Single Incision Laparoscopic
Surgery for Gynecology:
Experience of Ankara Training and
Research Hospital
Yetkin Karasu, Mustafa Burak Akselim, Duygu Doğdu, Yusuf Ergün
Ankara Training and Research Hospital
2017-05-17
SILS for gynecology
 2014 Single center
 112 patients
 Benign adnexal masses
 Ectopic Pregnancies
 Surgical sterilization
SILS for benign adnexal masses
 32 patients
Surgeries Performed
 Single center
• Salpingectomy
Pathological
diagnosis
• Cystectomy
Functional cyst
15
•Endometrioma
Salpingooopherectomy
3
• Oopherectomy
 2014-
 Prospective study
21
2
4
4
• Cystectomy-Ovarian Detorsion
1
Dermoid
cyst
6
Estimated Blood
Loss (ml) (mean) (±SD)
28.1±24.4
Hematocrit Change (%) (mean) (±SD)
2.9±2.2
Conversion to Laparotomy
0
Mucinous cystadenoma 4
Intraoperative Complication
Parasitic myoma
0
0
Postoperative Complication
0
Operation Time (min.) (mean) (±SD) 2
Hydrosalpinx
65.9±19.7
Length of Hospital-Stay (days) (mean)
Cystadenofibroma
2 1.79±0.8
(±SD)
Karasu, Yetkin, et al. "Comparison of single-incision and conventional laparoscopic surgery for benign adnexal
masses." Minimally Invasive Therapy & Allied Technologies (2017): 1-6.
SILS for benign adnexal masses
Age (years) (mean) (±SD)
CLS (n=39) SILS (n=32) P
29.9±7.96 31.1±8.35 0.628
Gravidity (median) (min-max)
2 (0-5)
2 (1-5)
0.309
Parity (median) (min-max)
2 (0-2)
2 (1-5)
0.57
BMI (kg/m2) (mean) (±SD)
23.4±2.83 24.8±3.69
0.218
Previous abdominal surgery)
Laparotomy
4
12
Laparoscopy
2
0
Adnexal mass size (cm) (mean) (±SD) 7.48±1.89 7.92±1.41
0.014
0.162
Karasu, Yetkin, et al. "Comparison of single-incision and conventional laparoscopic surgery for benign adnexal
masses." Minimally Invasive Therapy & Allied Technologies (2017): 1-6.
SILS for benign adnexal masses
Postoperative pain scores (mean)
CLS (n=39) SILS (n=32) P
(±SD)
Recovery room
7.94±1.24 6.71±1.46
0.001
6th hour
4.29±1.20 3.07±1.39
<0.001
12th hour
2.89±1.30 1.86±1.21
0.003
24th hour
1.60±0.95 1.28±1.24
0.195
Additional analgesic dose (ampules) 1.37±0.49 1.18±0.39
0.095
SILS for surgical sterilization
 48 patients
 Single center
 2014 Method: Parsial salpingectomy
SILS for surgical sterilization
CLS (n=62)
Age (years) (mean) (±SD)
Gravidity (median) (min-max)
Parity (median) (min-max)
Abortion (median) (min-max)
BMI (kg/m2) (mean) (±SD)
SILS
(n=48)
34.7 (±3,26) 36.1 (±3,45)
4 (1-6)
3 (1-6)
0 (0-4)
4 (2-11)
3 (2-8)
1 (0-4)
24.9 (±3,80) 25.1 (±2,82)
P
0.055
0.031
0.722
0.005
0.267
Mode of previous deliveries
Vaginal
Caesarean section
45 (72.6%)
17 (27.4%)
33 (68.8%)
15 (31.3%)
0.661
§
SILS for surgical sterilization
CLS (n=62)
SILS (n=48)
P
Mean Laparoscopic Entry Time
(min.) (±SD)
6,96 (±2,89)
4.85
(±1,45)
<0.001
Mean Operation Time (min.) (±SD)
39.1 (±12,04)
37.2
(±8,43)
0.190
Mean Hematocrit Change (%)(±SD)
2.35 (±2,02)
2.43
(±2,44)
0.491
Mean Length of Hospital-Stay
(days) (±SD)
1.56 (±0,49)
1.45
(±0,50)
0.271
Conversion to Laparotomy %
0
0
NA
SILS for surgical sterilization
Postoperative pain scores
(mean) (±SD)
CLS (n=62)
SILS
(n=48)
P
Initial (recovery room)
7,12 (±1,26)
6,79 (± 1,35)
0.506
6th hour
3,71 (± 0,80)
4,04 (± 1,20)
0.119
12th hour
2,65 (± 0.95)
2,46 (± 0,85)
0.279
24th hour
1,77 (± 1,02)
1,58 (± 0,82)
0.373
Additional analgesic dose
(ampule)
1,81 (± 0,82)
1,02 (± 0,40)
0.739
SILS for ectopic pregnancy
Age (years) (mean)
(±SD)
Gravidity (median)
(min-max)
Parity (median) (minmax)
BMI (kg/m2) (mean)
(±SD)
SILS
n=32
32,4
(±5,68)
3 (2-5)
2 (0-3)
26,5
(±3,57)
Previous Surgery
LPT
5 (15,6%)
LS
3 (9,4%)
SILS for ectopic pregnancy
SILS
SILS
(n=32)
Postoperative pain
scores (mean) (±SD)
Mean Operation Time
(min.) (±SD)
52,8
(±21,1
8)
Initial (recovery
room)
7,9 (± 1,39)
Mean Hematocrit Change
(%)(±SD)
3,4
(±2,14)
6th hour
4,34 (± 1,14)
Mean Length of HospitalStay (days) (±SD)
1,6
(±0,49)
12th hour
3,04 (± 1,17)
24th hour
1,47 (± 1,36)
(n=32)
Conclusion
 SILS is effective and safe method for the treatment of
benign adnexal masses and ectopic pregnancies.
 SILS may also be preferred in cases of surgical
sterilization.
Thank you for your
attention