• Taejong Song, Mi-La Kim, Yong Wook Jung, Bo Sung Yoon, Won Duk Joo, and Seok Ju Seong.
• Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
• Am. J. Obstet. Gynecol. 2013 Oct 1; 209 (4): 317.e1-9.

ObjectiveTo assess the current evidence regarding the efficiency, safety, and potential advantages of laparoendoscopic single-site surgery (LESS) for treating gynecologic diseases.Study DesignWe comprehensively searched PubMed, Embase, and the Cochrane Library from their inception to December 2012. Two authors screened out duplicates and independently reviewed eligibility of each study. We included randomized controlled trials comparing LESS with conventional laparoscopy (CL) for treating gynecologic diseases. The primary outcomes were perioperative complication rate, conversion rate, postoperative pain, and cosmetic satisfaction.ResultsWe included 6 randomized controlled trials with 439 participants in the final analysis. There were no significant differences between LESS and CL in terms of perioperative complication rate (15.5% and 14.3%; risk ratio, 1.11; 95% confidence interval [CI], 0.74-1.67; P = .61), conversion rate (3.8% and 1.1%; risk ratio, 2.75; 95% CI, 0.73-10.33; P = .13), postoperative pain (weighted mean difference [WMD], -0.22; 95% CI, -1.29 to 0.85; P = .68), analgesic requirement (WMD, 0.41; 95% CI, -1.69 to 2.51; P = .70), and cosmetic satisfaction (WMD, 0.19; 95% CI, -0.30 to 0.68; P = .46). There were also no differences in terms of operative time (P = .65), hemoglobin change (P = .23), time to first flatus (P = .17), and length of hospital stay (P = .99) between both techniques.ConclusionThis metaanalysis provides evidence that LESS is comparable in the efficacy and safety, but does not offer potential advantage such as better cosmesis and lesser pain compared with CL for treating gynecologic diseases.Copyright © 2013 Mosby, Inc. All rights reserved.

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