Single-port compared with conventional laparoscopic ovarian cystectomy for benign ovarian cysts: a systematic review and meta-analysis

Objective To evaluate current evidence on the safety and impact on ovarian reserve of single-port laparoscopic cystectomy (SLC) for the treatment of benign ovarian cysts. Methods We comprehensively searched PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov from their inception to 31 December 2025. We included randomized controlled trials (RCTs) or non-randomized studies (NRSs) comparing SLC with conventional laparoscopic cystectomy (CLC) for benign ovarian cysts. The primary outcomes were postoperative changes in serum anti-Müllerian hormone (AMH) concentration, intraoperative complications, postoperative complications, and cosmetic outcomes. All analyses were performed using random-effects or fixed-effects models. Results In total, 14 full-text studies involving 1, 691 participants were included in the final analysis. There were no significant differences between SLC and CLC in the incidence of intraoperative complications ( P = 0.50), postoperative complications ( P = 0.49), postoperative changes in serum AMH concentration ( P = 0.06), estimated blood loss ( P = 0.99), hemoglobin loss ( P = 0.76), time to flatus ( P = 0.68), length of hospital stay ( P = 0.17), or analgesic use ( P = 0.91). SLC was associated with significantly lower postoperative pain scores at 24 hours ( P = 0.02) but longer operative time ( P = 0.001) compared with CLC. Conclusion This systematic review and meta-analysis provides evidence that SLC may be offered as a minimally invasive surgical alternative for women with benign ovarian cysts, at the cost of a longer operative time compared with CLC. Given the retrospective design of the majority of the included studies, further large-scale randomized controlled trials are warranted to validate these findings. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/ , identifier CRD42024602477.