The proposal and application of the "Suture Formula" make single port laparoscopic myomectomy simpler and more efficient: a retrospective cohort study

Background: Single-port laparoscopic surgery offers unique minimally invasive and cosmetic results and facilitates the patient's postoperative recovery.In transumbilical single-port laparoscopic myomectomy, suturing of the uterine wound is a critical intraoperative step.Due to the difficulty of operating with a single hole, it takes longer to suture the uterine wound, which somewhat increases the potential risk and limits the development of this procedure.This study describes the technique of the "suture formula" and compares it with the traditional randomized suture pattern. Materials and Methods: The author's team summarized the uterine incision selection and suture pattern in single-port laparoscopic myomectomy, conceptualizing the steps of uterine incision selection and suture closure to reduce unnecessary intraoperative backstitching and thread winding operations.In this study, we retrospectively analyzed 91 patients who underwent transumbilical single-port laparoscopic myomectomy and compared the intraoperative and postoperative indices between the two groups. Results: Surgical time, intraoperative bleeding, and hemoglobin drop were lower in the "suture mode" group than in the traditional randomized suture group (p<0.05).There was no statistically significant difference between the "suture formula" group and the traditional randomized suture group in terms of the number of days of postoperative hospitalization, the time to the first postoperative anal evacuation, the VAS score at 12h postoperatively, the VAS score at 24h postoperatively, and the postoperative complications (P > 0.05).Suture pattern (Beta: -19, P=0.043), number of leiomyosarcomas (Beta: 43, P=0.002), maximum diameter of the tumor (Beta: 6.2, P=0.032), and BMI (Beta: 4.0, P=0.018) were the factors influencing the duration of surgery.Suture pattern (Beta: -46, p=0.011), and maximum tumor diameter (Beta: 13, p=0.027) were the factors influencing intraoperative bleeding. Conclusion: The "Suture Formula" technique conceptualizes the selection of the uterine incision and the suture steps, which reduces the difficulty of the operation and ensures the hemostatic effect while reducing the unnecessary inverted needle and thread wrapping during the operation, thus shortening the operation time and improving the efficiency of the operation.The use of the "suture formula" does not increase the risk of surgery or the incidence of surgical complications compared with conventional single-port laparoscopic myomectomy.This suture pattern provides a new breakthrough in single-port laparoscopic myomectomy.