# Dual-port laparoscopic myomectomy: a balanced yet potentially more optimal surgical approach

## TL;DR

This study compares two laparoscopic myomectomy techniques and finds that dual-port surgery offers better outcomes for patients with large or posterior fibroids.

## Contribution

Dual-port laparoscopic myomectomy is shown to have better perioperative outcomes compared to single-incision surgery for specific fibroid types.

## Key findings

- Dual-port myomectomy resulted in less blood loss, less analgesic use, and shorter hospital stays compared to single-incision surgery.
- Posterior wall fibroids were associated with higher analgesic use and delayed discharge.
- Dual-port surgery maintained good cosmetic results despite an additional incision.

## Abstract

This study aimed to compare the perioperative outcomes of single-incision laparoscopic surgery (SILS) and dual-port laparoscopic myomectomy in patients with solitary uterine fibroids.

This retrospective observational study included 162 patients who underwent laparoscopic myomectomy for solitary fibroids from January 2022 to December 2023 at a single tertiary center. Patients were divided into a SILS group (n = 77) and a dual-port group (n = 85). Perioperative outcomes—including operative time, intraoperative blood loss, analgesic use, hospital stay, and cosmetic results—were compared between the groups. Multivariate linear and logistic regression analyses were conducted to identify factors associated with surgical complexity and recovery.

The dual-port group had significantly lower intraoperative blood loss (41.71 ± 65.37 mL vs. 89.55 ± 93.70 mL, p < 0.001), lower rates of postoperative analgesic use (24.7% vs. 40.3%, p = 0.034), and shorter hospital stays (1.07 ± 0.30 vs. 1.30 ± 0.65 days, p = 0.005) compared to the SILS group. Fibroid size and procedure time were independent predictors of increased bleeding. Posterior wall fibroids were significantly associated with postoperative analgesic use. Delayed discharge was more common in patients with larger fibroids and those requiring postoperative analgesia. Cosmetic outcomes in the dual-port group remained favorable despite the auxiliary incision.

Dual-port laparoscopic myomectomy is a feasible and potentially more effective alternative to single-incision surgery, offering better ergonomic access, improved perioperative outcomes, and excellent cosmetic results. This approach may be especially advantageous when addressing large or posteriorly located fibroids. Individualized surgical planning remains essential to optimize outcomes in minimally invasive myomectomy.