Korean J Obstet Gynecol.  2010 Aug;53(8):720-726. 10.5468/kjog.2010.53.8.720.

Transumbilical single-port access laparoscopic surgery of ectopic pregnancy

• Eom JM
• Roh HJ
• Lee SJ
• Joo WD
• Lee MY
• You RM
• Yoo HJ

• KMID: 2273990
• DOI: http://doi.org/10.5468/kjog.2010.53.8.720

Abstract

OBJECTIVE
To evaluate the effectiveness of transumbilical single-port access laparoscopic surgery of ectopic pregnancy.
METHODS
Retrospective analysis was performed on six patients who underwent transumbilical single-port access laparoscopic management of ectopic pregnancies.
RESULTS
The median age of 6 cases was 33.5 years (range, 32 to 36), and the median body mass index was 20.6 kg/m2 (range, 16.5 to 28.7). The median largest diameter of G-sac was 4.8 cm (range, 3.0 to 5.4). Intracorporeal rupture and hemoperitoneum were accompanied in all cases. The median time needed for the surgery was 77.5 minutes (range, 59 to 95). The median estimated blood loss was 40 mL (range, 20 to 50). The median postoperative hospital day was 2 days (range, 1 to 3). There were no complications on postoperative course and follow-up.
CONCLUSION
Transumbilical single-port access laparoscopic surgery for ectopic pregnancy was feasible and safe. This approach might be reasonable alternative to conventional laparoscopic surgery using 3 or 4 port in the management of ectopic pregnancy.

Keyword

Single-port access; Multi-channel port; Ectopic pregnancy; Laparoscopy

MeSH Terms

Body Mass Index
Female
Follow-Up Studies
Hemoperitoneum
Humans
Laparoscopy
Pregnancy
Pregnancy, Ectopic
Retrospective Studies
Rupture

Figure

• 

  Fig. 1 (A) Preparation of single umbilical port. ① An ALEXIS® wound retractor XS was inserted through the umbilicus. ② The wrist portion of a 6 1/2 glove wrapped the retractor, and 3 trocars (5 mm, 10 mm, 5 mm) were inserted into the fingers of the glove and tied. (B), (C) 5 mm endoscope, suction irrigator and flexible instruments (Roticulator®, Covidien, Mansfield, MA; Real Hand®, Novare Surgical System, Cupertino, CA, USA) were inserted through single umbilical port.

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  Fig. 2 Intraoperative view of transumbilical single port laparoscopic salpingectomy. (A) Left tubal pregnancy and hemoperitoneum. (B) Rupture of left tubal pregnancy was identified. (C) Left salpinx was being resected. (D) The left salpinx was surgically resected and the hematoma was evacuated.

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  Fig. 3 Postoperative umbilical wound after two months later. It is hard to find skin incision scar in umbilicus.

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