Generally, gynecologic laparoscopic surgery involves about 3-4 incisions, including an incision at the navel measuring 0.5-1.2 centimeters, depending on the size of the lens used for surgery. Additionally, there are 2-3 incisions in the lower abdomen. However, the new single-port laparoscopic surgery technique involves only one incision at the navel, approximately 1.2-1.5 centimeters in size. Single-port laparoscopic surgery is a medical technique that started about 10-15 years ago but was not popular because it is difficult to perform, often not feasible in many cases, and the incision size is relatively large, about 2.5-4 centimeters. Moreover, surgeons need specific skills and appropriate instruments to perform it effectively.
To advance Thai medical practice to be on par with international standards, Dr. Kitti Tujinda, a specialist in gynecologic laparoscopic surgery at Phyathai 2 Hospital, designed and developed a new Single Port Platform device called Kitti Port. He collaborated with a medical device company in Japan to produce this device to international standards, making single-port laparoscopic surgery much easier than before.
From using this special technique to perform gynecologic laparoscopic surgery on more than 80 patients, Dr. Kitti, the patent holder, found that over 90% of gynecologic laparoscopic surgeries can effectively use the Single Port Platform. “In cases where patients have uterine fibroids and do not wish to preserve the uterus, most (over 90%) can have the uterus removed vaginally without any incision. If patients want to keep their uterus, single-port laparoscopic surgery can still be used. Additionally, single-port laparoscopic surgery can be applied to other gynecologic surgeries such as ovarian cyst removal, including chocolate cysts, adhesiolysis around the uterus or ovaries, fallopian tube removal, or even appendectomy,” the gynecologic laparoscopic surgery specialist explained further.
Advantages
- Because there is only one incision, patients experience less pain compared to multi-incision laparoscopic surgery.
- The incision is only at the navel. About five weeks after surgery, the wound heals completely and the scar is barely visible, resulting in a more aesthetically pleasing appearance for the patient.
Limitations
In difficult cases, such as when the tumor is very large (over 8 centimeters), patients have had multiple previous surgeries, or there is extensive adhesion, these limitations may prevent laparoscopic surgery from being performed either by single-port or multi-port methods. Such cases occur in about 5-10% of patients. In these situations, the surgeon may consider open abdominal surgery or other appropriate treatments.
Success of the New Single-Port Laparoscopic Surgery Technique
Dr. Kitti shared an example case: “Six months ago, there was a patient with a uterine fibroid about six centimeters in size who still wanted to have children. After surgery using the Single Port Platform for about 3-4 months, the treatment outcome was good, and she was able to conceive normally. In gynecology, uterine fibroids are very common. For example, in the United States, statistics show that up to 70% of women have uterine fibroids. In Thailand, I estimate it to be around 40%. However, only about 20-25% of women with fibroids require treatment due to symptoms such as heavy bleeding, abdominal pain, frequent urination, or if they want to conceive, the fibroids should be removed first. Most cases with small fibroids and no symptoms only need annual monitoring. When women reach menopause, the fibroids usually disappear on their own.”
Recovery Time
Generally, after laparoscopic surgery, patients stay in the hospital for no more than 1-2 days. After that, they can continue recovery at home and return to work within a week. They can perform daily activities such as walking up and down stairs and driving normally but should avoid heavy lifting for about two weeks.
Dr. Kitti Tujinda
Obstetrician and Gynecologic Laparoscopic Surgery Specialist
Women’s Health Center, Phyathai 2 Hospital
