Role of single-site and mini-laparoscopy in gynecologic surgery
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INTRODUCTION: Laparoscopy is a surgical procedure that has been used widely in medicine over the last thirty years. In gynecology, laparoscopy is the "gold standard" for the majority of gynecological procedures, as its superiority over laparotomy has been widely demonstrated. In recent years, the current trend of gynecologists is to make laparoscopy surgery even less invasive by reducing the number of incisions in the skin, as it happens with laparoendoscopic single-site surgery, or by reducing the size of them as in mini-laparoscopy. The aim of this work was to perform an extensive review and update of the evolution of single-port surgery and mini-laparoscopic surgery in gynecology as well as to evaluate its current role in this field.EVIDENCE ACQUISITION: A systematic review was performed during April and May 2020. PRISMA guidelines were followed for the literature search.EVIDENCE SYNTHESIS: The main objective of performing less invasive procedures is to reduce both intraoperative complications (decreased risk of bleeding or damage to internal organs), and postoperative ones (hernias through the trocar) and improve cosmetic results. Results of studies about LESS and mini-LPS showed encouraging results, being both of them safe with a similar perioperative and postoperative outcome. They have the approval of the international surgical community as well as patients' satisfaction with cosmetic results.CONCLUSIONS: Minimally invasive surgery is the present and future in gynecological surgery. More prospective randomized trials are needed in order to obtain valid results and affirm that both LESS and Mini-LPS are superior to conventional laparoscopy.Keywords:
Gold standard (test)
Gynecological surgery
Invasive surgery
Abstract. A comparison of surgical techniques (SILS, NOTES, Da Vinci robotic system, 3D modeling, Radius Surgical System) showed that they will provide endovideosurgery with new ways of performing surgical interventions in the near future. The aim of the research. Conducting a comparative analysis of minimally invasive surgical methods of treatment used in modern gynecological practice, as well as identifying their advantages and disadvantages, indications and contraindications for use, possible complications. Material and methods. A review of the data in PubMed, eLibrary, Cyberleninka, Scopus and WoS on the keywords “minimally invasive surgery”, “NOTESsurgery”, “SILS-surgery”, “Da Vinci system”, “3D modeling”, “gynecology” for 2016-2021 was performed. In addition, a manual search for articles in journals was carried out. Exclusion criteria from the analysis: description of individual clinical cases, books and documents. The final analysis included 60 sources out of 127 initially identified. Results. Minimally invasive surgical technologies have become the method of choice in the diagnosis and treatment of many gynecological pathologies
Gynecological surgery
Invasive surgery
Minimally invasive procedures
Clinical Practice
Surgical procedures
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OBJECTIVE To discuss the item management mode for the minimally invasive laparoscopic,the coordination of the countermeasures for the minimally invasive laparoscopic surgery so as to meet the requirement of the minimally invasive laparoscopic surgery.METHODS The various minimally invasive laparoscopic surgeries that completed in the surgery building from May to Jan 2011 were studied,the clinical data of the 2449 patients who underwent the laparoscopic surgery were extracted and analyzed.The daily table management of the laparoscopic surgery was carried out.The shortcut green channel was established for the procedure.The laparoscopic resources were allocated integrally through the distribution management pattern.RESULTS From May 2010 to Jan 2011,a total of 2449 minimally invasive laparoscopic surgeries were studied,there were 28 cases that have met the standard of the management procedure pattern of item supply rmanagement.There was no case of surgery influenced by improper management of items and was case of cross infections,which ensured the smooth progress of the surgery.CONCLUSION The application of schedule of the laparoscopic surgery and the establishment of the shortcut green channel ensure the medical quality and medical safety and acquire both the economic and social benefit.
Invasive surgery
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In this paper, the development of an assisting system for laparoscopic surgical training is presented. With this system, we expect to facilitate the training process at the first stages of training in laparoscopic surgery and to contribute to an objective evaluation of surgical skills. To achieve this, we propose the insertion of multimedia contents and outlines of work adapted to the level of experience of trainees and the detection of the movements of the laparoscopic instrument into the monitored image. A module to track the instrument is implemented focusing on the tip of the laparoscopic tool. This tracking method does not need the presence of artificial marks or special colours to distinguish the instruments. Similarly, the system has another method based on visual tracking to localize support multimedia content in a stable position of the field of vision. Therefore, this position of the support content is adapted to the movements of the camera or the working area. Experimental results are presented to show the feasibility of the proposed system for assisting in laparoscopic surgical training.
Invasive surgery
Training System
Surgical instrument
Tracking (education)
Position (finance)
Tracking system
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Minimally invasive surgery is one of the major directions of surgical development in the 21st century.For laparoscopic surgery,representative of minimally invasive surgery,its development will lead revolution of surgical technology.The pattern,equipment and instruments involved in laparoscopic surgery are far different from the conventional operation,and so are the concepts and skills.Strengthening continuing education and operative skill training of laparoscopic surgeons are the key to reducing operation-related complications and achieve minimally invasive surgery.Standardized training plays an important role in the transformation from a surgeon to a laparoscopic surgeon.
Invasive surgery
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Objective: To compare and analyze the effects of laparoscopic surgery and laparotomy for coagulation system in patients.Methods: Seventy-five hysterectomy patients were randomly divided into the laparoscopic surgery group with 38 and laparotomy surgery group with 37.Blood coagulation method was used to determine the plasm prothrombin time(PT),active partial thromboplastic time(APPT),thrombin time(TT) and fibrinogen(FIB);and enzyme linked immunosorbent assay(ELISA) was used to measure the value of D-Dimer in blood at 24 hours before,24 and 48 hours after operation.Use automated bold cell technology to analyze platelet.Results: ①There were no significant differences between the laparoscopic surgery and laparotomy surgery groups of the contents of PT,APPT,TT,FIB,PLT and D-D in blood at 24 hours before and 48 hours after operation(P0.05).②The contents of PT and APTT decreased 24 hours and 48 hours after operation,but there were no significant differences between the laparoscopic surgery and laparotomy surgery groups(P0.05).However,there were significant differences between the results of 24 hours before and 24 and 48 hours after operation(P0.05).③ There were no significant differences between the laparoscopic surgery and laparotomy surgery groups of the content of TT and PLT at 24 hours before and 24 hours after operation(P0.05).④ The content of both FIB and D-D increased at 24 hours after operation,and this differs significantly from the content before operation(P0.05).However,there were no significant differences between the laparoscopic surgery and laparotomy surgery groups(P0.05).Conclusion: The establishment of a special carbon dioxide pneumoperitoneum,the low head and high hips bladder lithotomy position,and general anesthesia in laparoscopic hysterectomy,lead to the change of patient's hemodynamic,which slow down the speed of blood flow.This effect is the same as the effect in laparotomy surgery,which increases in the blood of patients showing hypercoagulable state and increase the risk of deep venous thrombosis.So we should highly care about laparoscopic patients associated with high risk factors of thrombosis,guard against the occurrence of thrombosis.
Thrombin time
Prothrombin time
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To compare the laparoscopic approach with laparotomy in the treatment of ectopic pregnancy. The aim of this study was to evaluate the efficiency of laparoscopic surgery for ectopic pregnancies in China.A retrospective analysis involving 142 patients with ectopic pregnancies was done. Seventy-two of the 142 patients were treated laparoscopically.In the laparoscopic group, the operating time and post-hospital stay were significantly shorter but the total cost was higher compared with the laparotomy group.Although the laparoscopic surgery for ectopic pregnancies is a new approach and it is not widely practiced in China; it has more advantages than open surgery and it has been well accepted by the surgeons and patients. It is a safe and feasible approach, but the rate of laparoscopic approach for ectopic pregnancy is still low in China when compared with the developed countries.
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Objective To study the clinical effect of laparoscopic colorectal surgery.Methods Clinical data of 110 cases underwent laparoscopic colorectal surgery from November 1996 to August 2006 were retrospectively reviewed and compared with those of 123 comparable patients treated by conventional laparotomy in the same period.Results Comparing with laparotomy group, there was longer mean operative time, less blood loss during operation, shorter postoperative bowel function recovery time, shorter postoperative hospitalization days, less complications, less average number of lymph nodes dissected and higher hospitalization costs in laparoscopic surgery group. The postoperative 1-, 3-,5-year survival of laparoscopic surgery group was 97.1%,83.1%, 67.6% ,respectively, equivalent to that of laparotomy surgery(P0.05).Conclusion Laparoscopic colorectal surgery for colorectal cancer is safe, with minimal invasion and rare complications. It can achieve long-term effect as conventional laparotomy. But the medical expenses must be lowered and systemic lymph node clearance should be improved.
Bowel function
Colorectal Surgery
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Invasive surgery
Gynecological surgery
Gynecologic surgical procedures
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Objective To assess the feasibility and safety of laparoscopy combined with minor laparotomy in managing gynecological benign diseases.Methods A retrospective analysis was made on 177 gynecological cases managed by performing laparoscopy combined with minor laparotomy.A series of 160 patients with comparable illnesses were subjected to routine laparotomic surgery to form a control group.Comparisons were made in terms of time of operation,amount of blood loss,recovery of bowel activities,length of hospital stay,and perioperative complications as well.Results No differences in operation time and blood loss were found between the two groups(P 0.05).Pass of flatus and mobilization were both earlier in the test group than in the control.No complications were encountered in the study.Conclusion Laparoscopic surgery combined with minor laparotomy can be safely and effectively adopted in most cases of gynecological benign diseases for its quicker recovery,shorter hospital stay and less morbidity.
Gynecological surgery
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Invasive surgery
Open surgery
Modalities
Port (circuit theory)
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