Background: Hysterectomy is the most common gynecologic surgery. Approximately 600,000 hysterectomies are performed annually in the United States. Hysterectomy has increasingly been performed using minimally invasive approaches, which offer advantages, such as early recovery and return to routine activities, improved cosmesis, shorter length of hospital stay, and reduced pain, compared with laparotomy. Conventional laparoscopic hysterectomy consists of 3–4 incisions where separate ports are placed, one for laparoscope access and 2–3 for surgical instruments' access. One technique for reducing the invasiveness of conventional laparoscopy is laparoendoscopic single-site surgery—scarless stitchless hysterectomy (LESS-SSH). The technique involves no stitching of the skin incision, although there are vaginal stitches, and does not create scars. Objective: The aim of this study was to evaluate the feasibility of LESS-SSH and analyze its benefits. Materials and Methods: This was a prospective observational study of women undergoing LESS-SSH (Canadian Task Force classification II-3) at a tertiary-referral private hospital. Twenty seven patients who required hysterectomy underwent LESS-SSH between February 2012 and February 2014 in this study. The selected patients tolerated the surgery well and were followed-up at 1 week and at 3 months. Results: The operative time (mean 62.04±11.29 minutes), intraoperative blood loss (mean 34.44±6.98 mL), recovery time, and surgical outcomes for LESS-SSH were similar to those of conventional laparoscopic hysterectomies. However, the patients who underwent LESS-SSH patients had reduced visual analogue scale (VAS) pain scores on the day of surgery and on postoperative day 1. No patients had scars that were readily apparent at surgery or at 1- or 3-week follow-ups. Conclusions: As surgeons gain experience in performing LESS-SSH, this technique could be an alternative to conventional laparoscopic hysterectomy in selected patients in the future. (J GYNECOL SURG 31:144)
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