Single port access laparoscopic adnexal surgery.

STUDY OBJECTIVE To estimate the feasibility, safety, and operative outcomes for the management of adnexal masses by single port access (SPA) laparoscopy with a wound retractor and a surgical glove. DESIGN A prospective single-center study (Canadian Task Force classification III). SETTING University hospital. PATIENTS Twenty-four well selected patients with adnexal masses on imaging scans recruited from June 2008 through January 2009. INTERVENTIONS Single port access laparoscopic adnexal surgery. MEASUREMENTS AND MAIN RESULTS Single port access laparoscopic adnexal surgery was successfully completed in 22 of 24 patients. The median age of the patients was 45 years (range 23-63 years), and the median body mass index was 22 (range 18-29). The median tumor size was 5 cm (range 3-12 cm). The median operative time was 70 minutes (range 40-128 minutes). The estimated blood loss was minimal (range 10-100mL). The postoperative course was uneventful in all patients. The median postoperative hospital stay was 1 day (range 1-3 days). No postoperative complications were observed at follow-up. The 2 failed cases were as follow: 1 required an additional trocar for adequate adhesiolysis, and the other a staging laparotomy because of the finding of a borderline ovarian malignancy on frozen section pathologic study. CONCLUSION The single port access laparoscopic adnexal surgery was safe and feasible and provided almost no visual scar.