Effectiveness of laparoendoscopic surgical treatment with single-site / single-incision laparoscopic surgery method in gynecological practice

Laparoendoscopic single-site surgery (LESS) / single-incision laparoscopic surgery (SILS) is considered the effective minimally invasive laparoendoscopic method for solving gynecological problems. The aim of the study was to clinically analyze and evaluate the main advantages and disadvantages of transumbilical LESS / SILS surgeries used in the surgical treatment of patients with tubo-ovarian pathologies. Materials and methods. Depending on the tasks and the methods of examination and surgical treatment, patients were divided into 3 large groups: group I (comparison group I) patients underwent laparotomic surgical interventions on the pelvic organs; group II (comparison group II) patients were subjected to classical laparoscopic surgical treatment tactics, and group III (main group) patients underwent minimally invasive LESS / SILS surgeries. Results. Pain intensity was statistically significantly lower measuring to 1.8 ± 0.1 cm on the Visual Analogue Scale in the postoperative period when applying LESS compared to other methods. The final analysis of intraumbilical scar on the Vancouver Scar Scale has revealed the highest cosmetic effect with a statistically significant score of 0.14 ± 0.08 6 months after LESS. In the long-term postoperative period, the least statistically significant complications have been observed after LESS / SILS with a rate of ventral hernia of 2.1 % and adhesions – 6.3 %. Conclusions. The main advantages of LESS / SILS compared to laparotomy and laparoscopic surgeries are as follow: reduced blood loss, fewer postoperative complication rates, and faster recovery of patients in the early postoperative period. Since only a single incision is made, the pain sensation is minimal, and patients quicker return to usual daily activities. The main disadvantages of LESS are certain technical difficulties encountered during the procedure, as well as complications (conversion) observed during the intraoperative period. Since complications after LESS are minimal, this method is considered a more optimal approach for patients compared to classical laparoscopy. There is a need to optimize the application and functions of this method in clinical practice.