A simple gasless single-port laparoscopy suitable for use in middle- and low-income countries or primary hospitals.

Objectives: The purpose of the present study is to explore the effectiveness of a modified suspension method combined with gasless single-port laparoscopy (MS-GSPL) for the treatment of benign ovarian tumors. The aim of this approach is to provide a convenient, economical, and minimally invasive method that is suitable for widespread use, even in middle- and low-income countries or primary hospitals.

Material and methods: Retrospective analysis of patients who underwent laparoscopic unilateral ovarian cystectomy due to benign ovarian tumors from January 2019 to December 2019.Thirty-six cases were treated with MS-GSPL, and 36 cases were treated with single-port laparoscopy (SPL). The patients' medical records, perioperative surgical outcomes, postoperative pain scores and complications were reviewed and compared.

Results: There are no significant differences in age, body mass index, previous pelvic surgery, tumor diameter, and tumor pathologic outcomes between MS-GSPL group and SPL group. The median operation times were 50 (Q1~Q3, 44~62.25) min in the MS-GSPL group and 60.5 (Q1~Q3, 57.25~78) min in the SPL group with a significant difference. The median estimated blood loss was 40 (Q1~Q3, 30~50) mL in the MS-GSPL group and 50(Q1~Q3, 30~60) mL in the SPL group with no significant difference. Compared with SPL group, patients in MS-GSPL group had earlier postoperative exhaust times, shorter hospital stays and lower costs, and all these differences were statistically significant (p < 0.05). There was a strong positive correlation between operation time and BMI in the MS-GSPL groups.

Conclusions: The patients receiving MS-GSPL treatment have quick postoperative recoveries. MS-GSPL is a novel, safe and economical surgical method that is suitable for extensive clinical development in middle- and low-income countries or primary hospitals.