Single-Port Compared With Conventional Laparoscopic-Assisted Vaginal Hysterectomy A Randomized Controlled Trial

OBJECTIVE: To compare the immediate results of patients undergoing either two-channel single-port laparoscopic-assisted vaginal hysterectomy or conventional multiport laparoscopic-assisted vaginal hysterectomy. METHODS: Patients were randomly assigned to undergo laparoscopic-assisted vaginal hysterectomy using the single-port (n=50) or conventional (n=50) approach. The outcome measures included blood loss, operative time, intraoperative and immediate postoperative complications, time to flatus passage after operation, and postoperative pain (assessed by the visual analog scale score and postoperative analgesics use). RESULTS: The general characteristics of the patients were similar in both groups. There were no statistically significant differences in operative time, estimated blood loss, time to first flatus, intraoperative and immediate postoperative complications, shoulder tip pain, or length of hospital stay between the two groups. However, postoperative pain was significantly less in the single-port group compared with the conventional group, as evidenced by lower mean scores on the visual analog scale (3.64 +/- 2.75 compared with 5.08 +/- 2.76 at 24 hours, P=.011 and 1.94 +/- 2.31 compared with 2.84 +/- 2.07 at 48 hours, P=.043) and less mean accumulated dose of postoperative analgesics (74.40 +/- 24.25 mg compared with 104.80 +/- 57.08 mg of meperidine, P=.001; 16 +/- 13.40 mg compared with 33.6 +/- 28.7 mg of tenoxicam, P <.001). CONCLUSION: Transumbilical two-channel single-port laparoscopic-assisted vaginal hysterectomy significantly decreases postoperative pain and analgesic use.