To investigate the safety and feasibility of single-port laparoscopic myomectomy via of abdominal scar approach.

Clinical data of 42 patients with uterine fibroids who underwent single-port laparoscopic uterine myomectomy in the Department of Gynecology of the Affiliated Changzhou Second People′s Hospital of Nanjing Medical University from Jun. 2020 to Jul. 2023 were retrospectively analyzed. The patients were divided into the single-port laparoscopic group with transabdominal scar approach (14 cases) and in the simultaneous matched single-port laparoscopic group with transumbilical approach (28 cases) according to the surgical methods. The operation time, the loss of blood, the change of hemoglobin, the recovery time of gastrointestinal function, postoperative hospitalization days, treatment cost, cosmetic score (CS), and visual analog score (VAS) of pain were observed and compared between the two groups.

All operations were successfully completed in both groups, no intraoperative surgical changes and no postoperative complications. There was no statistically significant difference in the postoperative hospitalization days, treatment cost, CS score, and VAS score at 12 h after surgery between the two groups (P>0.05). The operation time, the loss of blood and hemoglobin drop were significantly lower in the transabdominal scar approach group than in the transumbilical single-port group, however, the recovery time of gastrointestinal function was shorter in the transumbilical approach group than in the transabdominal scar approach group, with statistically significant differences (P<0.05).

Single-port laparoscopic myomectomy transabdominal scar approach is safe and feasible, which adheres to the concept of minimally invasive surgery with less pain, faster recovery and "no scar" , and optimizes the surgical steps, shortens the surgical time, reduces intraoperative bleeding, and is easy to be promoted for clinical application.