Learning curve and surgical outcome for single-port access total laparoscopic hysterectomy in 100 consecutive cases

Aims: To define the learning curve for single-port access (SPA) total laparoscopic hysterectomy (TLH) and evaluate the surgical outcomes. Methods: Patient demographics and segmental operating times of all 100 patients who underwent SPA-TLH by a single surgeon were analyzed. Patients were arranged in order based on surgery date. Results: 100 patients underwent SPA-TLH. There was no conversion to conventional laparoscopy or laparotomy. The median time until the removal of a specimen (T _R) was 45 min and the median time for closure of the vaginal cuff (T _C) was 18 min. The median total operating time from skin opening to closure (T _O) was 80 min. T _R, T _C, and T _O decreased significantly over the study period. The T _C decreased significantly from the first 20 cases to the next 20 (p = 0.028) and the T _O from the second 20 cases to the next 20 (p = 0.029). Conclusions: Proficiency for SPA-TLH was achieved after 40 cases. Operating time and postoperative hemoglobin drop decreased with experience, without increasing complication.