Feasibility of reduced port surgery applying Higuchi's transverse incision

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• 作者：Kazu Ueda^a ; Yoko Nagayoshi^a ; Ayako Kawabata^a ; Takafumi Kuroda^a ; Yasushi Iida^a ; Motoaki Saitou^a ; Nozomu Yanaihara^a ; Kouhei Sugimoto^a ; Masaru Sakamoto^b ; Aikou Okamoto^a ; ^{aikou7000@gmail.com}
• 关键词：laparoscopically assisted myomectomy ; power morcellator ; reduced port surgery
• 刊名：Gynecology and Minimally Invasive Therapy
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：6
• 期：1
• 页码：12-16
• 全文大小：637 K
• 卷排序：6

文摘

Higuchi's transverse incision is made at a lower position than the Pfannenstiel transverse incision and is superior in terms of cosmetic outcomes. The purpose of this study was to examine the safety and efficacy of novel forms of reduced port surgery for ovarian cysts and uterine fibroids applying Higuchi's transverse incision.MethodsIn 33 patients with ovarian cysts who underwent low-position single-incision laparoscopic surgery (L-SILS)-modified single-port laparoscopy placed in the 2–3-cm Higuchi's incision above the pubis, patient's characteristics and perioperative outcomes were compared with those of patients who underwent multiport laparoscopy (n = 53). In addition, 18 patients with uterine fibroids who underwent dual-port laparoscopically assisted myomectomy without using power morcellators and conventional four-port laparoscopically assisted myomectomy were investigated.ResultsThere were no significant differences between L-SILS and multiport laparoscopy in tumor diameter, bleeding, hospital stay, or postoperative pain. However, the L-SILS group demonstrated significantly shorter operative and pneumoperitoneum times (p < 0.01 and p < 0.01). In comparison with cases of uterine fibroids, no significant differences were found in maximum fibroid diameter, operative time, pneumoperitoneum time, or bleeding. However, the dual-port laparoscopically assisted myomectomy group demonstrated a significantly shorter length of hospital stay than the conventional laparoscopically assisted myomectomy group (p < 0.05).ConclusionWe reported novel forms of reduced port surgery applying Higuchi's transverse incision. It was suggested that these procedures are relatively simple, but ensure the same safety and efficacy as conventional methods. We intend to increase the number of cases and examine safety, efficacy, and patient satisfaction for these procedures.