Single-Port Laparoscopically Assisted Transumbilical Ultraminilaparotomic Myomectomy

The objective of this prospective observational study, performed in a university hospital and a tertiary care center, was to describe the surgical technique and our initial experience with single-port laparoscopically assisted transumbilical ultraminilaparotomic myomectomy (SPLA-TUM). During July and August 2012, 15 women with symptomatic subserosal or superficial intramural myomas (≤8 cm) underwent SPLA-TUM. Mean (SD) operative time was 64.9 (9.5) minutes, hemoglobin change was 1.2 (0.5) g/dL, return of bowel activity was 32.8 (3.5) hours, and length of hospital stay was 3.1 (0.4) days. In 1 patient (6.7%), SPLA-TUM did not provide a satisfactory surgical field, and thus the procedure was converted to single-port laparoscopic myomectomy. There were no surgical or wound complications. Compared with single-port laparoscopic myomectomy, SPLA-TUM, which was designed by integrating the surgical techniques of single-port laparoscopy and laparotomy, can reduce operative time by enabling comfortable suturing and reliable knot tying while maintaining the advantages of single-port laparoscopy. SPLA-TUM is a feasible alternative in selected patients with symptomatic myomas.