Would fewer port numbers in laparoscopy produce better cosmesis? Prospective study.

STUDY OBJECTIVE To determine whether fewer ports in laparoscopic adnexal surgery would lead to better cosmesis. DESIGN Prospective comparative study (Canadian Task Force classification II-2). SETTING University hospital. PATIENTS One hundred thirty consecutive patients with adnexal tumors. INTERVENTIONS Patients underwent laparoscopy using a single port (n = 75), 2 ports (n = 22), or 4 ports (n = 33). Cosmetic satisfaction was assessed using a validated Body Image Questionnaire at 1, 4, and 12 weeks after surgery. MEASUREMENTS AND MAIN RESULTS Patient characteristics (age, parity, and sociodemographic data), details of the procedures performed, and histologic findings were similar between the 3 surgical groups. There was also no difference in number of conversions to other surgical approaches, operative time, estimated blood loss, postoperative pain, and perioperative complications. Compared with the 2- and 4-port groups, the single-port group reported substantially greater cosmetic satisfaction at 1, 4, and 12 weeks after surgery. However, there was no important difference in cosmetic outcome throughout follow-up in the 2-t and 4-port groups. CONCLUSION Unlike 2- or 4-port laparoscopy, single-port laparoscopy has a definite benefit in cosmetic satisfaction.