A prospective comparison of single-port laparoscopically assisted vaginal hysterectomy using transumbilical GelPort access and multiport laparoscopically assisted vaginal hysterectomy

Objective: To evaluate the feasibility and safety of single-port laparoscopically assisted vaginal hysterectomy (SP-LAVH) using transumbilical GelPort access. Study design: A prospective case-control study was performed at a University teaching hospital between January 2009 and March 2010, a total of 242 women with a uterus ≤16 weeks gestational size were enrolled in the study. Eighty women underwent SP-LAVH using transumbilical GelPort access (SP-LAVH group), and 162 women underwent conventional multiport LAVH (conventional LAVH group). Results: There were no statistical differences between groups in the patients' demographic characteristics, median operating time (92.5 vs. 90 min; P = 0.479), postoperative changes in hemoglobin concentration (1.4 vs. 1.4 g/dL; P = 0.290), weight of the resected uterus (246 vs. 256 g; P = 0.098), return of bowel activity (37.1 vs. 39.8 h; P = 0.103), hospital stay (3 vs. 3 days; P = 0.554), complication rate (3.8 vs. 4.3%; P = 1.000), and the rate of using an additional trocar or conversion to laparotomy (1.3 vs. 0.6%; P = 0.553). Conclusions: SP-LAVH using transumbilical GelPort access is feasible and safe in women with a uterus ≤16 weeks gestational size. However, a large prospective randomized study is needed to confirm this conclusion and to establish guidelines for the use of SP-LAVH.