To evaluate the feasibility and safety of laparoendoscopic single-site surgery (LESS) in exploration and biopsy in patients with suspected advanced ovarian cancer (AOC) who were thought unsuitable for primary debulking surgery (PDS).

From May 2016 to May 2020, 63 patients with suspected AOC who underwent laparoscopic exploration and biopsy were retrospectively analyzed. Among them, 30 received LESS and 33 received conventional multi-port laparoscopy (MPL). All patients met two conditions: lack of positive cytological pathology, evaluated as unlikelihood of achieving optimal PDS based on Suidan criteria. The laparoscopic procedure included thorough laparoendoscopic exploration (Fagotti score) and biopsy. The perioperative data, complications and port-site metastasis (PSM) based on CT or MRI were compared between the two groups.

All patients were operated uneventfully. In LESS group 28 patients were staged as FIGO Ⅲ and 2 were Ⅳ. No additional trocar was used. Two cased received PDS. In MPL group 31 patients were staged as FIGO Ⅲ and 2 were Ⅳ, no open surgery was conducted. The mean operative time [ (88.1±22.1) min vs (81.4±20.0)min, P>0.05], estimated blood loss [(39.7±33.8)ml vs (40.6±62.1)ml, P>0.05] and complications between two groups were not statistically significant. No incisional hernia or PSM happened in LESS group while 1 umbilical hernia and 2 PSM in MLP group, yet no statistical significance was found.

LESS is possibly superior to conventional MPL in the exploration and biopsy of AOC due to its advantages in minimal invasiveness, specimen collection as well as the protection of umbilical incision.