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Two-Port Access Laparoscopic Surgery in Gynecologic Oncology
  1. Maria Lee, MD*,
  2. Eun Ji Nam, MD, PhD,
  3. Sunghoon Kim, MD, PhD,
  4. Jae Hoon Kim, MD, PhD,
  5. Young Tae Kim, MD, PhD and
  6. Sang Wun Kim, MD, PhD
  1. *Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Kangdong Sacred Heart Hospital, Hallym University, Seoul, Republic of Korea; and
  2. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
  1. Address correspondence and reprint requests to Sang Wun Kim, MD, PhD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea. E-mail: san1{at}yuhs.ac.

Abstract

Purpose The purpose of this study was to evaluate the feasibility and safety of 2-port access (TPA) laparoscopy in gynecologic oncology.

Methods This was a retrospective review of 81 consecutive patients who underwent TPA laparoscopic surgery for various gynecologic cancers from March 2009 to September 2011. The TPA system consisted of a single multichannel port at the umbilicus and an ancillary 5-mm port in the suprapubic area.

Results The surgical procedures included comprehensive ovarian cancer staging (33 patients), radical hysterectomy with pelvic lymph node dissection (19 patients), and endometrial cancer staging (29 patients). All surgical procedures were completed laparoscopically with no conversion to laparotomy. Two cases required 1 or 2 additional ports. The mean operating time, estimated blood loss, and number of lymph nodes were 253.8 minutes, 170.7 mL, and 34.9, respectively. Three patients (9.1%) with ovarian cancer and 4 patients (13.8%) with endometrial cancer were upstaged after surgery. The mean postoperative hospital stay was 6.6 days, and the mean postoperative pain scores (0–10 scale) were 3.4 at 6 hours, 3.0 at 24 hours, and 2.5 at 48 hours. Postoperative complications occurred at a low incidence (4.9%) and included one umbilical hernia, one vault dehiscence, and one lumbosacral nerve injury.

Conclusions Two-port access laparoscopic surgery using a single multichannel port system is a feasible and safe procedure in selected patients with gynecologic cancers. Prospective randomized trials will permit the evaluation of the potential benefits of this minimally invasive surgical technique.

  • Two-port access
  • Minimally invasive surgical procedures
  • Laparoscopy
  • Gynecologic neoplasms
  • Gynecologic surgery

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Footnotes

  • This study was supported by the Brain Korea (BK) 21 project for medical sciences, Yonsei University, and the National Research Foundation of Korea grant funded by the Korean Government (2011-0013127).

  • Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (www.ijgc.net).

  • The authors declare no conflicts of interest.

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