Is single port laparoscopy for benign adnexal disease less painful than conventional laparoscopy A single center Randomized Controlled Trial

Capsule:
There is no difference in experienced postoperative pain between laparo-endoscopic single-site surgery and conventional laparoscopy for benign adnexal disease.

Authors:
Christian Hoyer-Sorensen, M.D., Ingvild Vistad, M.D., Ph.D., Karen Ballard, M.Sc., Ph.D.

Volume 98, Issue 4, Pages 973-979, October 2012

Abstract:

Objective:
To determine whether laparo-endoscopic single-site surgery (LESS) results in less postoperative pain and a better cosmetic surgical scar when compared to conventional laparoscopy.

Design:
A prospective, randomized controlled trial.

Setting:
A county hospital in Norway.

Patients:
Forty women with benign adnexal disease or a hereditary cancer risk scheduled for laparoscopic adnexal surgery.

Intervention:
LESS or conventional laparoscopy.

Main Outcome Measure:
Postoperative pain 24 hours after surgery.

Results:
There was no difference in pain at 24 hours after surgery, with a mean score of 3.0 (SD 2.1) in the LESS group and 2.5 (SD 1.5) in the conventional laparoscopy group. Significantly more shoulder tip pain was reported by women undergoing LESS compared with those having conventional surgery at 6 and 24 hours after surgery. A high satisfaction with the cosmetic result was reported in both groups, with no significant difference in the Manchester scar scale score.

Conclusions:
Although similar levels of postoperative pain are experienced by women having LESS and conventional laparoscopic surgery, women having LESS report significantly more shoulder tip pain compared to those having conventional laparoscopic surgery. This may relate to a significantly longer operation time in the LESS group.

Clinical Trials Registration Number:
NCT01288599

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