Clinical Application Of Transumbilical Small Incision Laparoscopic Assisted Extracorporeal Ovarian Cystectomy

Objective:To evaluate the clinical outcome of transumbilical small incision laparoscopic assisted extracorporeal ovarian cystectomy.Methods:Retrospectively collected the clinical data of 77 cases who underwent ovarian cystectomy at gynecology department of Qianfoshan Hospital Affiliated to Shandong University from November 2017 to March 2019.22 of them underwent transumbilical small incision laparoscopic assisted surgery(the small incision group),18 of them underwent single-site laparoscopic surgery(the single-site group),and 37 of them underwent conventional multi-port laparoscopic surgery(the multi-port group).The operative time,intraoperative blood loss,complications,bowel function recovery time,postoperative pain score,postoperative hospital stay and hospital costs were compared between the three groups.Results:The median operation time in small incision group was shorter than in single-site group and multi-port group[(84.86±32.82)min vs.(122.83±54.1 6)min vs.(110.49±42.76)min],and the differences were statistically significant(P<0.05);the median operation time in single-site group and multi-port group showed no statistical difference(P>0.05).The incidence rate of bowel function recovery 12h postoperatively in small incision group was higher than in multi-port group[77.27%(17/22)vs.51.35%(19/37)],and the difference was statistically significant;the incidence rate in small incision group was also higher than in single-site group[77.27%(17/22)vs.55.56%(10/18)],but the difference was not statistically significant(P>0.05);the incidence rate in single-site group and multi-port group showed no statistical difference(P>0.05).Total cost of single-site group was higher than small incision group and multi-port group[(14710.40±3264.30)yuan vs.(12624.64±2652.57)yuan vs.(13002.65±2554.96)yuan],and the differences were statistically significant(P<0.05);total cost of small incision group and multi-port group showed no statistical difference(P>0.05).No significant differences were found in intraoperative blood loss,incidence of complications,postoperative pain score and postoperative hospital stay between the three groups.Two pregnant patients in small incision group were pregnant to term delivery after operation without complication.Conclusions:Transumbilical small incision laparoscopic assisted extracorporeal ovarian cystectomy retains the minimal invasive advantages of laparoscopic surgery,and overcomes the problems of space constraints and difficult operations in laparoscopic surgery for treatment of large ovarian cysts.Compared with single-site laparoscopic surgery and conventional multi-port laparoscopic surgery,it simplifies the surgical procedure and reduces the operation time.Transumbilical small incision laparoscopic assisted extracorporeal ovarian cystectomy is safe and feasible for treatment of large ovarian cysts and ovarian cysts during pregnancy after the adequate preoperative and intraoperative evaluation.