Would fewer port numbers in laparoscopy produce better cosmesis? Prospective study.

STUDY OBJECTIVE: To determine whether fewer ports in laparoscopic adnexal surgery would lead to better cosmesis.

DESIGN: Prospective comparative study (Canadian Task Force classification II-2).

SETTING: University hospital.

PATIENTS: One hundred thirty consecutive patients with adnexal tumors.

INTERVENTIONS: Patients underwent laparoscopy using a single port (n = 75), 2 ports (n = 22), or 4 ports (n = 33). Cosmetic satisfaction was assessed using a validated Body Image Questionnaire at 1, 4, and 12 weeks after surgery.

MEASUREMENTS AND MAIN RESULTS: Patient characteristics (age, parity, and sociodemographic data), details of the procedures performed, and histologic findings were similar between the 3 surgical groups. There was also no difference in number of conversions to other surgical approaches, operative time, estimated blood loss, postoperative pain, and perioperative complications. Compared with the 2- and 4-port groups, the single-port group reported substantially greater cosmetic satisfaction at 1, 4, and 12 weeks after surgery. However, there was no important difference in cosmetic outcome throughout follow-up in the 2-t and 4-port groups.

CONCLUSION: Unlike 2- or 4-port laparoscopy, single-port laparoscopy has a definite benefit in cosmetic satisfaction.