Laparoendoscopic Single-site Surgery for Fertility-sparing Staging of Border Line Ovarian Tumors: Initial Experience

Objective: To report feasibility of laparoscopic fertility-sparing staging of border line ovarian tumors (BOTs) by using a laparoendoscopic single-site trocar through a unique transumbilical access. Study Design: This study was conducted in our University Hospital. Four young patients, intended to be submitted to benign adnexal cysts enucleation by an innovative laparoendoscopic single-site approach using a multiport trocar inserted through a unique transumbilical access and straight laparoscopic devices, were found to be affected by border line ovarian tumor at intraoperative frozen analysis. Consequently patients were conservatively staged carrying out all the requested procedures in respect of oncologic guidelines and their child bearing desire, using same single-port access approach. Main outcome measures were conversion rate to multiaccess standard laparoscopic technique or to laparotomic approach and evaluation of intraoperative and postoperative-related complications. Results: All the laparoscopic staging procedures were feasible through a single transumbilical access: no conversion to multiaccess standard laparoscopic technique nor laparotomy and no intraoperative or postoperative complications were observed. Mean operative time was 79 minutes. All patients were discharged home on day 1 with complete satisfaction toward cosmetic outcome. Final pathologic analysis confirmed stage FIGO 1A for all cases. The patients are free from recurrence at 10 months follow-up. Conclusions: Laparoendoscopic single-site staging of border line ovarian tumors with preservation of fertility is feasible and effective with standard laparoscopic instruments. More clinical data are needed to confirm these advantages compared with standard multiaccess laparoscopic technique.