- Academic Editor
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†These authors contributed equally.
Background: The operative field in gasless surgery is limited, and it
is difficult to adequately expose the operative field when compared to the use of
gas surgery. Gasless laparoscopic single-site (GLESS) is difficult to apply to
endometrial cancer surgery. The aim of this study is to investigate the
improvement in GLESS lifting style for use in
surgery for endometrial cancer as well as to compare the outcome of different
surgical approaches in endometrial cancer. Methods: A tissue retractor
is added to the routine step of GLESS to lift the abdominal wall. The lateral
umbilical ligament is exposed, a 2-0 buckwheat thread is passed through the
lateral umbilical ligament and abdominal wall in order to lift the umbilical
ligament. We measured the changes of space length or height in different
dimensions of the improved GLESS approach. Also, we measured the vertical height
from the upper edge of the umbilical site to the abdominal cavity, the length
from the lower edge of the umbilical site to the right Michaelis point, the
height from the bottom of the uterus to the peritoneal cavity of the anterior
abdominal wall, and the length from the lateral umbilical ligament to the
ipsilateral psoas major muscle. We analyzed the differences in procedures in 177
cases of endometrial carcinoma. We collected data on operative time, hemoglobin
change, number of lymph nodes removed, postoperative recovery time and
postoperative complications for open surgery, multi site laparoscopic surgery,
single site laparoscopic surgery and gasless laparoscopic single-site surgery.
Results: The vertical height from the upper edge of the umbilical
foramen to the abdominal cavity (4.395