Rabischong B, Compan C, Savary D, Bourdel N, Canis M, Mage G, Botchorishvili R
Service de Gynécologie-Obstétrique et Reproduction Humaine, CHU de Clermont-Ferrand, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France.
J Gynecol Obstet Biol Reprod (Paris). 2013 Sep;42(5):445-57. doi: 10.1016/j.jgyn.2013.03.018. Epub 2013 Jun 10.
Single-incision laparoscopic surgery (SILS) is a recent technic of minimally invasive surgery that arouses a growing interest due to its potential benefits in terms of pain and cosmetic. However, in gynecology as well as in other surgical specialties, preliminary results seem to be controversial. Its feasibility and interest by comparison with conventional laparoscopy (CL) have not been confirmed by randomized multicenter studies.
Compare in gynecological surgery, feasibility and surgical outcomes (conversion rate and complications, postoperative pain, duration of surgery, length of hospital stay, appearance and cost) between SILS and CL.
For this, a review of the literature from a PUBMED and Medline databases was conducted. The clinical cases and series with fewer than 10 patients were excluded. Eligible data were compared and analyzed.
A total of 46 studies including five prospective randomized were studied in gynecology. Conversion rates and complications appear identical to those of the CL. The learning curve is also comparable. The technique is not standardized and some ergonomic problems are described. Operating time and duration of hospitalization seems to be comparable. The postoperative pain assessment found conflicting results. The cosmetic results are in favor of the single incision laparoscopy. Finally, the cost is higher.
According to the literature, the single incision laparoscopy seems feasible and safe, with better cosmetic results. But the cost is increased and associated with no benefit in terms of pain, operating time and duration of hospitalization. Beyond cosmetics results, further randomized studies are needed to identify a possible benefit.
单孔腹腔镜手术（SILS）是一种最新的微创手术技术，因其在疼痛和美观方面的潜在优势而引起越来越多的关注。然而，在妇科以及其他外科专科领域，初步结果似乎存在争议。与传统腹腔镜手术（CL）相比，其可行性和优势尚未得到随机多中心研究的证实。
比较妇科手术中SILS与CL的可行性和手术结果（中转率和并发症、术后疼痛、手术时长、住院时间、外观及费用）。
为此，对来自PUBMED和Medline数据库的文献进行了综述。排除了患者少于10例的临床病例和系列研究。对符合条件的数据进行了比较和分析。
共研究了妇科领域的46项研究，其中包括5项前瞻性随机研究。中转率和并发症与CL相似。学习曲线也相当。该技术尚未标准化，且存在一些人体工程学问题。手术时间和住院时间似乎相当。术后疼痛评估结果相互矛盾。美容效果有利于单孔腹腔镜手术。最后，费用更高。
根据文献，单孔腹腔镜手术似乎可行且安全，美容效果更好。但费用增加，且在疼痛、手术时间和住院时间方面并无益处。除美容效果外，还需要进一步的随机研究来确定可能的益处。
