Two-port access staging laparoscopy for gynecologic cancers: A pilot study

Background: The aims of this work were to introduce a two-port access (TPA) staging laparoscopy in gynecologic cancers and evaluate the feasibility and surgical outcomes of this operation. Materials and Methods: We performed 12 cases of TPA staging laparoscopy. The TPA system consisted of a single multichannel port at the umbilicus and an ancillary 5-mm port in the suprapubic area. Patient status was estimated in terms of operative morbidity and surgical outcomes. Results: All operations were completed laparoscopically, with no conversions to conventional laparoscopy or laparotomy. Procedures included endometrial cancer staging (n=6), ovarian cancer staging (n=3), 2 cases of type III radical hysterectomy, and 1 type II radical hysterectomy. Median patient age and body mass index were 48 years and 20.4, respectively. Median operation duration was 241 minutes (range, 188-360). Median estimated blood loss was 175mL. Median number of lymph nodes obtained was 30 (range, 14-49). Median postoperative hospital stay was 8 days. There were no perioperative complications. Conclusions: TPA staging laparoscopy, using the single multichannel port system, could be a feasible procedure in selected gynecologic cancer patients, with only minimal skin incisions. Prospective, randomized trials will permit the evaluation of potential benefits of this minimally invasive surgical technique.