Comparison of Transumbilical Single‑Port and Multi‑Port Laparoscopic Myomectomy in Patients with Uterine Fibroids: Effects on Stress Response, Immune Function, and Incision Cosmetic Outcomes.

TL;DR

Single-port laparoscopic myomectomy (SPLM) required longer operative time but achieved shorter postoperative exhaustion and hospitalization compared to multi-port laparoscopic myomectomy (MPLM) in uterine fibroid patients. SPLM demonstrated superior postoperative immune preservation, reduced oxidative stress markers, and better incision cosmetic outcomes, with comparable complication and recurrence rates.

Key findings

• SPLM resulted in longer operative time but shorter postoperative exhaustion and hospitalization duration versus MPLM
• At postoperative day 3, SPLM showed higher antioxidant (SOD) and T-cell markers (CD3+, CD4+/CD8+) with lower oxidative stress markers (MDA, ROS)
• SPLM demonstrated superior cosmetic outcomes by incision assessment scores despite comparable ovarian hormone function (AMH, LH, FSH) at 3 months
• Complication rates, menstrual recovery, and fibroid recurrence were similar between both approaches

Why this matters at the bedside

For surgeons performing myomectomy for symptomatic uterine fibroids, findings suggest single-port access may offer advantages in reducing inflammatory stress response and cosmetic outcomes, though at cost of increased operative time and requiring technical proficiency with minimally invasive techniques.