Percutaneous-Assisted versus Laparoscopic Hysterectomy: A Prospective Comparison

Emanuele Perrone, Cristiano Rossitto, Francesco Fanfani, Stefano Cianci, Anna Fagotti, Stefano Uccella, Giuseppe Vizzielli, Carmine Vascone, Stefano Restaino, Camilla Fedele, Farrah Layla Saleh, Giovanni Scambia, Salvatore Gueli Alletti

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate the feasibility of percutaneous approach, we prospectively compared our experience in percutaneous-assisted hysterectomy (PSS-H) with that in a series of laparoscopic hysterectomies (LPS-Hs). Methods: In this multicentric cohort study, from May 2015 to October 2017, 160 patients affected by benign and malignant gynecological conditions were considered eligible for minimally invasive surgery (MIS): 80 patients received PSS-H and 80 LPS-H. In each group, 30 cases of low-/intermediate-risk endometrial cancer were enrolled. For both groups, we documented preoperative outcomes, postoperative pain, and cosmetic outcomes. Results: No statistically significant differences were noted in baseline characteristics or operative time. We observed significant differences in estimated blood loss: median of 50 cc (PSS-H) and 100 cc (LPS-H) (p = 0.0001). In LPS-H, we reported 4 (5.0%) intraoperative complications and 1 (1.3%) in PSS-H. Thirty-day complications were 4 (5%) in PSS-H and 11 (13.8%) in LPS-H (p = 0.058). No significative differences were found in visual analog scale score, despite a relevant disparity in cosmetic outcome (p = 0.0001). For oncological cases, the 2 techniques had comparable intra- and postoperative outcomes and oncological accuracy. Conclusions: In this study, we reported that PSS-H is comparable to LPS-H for intra- and perioperative outcomes and postoperative pain, while PSS-H seems to be superior in cosmetic outcomes and patient satisfaction. PSS-H may represent a valid alternative in ultra-MIS for benign gynecological conditions and low-/intermediate-risk endometrial cancer.

Original languageEnglish
Pages (from-to)318-326
Number of pages9
JournalGynecologic and Obstetric Investigation
Issue number4
Publication statusPublished - Oct 1 2020


  • Gynecological surgery
  • Hysterectomy
  • Minimally invasive surgery
  • New technology
  • Percutaneous approach
  • Personalized surgical treatment

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology


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