Transumbilical versus lateral transabdominal removal of benign adnexal masses in laparoscopic surgery-A randomized trial

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Kilpio , O , Härkki , P S M , Mentula , M J , Jokela , R M & Pakarinen , P I 2017 , ' Transumbilical versus lateral transabdominal removal of benign adnexal masses in laparoscopic surgery-A randomized trial ' , European Journal of Obstetrics, and Gynecology ,and Reproductive Biology , vol. 218 , pp. 49-54 . https://doi.org/10.1016/j.ejogrb.2017.08.040

Title: Transumbilical versus lateral transabdominal removal of benign adnexal masses in laparoscopic surgery-A randomized trial
Author: Kilpio, Olga; Härkki, Päivi S. M.; Mentula, Maarit J.; Jokela, Ritva M.; Pakarinen, Paivi I.
Contributor: University of Helsinki, Department of Obstetrics and Gynecology
University of Helsinki, Department of Obstetrics and Gynecology
University of Helsinki, Department of Obstetrics and Gynecology
Date: 2017-11
Language: eng
Number of pages: 6
Belongs to series: European Journal of Obstetrics, and Gynecology ,and Reproductive Biology
ISSN: 0301-2115
URI: http://hdl.handle.net/10138/298123
Abstract: Objective: In laparoscopic adnexal surgery the conventional method of removing a mass from the abdominal cavity in Finland is through a 10-mm-wide lateral abdominal port. The larger the lateral trocar, the greater the risk of pain, complications and delayed recovery. Here, we assumed that adnexal mass removal through a 10-mm umbilical port together with 5-mm side trocars would decrease the postoperative need of analgesics when compared with removal through a 10-mm lateral abdominal port. Study design: Women scheduled for laparoscopic surgery of a benign adnexal mass were invited to participate. The participants were randomized into two groups: removal via the transumbilical (TO) (n = 21) or lateral transabdominal (TA) (n= 21) route. General anesthesia and use of local anesthetics were standardized. The amount of postoperative opioid (oxycodone) and visual analog scale (VAS) scores for pain were the primary outcome measures. Secondary outcome measures were nausea/vomiting (VAS evaluation), time to discharge, peri- and postoperative complications, surgeons' opinions of the alternative methods and patients' satisfaction, evaluated via a questionnaire sent six months postoperatively. Results: There were no significant differences in the use of opioids or median pain-VAS scores between the groups during the first 24 h postoperatively. However, in the TU group the amount of women with very low pain-VAS scores (0-1) during the whole 12-h follow-up time was significantly greater than in the TA group (4 vs. 0 women p=0.04). The amounts of nausea and vomiting, and median times to discharge were similar in both groups. There were no major complications. Conclusions: Both transumbilical and transabdominal routes of abdominal mass removal during laparoscopy were feasible and safe. However, the transumbilical route resulted in more women with very low pain-VAS scores. (C) 2017 Elsevier B.V. All rights reserved.
Subject: Adnexal mass
Laparoscopy
Postoperative pain
Ports
Removal route
Oxycodone
SPECIMEN RETRIEVAL
COMPLICATIONS
INFILTRATION
INCISION
HERNIAS
PORTS
PAIN
3123 Gynaecology and paediatrics
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