AAGL 2013: Single-Port Surgery Feasible, Safe for Many Gynecologic Cancer Patients

Single port pelvic surgery (SiPPS) is feasible and safe for many gynecologic oncology indications, with outcomes similar to those of traditional laparoscopic surgical techniques, according to new research presented last month at AAGL’s 42nd Global Congress on Minimally Invasive Gynecology.

Ahmed Al-Niaimi, MD, and colleagues from the University of Wisconsin Hospital, Madison, analyzed the results of patients treated for a variety of gynecologic oncology indications over a 12-month period since SiPPS had been adopted at the institution. A total of 39 consecutive patients, aged 35 to 83 years, were included. The average patient age was 55 years, and mean BMI was 32.3. Most of the patients (69.2%) had at least 1 previous abdominal surgery.

Of the 39 patients, 28 (72.2%) had ovarian pathology, 8 had (20.5%) had uterine pathology, and 2 had (5.2%) had cervical pathology. Six patients required conversion to laparotomy due to technical difficulty (n=4), advanced pathology (n=1), or vascular injury (n=1).

Of the 33 patients whose surgeries were completed entirely with SiPPS, the average hospital stay was 1 day. The average procedure time was 133 minutes, and mean estimated blood loss was 51 mL. In comparison, for the cases converted to laparotomy, the average hospital stay was 6.3 days, average procedure time was 297 minutes, and mean estimated blood loss was 1400 mL.

Most of the SiPPS procedures (41%) occurred in the last quarter of the first year of adoption. In addition, most (75%) full uterine cancer staging occurred in the last 2 quarters of the year.

The surgical outcomes for SiPPS procedure are similar to those of traditional laparoscopic technique, according to the study data. However, SiPPS was clearly beneficial in terms of length of hospital stay and estimated blood loss.