TY - JOUR
T1 - Total laparoscopic hysterectomy using a percutaneous surgical system: A pilot study towards scarless surgery
AU - Rossitto, Cristiano
AU - Gueli Alletti, Salvatore
AU - Rotolo, Stefano
AU - Cianci, Stefano
AU - Panico, Giovanni
AU - Scambia, Giovanni
PY - 2016
Y1 - 2016
N2 - Objective The evolution of minimally invasive surgery has moved beyond reduction of surgical trauma while maintaining adequate efficacy and safety standards. Percuvance™ Percutaneous Surgical System (PSS) instruments represents the last novelty in this panorama. Consisting of less than 3 mm laparoscopic shaft introduced percutaneously with an interchangeable 5 mm tool installed in place of the needle tip, they combine micro-invasiveness and operative performance. Study design We prospectively collected and retrospectively analyzed data of 10 cases of laparoscopic total hysterectomy with Percuvance™ PSS for benign or early malignant gynecological diseases in order to assess the capability and safety of this new device. Data were recorded in a prospectively designed clinical database including patient demographics characteristics, operative data, intra- and postoperative complications, conversion rate, length of hospital stay and cosmetic outcome. Results The reported series consisted of 10 patients undergoing total laparoscopic hysterectomy with a median age of 51.5 years (range 44-72 years) and a median BMI (body mass index) of 25.3 (range 19.7-30.4). All patients had bilateral salpingo-oophorectomy or bilateral salpingectomy and two of them underwent pelvic lymphadenectomy. A median operative time of 67 min (range 45-180 min) and a median estimated blood loss (EBL) of 50 ml (range 10-100 ml) were registered. Median PSS introduction time was 5 min (range 3-10 min). No conversions to standard laparoscopy or laparotomy were required and no intraoperative complications occurred. Discharge was on day 1 in 4 cases, on day 2 in the other 6 cases. All patients conveyed complete satisfaction with the cosmetic result and postoperative pain control. No complications were registered within 30 days after surgery. Conclusions PSS total laparoscopic hysterectomy is safe and feasible with good results in terms of operative time, cosmesis, postoperative pain, recovery and short hospitalization. Further studies are needed to compare PSS total hysterectomy to conventional multi-access laparoscopic and other mini-invasive approaches.
AB - Objective The evolution of minimally invasive surgery has moved beyond reduction of surgical trauma while maintaining adequate efficacy and safety standards. Percuvance™ Percutaneous Surgical System (PSS) instruments represents the last novelty in this panorama. Consisting of less than 3 mm laparoscopic shaft introduced percutaneously with an interchangeable 5 mm tool installed in place of the needle tip, they combine micro-invasiveness and operative performance. Study design We prospectively collected and retrospectively analyzed data of 10 cases of laparoscopic total hysterectomy with Percuvance™ PSS for benign or early malignant gynecological diseases in order to assess the capability and safety of this new device. Data were recorded in a prospectively designed clinical database including patient demographics characteristics, operative data, intra- and postoperative complications, conversion rate, length of hospital stay and cosmetic outcome. Results The reported series consisted of 10 patients undergoing total laparoscopic hysterectomy with a median age of 51.5 years (range 44-72 years) and a median BMI (body mass index) of 25.3 (range 19.7-30.4). All patients had bilateral salpingo-oophorectomy or bilateral salpingectomy and two of them underwent pelvic lymphadenectomy. A median operative time of 67 min (range 45-180 min) and a median estimated blood loss (EBL) of 50 ml (range 10-100 ml) were registered. Median PSS introduction time was 5 min (range 3-10 min). No conversions to standard laparoscopy or laparotomy were required and no intraoperative complications occurred. Discharge was on day 1 in 4 cases, on day 2 in the other 6 cases. All patients conveyed complete satisfaction with the cosmetic result and postoperative pain control. No complications were registered within 30 days after surgery. Conclusions PSS total laparoscopic hysterectomy is safe and feasible with good results in terms of operative time, cosmesis, postoperative pain, recovery and short hospitalization. Further studies are needed to compare PSS total hysterectomy to conventional multi-access laparoscopic and other mini-invasive approaches.
KW - Laparoscopy
KW - Microlaparoscopy
KW - Minimally invasive surgery
KW - Obstetrics and Gynecology
KW - Reproductive Medicine
KW - Scar-hidden endoscopic surgery
KW - Scarless surgery
KW - Laparoscopy
KW - Microlaparoscopy
KW - Minimally invasive surgery
KW - Obstetrics and Gynecology
KW - Reproductive Medicine
KW - Scar-hidden endoscopic surgery
KW - Scarless surgery
UR - http://hdl.handle.net/10807/91645
UR - http://www.elsevier.com/locate/ejogrb
U2 - 10.1016/j.ejogrb.2016.05.007
DO - 10.1016/j.ejogrb.2016.05.007
M3 - Article
SN - 0301-2115
VL - 203
SP - 132
EP - 135
JO - EUROPEAN JOURNAL OF OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE BIOLOGY
JF - EUROPEAN JOURNAL OF OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE BIOLOGY
ER -