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Comparative efficacy and safety of newest generation minimally invasive techniques in hysterectomy: A meta-analysis of miniature laparoscopy versus single-port laparoscopy
Journal article   Peer reviewed

Comparative efficacy and safety of newest generation minimally invasive techniques in hysterectomy: A meta-analysis of miniature laparoscopy versus single-port laparoscopy

Greg J. Marchand, Amanda Arroyo, Daniela Gonzalez Herrera, Brooke Hamilton, Mckenna Robinson and Ali Azadi
European journal of obstetrics & gynecology and reproductive biology, Vol.314, pp.114636-114636
11/01/2025
PMID: 40816228

Abstract

Complications Estimated blood loss Hysterectomy Laparo-endoscopic single-site surgery Meta-analysis Mini-laparoscopic surgery Minimally invasive surgery Operative time Postoperative pain
•Single Site Laparoscopic Surgery and “MiniLaparoscopy” are two new minimally invasive techniques that have gained popularity in the field of gynecologic surgery.•Many surgeons refer to these as the “latest generation” of minimally invasive techniques in gynecologic surgery.•This is the first analysis to compare these two novel techniques.•Our analysis showed that both techniques had similar outcomes, but that MiniLaparoscopy may be associated with less postop pain at some time intervals. Laparo-Endoscopic Single-Site Surgery (LESS) and MiniLaparoscopy are two new minimally invasive techniques that have gained popularity in the field of gynecologic surgery. This meta-analysis aims to compare the efficacy and safety outcomes of MLS and LESS in hysterectomy. We performed a systematic review and meta-analysis of the MLS and LESS techniques for performing hysterectomy. Meta-analyses were performed using RevMan software we used mean differences and odds ratios (OR) with 95% confidence intervals. Our analysis found no significant differences in operative time (MD = 2.89, P = 0.29) or estimated blood loss (MD = 0.79, P = 0.80). The length of hospital stay was also similar (MD = −0.11, P = 0.18). In terms of postoperative pain, MLS had significantly lower VAS scores at 2 h (MD = −1.40, P = 0.003) and 24 h postop (MD = −0.67, P = 0.001), although pain scores were comparable at 8 h (MD = −0.33, P = 0.07). There was no difference in the duration of the time to first flatus between the techniques (MD = −0.63, P = 0.65). The incidence of intraoperative (OR = 0.703, P = 0.634) and postoperative (OR = 1.33, P = 0.5) complications was also similar for both techniques, as was the rate of conversion (OR = 1.79, P = 0.29). Results for both techniques were similar, but MLS may provide better postoperative pain relief at specific time intervals. Further studies with larger sample sizes and comprehensive data on cosmetic outcomes are necessary to confirm these results and identify any additional advantages.

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