Minilaparotomy in the management of benign gynecologic disease

Background: Considering the enormous advantages of minimally invasive surgery, attempts to explore less invasive trans-abdominal incisions could represent an alternative to laparoscopic gynecologic surgery. The aim of this study was to assess the feasibility and clinical outcome of minilaparotomy in a large series of patients. Methods: In this retrospective study we describe our 6-year experience on 252 patients undergoing surgery by minilaparotomy for benign adnexal or uterine disease. Surgical treatments included total abdominal hysterectomy, myomectomy, mono or bilateral salpingo-oophorectomy and adnexal surgery. Results: The mean population age and BMI were 39.2 years (±13.2 S.D.) and 23.6 (±3.31 S.D.), respectively. The mean operative time was 75.4 min (±31.8) and the estimated blood loss was never significant except in two cases (0.8%). The mean duration of ileus was 1.58 days (±0.6 S.D.) and the mean days until discharge were 3.06 (±1.14 S.D.), with a significantly lower duration of recovery in the group of simple adnexal surgery with respect to the others (p = 0.0001). No severe early post-operative morbidity was observed. Conclusions: The current report describes minilaparotomy as a feasible surgical approach in benign gynecological diseases. The operative time is quite similar or shorter than reported for laparoscopy, laparotomy and vaginal surgery. The estimated blood loss is not significant as well as the duration of the ileus and discharge. Moreover, a prospective randomised study, already ongoing in our department, will better answer the question of whether minilaparotomy could be an alternative to laparoscopic and vaginal surgery.