Two-port access staging laparoscopy for gynecologic cancers: a pilot study

Abstract

BACKGROUND: The aims of this work were to introduce a two-port access (TPA) staging laparoscopy in gynecologic cancers and evaluate the feasibility and surgical outcomes of this operation.

MATERIALS AND METHODS: We performed 12 cases of TPA staging laparoscopy. The TPA system consisted of a single multichannel port at the umbilicus and an ancillary 5-mm port in the suprapubic area. Patient status was estimated in terms of operative morbidity and surgical outcomes.

RESULTS: All operations were completed laparoscopically, with no conversions to conventional laparoscopy or laparotomy. Procedures included endometrial cancer staging (n = 6), ovarian cancer staging (n = 3), 2 cases of type III radical hysterectomy, and 1 type II radical hysterectomy. Median patient age and body mass index were 48 years and 20.4 kg/m(2), respectively. Median operation duration was 241 minutes (range, 188-360). Median estimated blood loss was 175 mL. Median number of lymph nodes obtained was 30 (range, 14-49). Median postoperative hospital stay was 8 days. There were no perioperative complications.

CONCLUSIONS: TPA staging laparoscopy, using the single multichannel port system, could be a feasible procedure in selected gynecologic cancer patients, with only minimal skin incisions. Prospective, randomized trials will permit the evaluation of potential benefits of this minimally invasive surgical technique.