective cohort study using the most recent MIS techniques as single-site (LESS) surgery, 3Â mm laparoscopy (MiniLPS) and percutaneous system (PSS) with standard laparoscopy (LPS). Study design This is a matched retrospective cohort study. Endometrial Hyperplasia/Early stage endometrial cancer or benign pathology were the indication for surgery. Data of laparoscopic hysterectomies performed between May 2013 and April 2016 using PSS, LPS, MiniLPS, and LESS were collected and compared. Results The characteristics of each group were similar. The median Operative time (OT) was significantly longer in LESS compared to all other groups (120Â min [range 55â165] in LESS, 91Â min [range 60â180] in MiniLPS, 70Â min [range 55â230] in LPS and 65 [range 40â180] in PSS; pÂ =Â 0.0001). No significant differences among the 4 groups were observed in terms of estimated blood loss, conversion to laparoscopy or laparotomy, and intra e post-operative complications. Statistically significant differences were recorded in median VAS 24Â h (2 [range 0â3] in PSS, 2 [range 0â3] in MiniLPS, 3 [range 2â5] in LESS and 2 [range 1â5] in LPS; pÂ =Â 0.0001). The average time of discharge was (1Â day [range 1â3] in PSS, 1Â day [range 1â2] in MiniLPS, 1Â days [range 1â2] in LESS and 1Â day [range 1â3] in LPS; pÂ =Â 0.99). Conclusions Data show that the effort to minimize the impact of surgical invasiveness can be feasible and could improve the advantages, not only in terms of aesthetic outcomes, even if the differences among the endoscopic approaches have not a relevant clinical impact. The technology innovations like PSS maintain the same triangulation between instruments as standard LPS with an evident decrease of the invasiveness thanks to reduced instruments size, even if the lack of suitability of bipolar energy, that require a multifunction instrument, remain a limit of these instruments.
|Numero di pagine||5|
|Rivista||EUROPEAN JOURNAL OF OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE BIOLOGY|
|Stato di pubblicazione||Pubblicato - 2017|
- Minimally invasive surgery (MIS)
- Obstetrics and Gynecology
- Percutaneous instruments
- Reproductive Medicine