Kuo-Hu Chen1, Li-Ru Chen2, Kok-Min Seow3. 1. Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, Taipei, Taiwan, and School of Medicine, Tzu-Chi University, Hualien, Taiwan. Electronic address: alexgfctw@yahoo.com.tw. 2. Mackay Memorial Hospital, Taipei, Taiwan, and Department of Mechanical Engineering, National Chiao-Tung University, Hsinchu, Taiwan. 3. Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, and Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan.
Abstract
STUDY OBJECTIVE: To describe a method of ovarian suspension with adjustable sutures (OSAS) for facilitating laparoendoscopic single-site gynecologic surgery (LESS) and to investigate the effect of OSAS on LESS. DESIGN: Prospective cohort study (Canadian Task Force classification: II-2). SETTING: University teaching hospital. PATIENTS: One hundred seventy-eight patients with benign 5- to 15-cm cystic ovarian tumors who underwent LESS with OSAS (suspension group, n = 90) and without OSAS (control group, n = 88). INTERVENTIONS: For patients who underwent OSAS (suspension group), 1 end of double-head straight needles with a polypropylene suture was inserted into the pelvic cavity through the abdominal skin to penetrate the cyst or ovarian parenchyma and puncture outside the abdominal skin. After cutting off the needles, both sides of the remaining suture were held together by a clamp, without knotting, so that the manipulator could "lift," "loosen," or "fix" the stitches to adjust the tension. MEASUREMENTS AND MAIN RESULTS: The average time to create OSAS was 2.9 min. For the suspension and control groups, the average blood loss was 81.4 and 131.8 mL (p < .001), and the operative time was 42.0 and 61.3 min (p < .001), respectively. There were no significant differences in the incidence of complications (5.6% vs 9.1%; p = .365), but there were significant differences in conversions to standard non-single-site laparoscopy (5.6% vs 15.9%; p = .025) and laparotomy (1.1% vs 6.8%; p = .040). Logistic regression analysis revealed that the ratios of conversion to standard non-single-site laparoscopy (odds ratio [OR], 0.126; 95% confidence interval [CI], 0.311-0.508) and laparotomy (OR, 0.032; 95% CI, 0.002-0.479) were much lower in the suspension group; the risk of complications was comparable (OR, 0.346; 95% CI, 0.085-1.403). CONCLUSION: OSAS is an easy, safe, and feasible method that offers advantages during LESS. Although routine use of OSAS is not necessary, OSAS can be considered during LESS to facilitate the surgery.
STUDY OBJECTIVE: To describe a method of ovarian suspension with adjustable sutures (OSAS) for facilitating laparoendoscopic single-site gynecologic surgery (LESS) and to investigate the effect of OSAS on LESS. DESIGN: Prospective cohort study (Canadian Task Force classification: II-2). SETTING: University teaching hospital. PATIENTS: One hundred seventy-eight patients with benign 5- to 15-cm cystic ovarian tumors who underwent LESS with OSAS (suspension group, n = 90) and without OSAS (control group, n = 88). INTERVENTIONS: For patients who underwent OSAS (suspension group), 1 end of double-head straight needles with a polypropylene suture was inserted into the pelvic cavity through the abdominal skin to penetrate the cyst or ovarian parenchyma and puncture outside the abdominal skin. After cutting off the needles, both sides of the remaining suture were held together by a clamp, without knotting, so that the manipulator could "lift," "loosen," or "fix" the stitches to adjust the tension. MEASUREMENTS AND MAIN RESULTS: The average time to create OSAS was 2.9 min. For the suspension and control groups, the average blood loss was 81.4 and 131.8 mL (p < .001), and the operative time was 42.0 and 61.3 min (p < .001), respectively. There were no significant differences in the incidence of complications (5.6% vs 9.1%; p = .365), but there were significant differences in conversions to standard non-single-site laparoscopy (5.6% vs 15.9%; p = .025) and laparotomy (1.1% vs 6.8%; p = .040). Logistic regression analysis revealed that the ratios of conversion to standard non-single-site laparoscopy (odds ratio [OR], 0.126; 95% confidence interval [CI], 0.311-0.508) and laparotomy (OR, 0.032; 95% CI, 0.002-0.479) were much lower in the suspension group; the risk of complications was comparable (OR, 0.346; 95% CI, 0.085-1.403). CONCLUSION: OSAS is an easy, safe, and feasible method that offers advantages during LESS. Although routine use of OSAS is not necessary, OSAS can be considered during LESS to facilitate the surgery.
Authors: Martin Berducci; Hans F Fuchs; Pablo Omelanczuk; Ryan C Broderick; Cristina R Harnsberger; Joshua Langert; Jorge Nefa; Pablo Jaureguiberry; Pablo Gomez; Laura Miranda; Garth R Jacobsen; Bryan J Sandler; Santiago Horgan Journal: Surg Endosc Date: 2015-06-27 Impact factor: 4.584
Authors: Rabi R Datta; Georg Dieplinger; Roger Wahba; Robert Kleinert; Michael Thomas; Florian Gebauer; Lars Schiffmann; Dirk L Stippel; Christiane J Bruns; Hans F Fuchs Journal: Surg Endosc Date: 2019-10-28 Impact factor: 4.584
Authors: Omar M Abuzeid; John Hebert; Mohammad Ashraf; Mohamed Mitwally; Michael P Diamond; Mostafa I Abuzeid Journal: Facts Views Vis Obgyn Date: 2018-06