Background Single-port access laparoscopy (SPAL) technique is developing in thegynaecological field This approach may increase the benefits of traditional minimally invasive surgery such as decreased blood loss and postoperative pain, faster recovery time, fewer complications, and better cosmetic results, without increasing costs. Nevertheless, few cases on SPAL ovarian surgery concomitant with the treatment of other diseases located in different abdominal locations have been reported. Methods Description of two cases of concomitant SPAL surgery in the Division of Gynecology and Obstetrics, University of Cagliari, Italy with X-cone (K. Storz, Tuttlingen, Germany). Results The first patients (28 years old, BMI 22) complained of pelvic pain related to an ovarian endometriosis of 5 cm in the left ovary and abdominal post prandial pain related to gallstones. She underwent single port laparoscopy for cholecystectomy and ovarian endometrioma excision. Surgery lasted 55 minutes, she was discharged after two days without any early or late complications. She had two pregnancy with two live vaginal deliveries of healthy children. The second patients (34 y, BMI 24) presented an ovarian dermoid cysts and chronic abdominal pain related to chronic appendicitis. She underwent SPAL for the removal of the cyst and appendectomy with Endo Gia stapler (Covidien). Surgery lasted 50 minutes and the patients was discharged on day three. Follow-up was uneventful and she reported the resolution of pre-surgical symptoms. Conclusions Single port laparoscopy seems the best approach when concomitant disease in different abdominal quadrants are present. Infact, this approach eliminates the problem of multiple and different site placement for accessory ports, typical of these procedures when performed simultaneously at conventional laparoscopy. It consents to reduce surgical risks related to the number of ports, it is a feasible and simple technique and has good cosmetic results with high patient satisfaction
Single port access laparoscopy (spal): is it the best treatment of concomitant diseases in different abdominal quadrant?
Gianmarco Dancona;Maurizio Nicola D'Alterio;Stefano Angioni
2019-01-01
Abstract
Background Single-port access laparoscopy (SPAL) technique is developing in thegynaecological field This approach may increase the benefits of traditional minimally invasive surgery such as decreased blood loss and postoperative pain, faster recovery time, fewer complications, and better cosmetic results, without increasing costs. Nevertheless, few cases on SPAL ovarian surgery concomitant with the treatment of other diseases located in different abdominal locations have been reported. Methods Description of two cases of concomitant SPAL surgery in the Division of Gynecology and Obstetrics, University of Cagliari, Italy with X-cone (K. Storz, Tuttlingen, Germany). Results The first patients (28 years old, BMI 22) complained of pelvic pain related to an ovarian endometriosis of 5 cm in the left ovary and abdominal post prandial pain related to gallstones. She underwent single port laparoscopy for cholecystectomy and ovarian endometrioma excision. Surgery lasted 55 minutes, she was discharged after two days without any early or late complications. She had two pregnancy with two live vaginal deliveries of healthy children. The second patients (34 y, BMI 24) presented an ovarian dermoid cysts and chronic abdominal pain related to chronic appendicitis. She underwent SPAL for the removal of the cyst and appendectomy with Endo Gia stapler (Covidien). Surgery lasted 50 minutes and the patients was discharged on day three. Follow-up was uneventful and she reported the resolution of pre-surgical symptoms. Conclusions Single port laparoscopy seems the best approach when concomitant disease in different abdominal quadrants are present. Infact, this approach eliminates the problem of multiple and different site placement for accessory ports, typical of these procedures when performed simultaneously at conventional laparoscopy. It consents to reduce surgical risks related to the number of ports, it is a feasible and simple technique and has good cosmetic results with high patient satisfaction
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