Minilaparoscopic Versus Conventional Laparoscopic Hysterectomy: Insights from a Single-Center Retrospective Cohort Study with Legal Considerations

<i>Background and Objectives</i>: We compared mini-laparoscopic and laparoscopic hysterectomy in terms of surgery duration, postoperative pain, conversion rate, blood loss, postoperative complications (Clavien-Dindo classification), and the length of hospital stay. <i>Materials and...

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Main Authors: Valentina Billone, Giuseppe Gullo, Eleonora Conti, Silvia Ganduscio, Sofia Burgio, Giovanni Baglio, Gaspare Cucinella, Lina De Paola, Susanna Marinelli
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/7/1216
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author Valentina Billone
Giuseppe Gullo
Eleonora Conti
Silvia Ganduscio
Sofia Burgio
Giovanni Baglio
Gaspare Cucinella
Lina De Paola
Susanna Marinelli
author_facet Valentina Billone
Giuseppe Gullo
Eleonora Conti
Silvia Ganduscio
Sofia Burgio
Giovanni Baglio
Gaspare Cucinella
Lina De Paola
Susanna Marinelli
author_sort Valentina Billone
collection DOAJ
description <i>Background and Objectives</i>: We compared mini-laparoscopic and laparoscopic hysterectomy in terms of surgery duration, postoperative pain, conversion rate, blood loss, postoperative complications (Clavien-Dindo classification), and the length of hospital stay. <i>Materials and Methods</i>: Patients were recruited between 1 January 2017 and 1 January 2024, at the Department of Gynecology, “Villa Sofia-Cervello” Hospital. Indications for hysterectomy included uterine myoma, endometriosis, endometrial hyperplasia, adenomyosis, high-grade cervical dysplasia, early-stage endometrial cancer, and microinvasive cervical cancer. Patients were divided according to treatment into conventional laparoscopic hysterectomy (LH) with all 5 mm ports or the needlescopic approach (minilaparoscopic hysterectomy [MLH]), using 3 mm instruments. Postoperative pain was assessed using the visual analog scale (VAS) at multiple time points (2, 6, 12, and 24 h post-surgery). <i>Results</i>: A total of 308 patients were enrolled, with 153 women in the LH group and 155 in the MLH group. The surgery duration was on average 105.5 min in LH and 98.8 min in MLH (<i>p</i> < 0.0001). The intraoperative blood loss averaged 195.1 mL in LH and 100.3 mL in MLH (<i>p</i> < 0.001). The average length of hospital stay was 4.0 days for women undergoing LH compared to 3.2 days for women undergoing MLH (<i>p</i> < 0.001). <i>Conclusions</i>: This retrospective study demonstrated that MLH is an effective and functional technique for treating various gynecological conditions, with advantages in terms of aesthetic outcomes and reduced perioperative pain and recovery times. The positive results, supported by key parameters such as surgical duration, blood loss, and complications, could serve as a foundation for future studies on larger populations and for improving clinical practices in gynecology.
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spelling doaj-art-4c4150a9cbff44acb89f484ba72ddf6e2025-08-20T02:47:09ZengMDPI AGMedicina1010-660X1648-91442025-07-01617121610.3390/medicina61071216Minilaparoscopic Versus Conventional Laparoscopic Hysterectomy: Insights from a Single-Center Retrospective Cohort Study with Legal ConsiderationsValentina Billone0Giuseppe Gullo1Eleonora Conti2Silvia Ganduscio3Sofia Burgio4Giovanni Baglio5Gaspare Cucinella6Lina De Paola7Susanna Marinelli8Department of Obstetrics and Gynaecology, AOOR Villa Sofia–Cervello, University of Palermo, 90127 Palermo, ItalyDepartment of Obstetrics and Gynaecology, AOOR Villa Sofia–Cervello, University of Palermo, 90127 Palermo, ItalyDepartment of Obstetrics and Gynaecology, AOOR Villa Sofia–Cervello, University of Palermo, 90127 Palermo, ItalyDepartment of Obstetrics and Gynaecology, AOOR Villa Sofia–Cervello, University of Palermo, 90127 Palermo, ItalyIVF Unit, Department of Obstetrics and Gynaecology, AOOR Villa Sofia-Cervello, University of Palermo, 90127 Palermo, ItalyItalian National Agency for Regional Healthcare Services, 00187 Rome, ItalyDepartment of Obstetrics and Gynaecology, AOOR Villa Sofia–Cervello, University of Palermo, 90127 Palermo, ItalyDepartment of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, ItalySchool of Law, Polytechnic University of Marche, 60121 Ancona, Italy<i>Background and Objectives</i>: We compared mini-laparoscopic and laparoscopic hysterectomy in terms of surgery duration, postoperative pain, conversion rate, blood loss, postoperative complications (Clavien-Dindo classification), and the length of hospital stay. <i>Materials and Methods</i>: Patients were recruited between 1 January 2017 and 1 January 2024, at the Department of Gynecology, “Villa Sofia-Cervello” Hospital. Indications for hysterectomy included uterine myoma, endometriosis, endometrial hyperplasia, adenomyosis, high-grade cervical dysplasia, early-stage endometrial cancer, and microinvasive cervical cancer. Patients were divided according to treatment into conventional laparoscopic hysterectomy (LH) with all 5 mm ports or the needlescopic approach (minilaparoscopic hysterectomy [MLH]), using 3 mm instruments. Postoperative pain was assessed using the visual analog scale (VAS) at multiple time points (2, 6, 12, and 24 h post-surgery). <i>Results</i>: A total of 308 patients were enrolled, with 153 women in the LH group and 155 in the MLH group. The surgery duration was on average 105.5 min in LH and 98.8 min in MLH (<i>p</i> < 0.0001). The intraoperative blood loss averaged 195.1 mL in LH and 100.3 mL in MLH (<i>p</i> < 0.001). The average length of hospital stay was 4.0 days for women undergoing LH compared to 3.2 days for women undergoing MLH (<i>p</i> < 0.001). <i>Conclusions</i>: This retrospective study demonstrated that MLH is an effective and functional technique for treating various gynecological conditions, with advantages in terms of aesthetic outcomes and reduced perioperative pain and recovery times. The positive results, supported by key parameters such as surgical duration, blood loss, and complications, could serve as a foundation for future studies on larger populations and for improving clinical practices in gynecology.https://www.mdpi.com/1648-9144/61/7/1216laparoscopic hysterectomymini-laparoscopic hysterectomypostoperative complicationsprofessional liability
spellingShingle Valentina Billone
Giuseppe Gullo
Eleonora Conti
Silvia Ganduscio
Sofia Burgio
Giovanni Baglio
Gaspare Cucinella
Lina De Paola
Susanna Marinelli
Minilaparoscopic Versus Conventional Laparoscopic Hysterectomy: Insights from a Single-Center Retrospective Cohort Study with Legal Considerations
Medicina
laparoscopic hysterectomy
mini-laparoscopic hysterectomy
postoperative complications
professional liability
title Minilaparoscopic Versus Conventional Laparoscopic Hysterectomy: Insights from a Single-Center Retrospective Cohort Study with Legal Considerations
title_full Minilaparoscopic Versus Conventional Laparoscopic Hysterectomy: Insights from a Single-Center Retrospective Cohort Study with Legal Considerations
title_fullStr Minilaparoscopic Versus Conventional Laparoscopic Hysterectomy: Insights from a Single-Center Retrospective Cohort Study with Legal Considerations
title_full_unstemmed Minilaparoscopic Versus Conventional Laparoscopic Hysterectomy: Insights from a Single-Center Retrospective Cohort Study with Legal Considerations
title_short Minilaparoscopic Versus Conventional Laparoscopic Hysterectomy: Insights from a Single-Center Retrospective Cohort Study with Legal Considerations
title_sort minilaparoscopic versus conventional laparoscopic hysterectomy insights from a single center retrospective cohort study with legal considerations
topic laparoscopic hysterectomy
mini-laparoscopic hysterectomy
postoperative complications
professional liability
url https://www.mdpi.com/1648-9144/61/7/1216
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