Background: This study aimed to compare single-port transumbilical total laparoscopic hysterectomy (SPLS-TLH) and four-port total laparoscopic hysterectomy (TLH) in terms of postoperative pain. Methods: The study enrolled 68 patients who underwent TLH from October 2009 to March 2010 and randomly assigned them to one of two groups. Patient demographics, operative outcomes, and postoperative pain were prospectively examined. Results: Four cases in the SPLS-TLH group were converted to other laparoscopic approaches. The two study groups did not differ in terms of patient demographics and surgical outcomes. Postoperative pain scores, measured using a visual analog scale, did not differ between the two groups. However, significantly higher total requests for analgesics were observed in the SPLS-TLH group (11.3 ± 4.1 vs. 7.7 ± 2.7; p < 0.001). Conclusion: Compared with four-port TLH, SPLS-TLH is a feasible approach with comparable operative outcomes. However, reduction of postoperative pain is not evident with SPLS-TLH.
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