Safety and feasibility of laparoendoscopic single-site surgery in the management of giant ovarian cysts

Objective To investigate the safety and feasibility of laparoendoscopic single-site surgery (LESS) in the treatment of giant ovarian cysts. Methods A total of 76 patients with giant ovarian cyst (diameter ≥ 10 cm) who received surgical treatment in our hospital from January 2018 to May 2021 were divided into experimental cohort (single-port laparoscopic cohort) (n = 30) and control cohort (traditional laparoscopic cohort) (n = 46).The operation time, intraoperative blood loss, intraoperative cyst fluid spillage rate, application of postoperative analgesic drugs, postoperative first anus exhaust time, incidence rate of perioperative complications, length of postoperative hospital stay and other clinical indicators were summarized and analyzed between the two cohorts. Results The LESS cohorts had an earlier onset of age[ (27.6 ± 8.4) ,years of age], shorter of operation time [(82.2 ± 16.0)min], less of intraoperative blood loss [( 17.5 (10-22.5) ml)] as compared with traditional laparoscopic cohort[ (40.9 ± 15.5 )years of age, (102.7 ± 26.2)min, (20 (18.7–35) )m,P ༜ 0.05]. The first postoperative exhaust time,the rate of postoperative analgesic drugs, incidence rate of perioperative complications and postoperative hospital stay in two cohorts were in the similar line. Conclusion After adequate evaluation and screening of patients, the size of ovarian cysts cannot be the reason for refusing LESS surgery. It is safe and feasible for clinical promotion in the management of giant ovarian cysts.

Fundamentals of the Robotic Assisted Laparoscopic Single Port System and Utility in Minor Gynecologic Surgery

This chapter will introduce the single port robotic system. Topics include an introduction to the robotic single site port, the trocars, and the single site instruments. Step-by-step instruction is provided on how to create the umbilical incision and properly insert the single site port and trocars. The advantages and disadvantages of single port robotic surgery compared to multiple port robotic surgery and laparoscopic single site surgery are reviewed. Surgical tips and tricks are provided throughout each section to maximize efficiency, minimize complications, and overcome inherent limitations of the robotic single site system. The utility of the robotic single site platform for performing minor gynecologic surgery is discussed. Finally, a simple method for umbilical closure is described.

Comparison of Weighted and Unweighted Task Load Indices for Single-Site Surgery Tasks

Background: The National Aeronautics and Space Administration Task Load Index (NASA-TLX) a nd Surgery Task Load Index (SURG-TLX) are two subjective workload m easurement instruments. Both instruments provide unweighted andweightedworkload measurements. Weighted TLX m easures have seldomly been used byresearchers typically becauseof its high correlation with unweighted TLX a nd addedexperimentaltime to collect pairwise weightings. Therefore, theaim of thestudy wa s to compare weighted TLX scores with unweighted TLX scores and each’s sensitivity for demographic and experimentalfactors. Methods: Two simulated la paroscopic single site surgery tasks were completedusing four surgicalmethods by 25 participants. Pearson correlations, principle componentanalyses and mixed effect models were used to compare the unweightedandweighted TLXscores across tasks a nd methods. Results: There was a high correlation(r > 0.950, p < 0.001) betweentheunweighted TLXscores and the weighted TLX scores. The weighted TLX scores showed better sensitivity to both demographic and experimental factors for both TLX instruments. Conclusion: The overall weighted NASA-TLX and SURG-TLX scores differed from their respective unweighted scores even with a high correlation. The weighted TLXshowed potentialto better discriminate subjective workloadfor single-site ta sks. Future research is needed to identify and validatea more streamlinedweightingmethodparticularly for complex experimental taskslike single-site surgery.

Laparoendoscopic Single Site Hysterectomy: Literature Review and Procedure Description

Laparoendoscopic single site surgery (LESS) refers to a spectrum of surgical techniques that allow the performance of laparoscopic surgery through consolidation of all ports into one surgical incision. LESS has emerged as a potentially less invasive alternative to multiport laparoscopy and in the last year in gynecology; hence, this approach has been largely applied for selective indications to perform total hysterectomy. We performed a literature review on single site hysterectomy and described indications and technique, highlighting practical problems, pointers, limitations and recent technical development as robotic assistance.