Postoperative abdominopelvic adhesion and umbilical wound validation after single-port laparoscopy or two-port laparoscopy for gynecological surgery: a comparison with conventional laparoscopy.

PURPOSE: The emergence of minimally invasive surgery has led to the development of laparoscopic surgery to reduce the number of ports. Although the incision for the umbilical port is sufficiently large, thus reducing the number of ports used during laparoscopic surgery, postoperative complications involving incisions at port sites have been reported. Thus, we analyzed postoperative intraperitoneal outcomes after laparoscopy by reviewing operation records and photographs of consecutive surgeries.

METHODS: A total of 134 patients were enrolled in the clinical study to analyze their intraperitoneal outcomes. The patients were divided into groups, which were compared and analyzed on the basis of the number of ports used intraoperatively. The clinical characteristics of the patients were obtained from their medical records, and their operation records, including those of their consecutive operations, were analyzed.

RESULTS: Patients who underwent single-port laparoscopy were included in Group 1, patients who underwent two-port laparoscopy were included in Group 2, and patients who underwent three-port laparoscopy or four-port laparoscopy were included in Group 3. Correlation analysis of the number of ports used during surgery revealed that the white blood cell count before and after surgery and the intraperitoneal umbilical adhesion score were negatively correlated. The incidence of intraperitoneal umbilical adhesions increased as the number of ports used during laparoscopy decreased.

CONCLUSIONS: Because the incidence of postoperative intraperitoneal umbilical adhesion increases as the size of the umbilical wound increases, such as after single-port laparoscopy, surgical umbilical wounds should be cautiously repaired after single-port laparoscopic surgery.