Suprapubic-Assisted Umbilical Dual-Port versus Four-Port Laparoscopic Myomectomy: A Retrospective Comparative Study

Objective: This retrospective non-randomized study was performed to compare the safety, clinical efficacy and cosmetic satisfaction between suprapubic-assisted umbilical laparoendoscopic dual-site surgery (SAU-LEDS) and traditional multiport laparoscopic myomectomy for myomectomy. Methods: Seventy-five patients diagnosed with uterine fibroids in our Hospital between June 2022 and June 2024 were enrolled in this study, 35 cases underwent SAU-LEDS (dual-port group) and 40 cases underwent four-port laparoscopic surgery (four-port group). We mainly compared operative time, intraoperative blood loss, myoma removal time, wound suturing time, time to first flatus, postoperative maximum body temperature, length of hospital stays, numeric rating scale (NRS) pain score at 24 h postoperatively, postoperative cosmetic scale score and satisfaction at 1 month postoperatively between the two groups. Results: Both groups underwent surgery successfully without the conversion to laparotomy or major surgical complications. There were no statistically significant differences between the two groups in operation time, intraoperative blood loss, time to first flatus, postoperative maximum body temperature, and length of hospital stays (p > 0.05). However, compared with the four-port group, the dual-port group exhibited the shorter myoma removal time (15.49 (6.42) vs 25.78 (7.26), p = 0.003), the lower NRS pain score at 24 h postoperatively (1.20 (0.40) vs 1.62 (0.74), p = 0.045), the higher postoperative incision cosmetic scale score (16.80 (3.78) vs 10.80 (2.10), p = 0.009), and better satisfaction (3.60 (0.40) vs 3.00 (0.50), p = 0.032). Conclusion: SAU-LEDS appeared feasible and may provide cosmetic and pain-related advantages in selected patients, but prospective studies are needed.