Our Summary

This research paper compares two surgical techniques - Laparoendoscopic single-site surgery (LESS) and mini-laparoscopic surgery (Mini-LPS) - used for hysterectomies (removal of the uterus) in cases of benign (non-cancerous) pathology. The study looked at 161 patients who underwent these procedures in Spanish and Italian medical centers between 2010 and 2015.

The research found that the Mini-LPS method generally resulted in shorter surgical times and shorter hospital stays than the LESS method. However, there was a higher rate of complications with the Mini-LPS technique that required conversion to a standard laparoscopy.

The study concludes that both methods are safe for performing hysterectomies for non-cancerous conditions, but highlights the importance of surgical training to adapt these techniques to current practice.

It’s important to note that the study has some limitations, including the fact that it was retrospective (looking back on past data), not all data was completely recorded, and the decision to use one technique over the other was made by the surgeon and not randomized.

FAQs

  1. What were the main findings of the research comparing LESS and Mini-LPS surgical techniques used for hysterectomies?
  2. What are the main differences between the LESS and Mini-LPS techniques in terms of surgical times, hospital stays, and complication rates?
  3. What were the limitations of the study comparing the LESS and Mini-LPS techniques for hysterectomies?

Doctor’s Tip

A helpful tip that a doctor might give to a patient about hysterectomy is to discuss with them the different surgical techniques available, such as LESS and Mini-LPS, and the potential benefits and risks of each. It’s important for the patient to have a clear understanding of their options and to feel comfortable asking questions and expressing any concerns they may have. Additionally, the doctor may advise the patient to follow post-operative care instructions carefully to ensure a smooth recovery process.

Suitable For

Patients who are typically recommended hysterectomy include those with conditions such as:

  • Uterine fibroids: non-cancerous growths in the uterus that can cause symptoms such as heavy menstrual bleeding, pelvic pain, and urinary frequency.
  • Endometriosis: a condition where the tissue that lines the uterus grows outside of it, causing pain and potential infertility.
  • Adenomyosis: a condition where the tissue that lines the uterus grows into the muscular wall of the uterus, causing heavy menstrual bleeding and pelvic pain.
  • Pelvic organ prolapse: a condition where the pelvic organs (such as the bladder, uterus, or rectum) descend into the vaginal canal due to weakened pelvic floor muscles.
  • Abnormal uterine bleeding: persistent or heavy bleeding that does not respond to other treatments.
  • Chronic pelvic pain: ongoing pain in the pelvic area that does not have a clear cause.

It is important for patients to discuss their individual circumstances with their healthcare provider to determine if a hysterectomy is the best course of treatment for their condition.

Timeline

Overall, a patient who undergoes a hysterectomy will typically experience a series of steps before and after the surgery.

Before the surgery:

  1. Consultation with a gynecologist to discuss the reasons for the hysterectomy and the different surgical options available.
  2. Pre-operative tests and evaluations to ensure the patient is healthy enough for surgery.
  3. Consent form signing and discussion of potential risks and complications.
  4. Preparing for the surgery by following any pre-operative instructions given by the medical team.

After the surgery:

  1. Recovery in the hospital for a few days to monitor for any complications.
  2. Post-operative pain management and monitoring of vital signs.
  3. Gradual resumption of normal activities under the guidance of the medical team.
  4. Follow-up appointments with the gynecologist to assess recovery and address any concerns or complications.

It’s important for patients to have a clear understanding of the entire process before undergoing a hysterectomy and to communicate openly with their healthcare providers.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with each surgical technique (LESS and Mini-LPS) for hysterectomy?
  2. How does the recovery process differ between the two techniques?
  3. Are there any long-term effects or considerations to be aware of after undergoing either technique?
  4. How experienced are you in performing hysterectomies using the Mini-LPS or LESS technique?
  5. Are there any specific criteria or factors that would make me a better candidate for one technique over the other?
  6. How will you determine which technique is most suitable for my individual case?
  7. What is the success rate of each technique in terms of achieving the desired outcome of the surgery?
  8. What post-operative care or follow-up appointments will be necessary after the procedure?
  9. Are there any lifestyle changes or precautions I should take after undergoing a hysterectomy using either technique?
  10. Can you provide any additional information or resources for me to learn more about the benefits and risks of the Mini-LPS and LESS techniques for hysterectomy?

Reference

Authors: Delgado-Sánchez E, Fanfani F, Malzoni M, Couso A, Zapico Á, Bogliolo S, Sánchez-Torres DA, Gardella B, Thuissard-Vasallo IJ, Zapardiel I. Journal: Gynecol Obstet Invest. 2022;87(6):381-388. doi: 10.1159/000526834. Epub 2022 Oct 21. PMID: 36273442