Assessment of Port-Specific Pain After Gynecological Laparoscopy: A Prospective Cohort Clinical Trial.

Abstract

OBJECTIVE To determine the association between pain related to laparoscopic port sites and different incision sizes after gynecological laparoscopy. DESIGN Prospective, cohort trial Canadian Task Force classification 2-II. SETTING Zhejiang Provincial People's Hospital, China. PATIENTS Two hundred patients who underwent three-port laparoscopic gynecological procedures for benign indications. INTERVENTIONS In total, 200 patients underwent laparoscopic gynecological procedures. Each patient had three incisions, one in the left lower abdomen, measuring 5, 10, or 15 mm based on the type of surgery, another measuring 10 mm in the umbilical port, and the third one measuring 5 mm, in the right lower abdomen. Port-related pain was registered and measured by visual analogue score (VAS). MEASUREMENTS AND MAIN RESULTS The VAS score showed statistically significant differences between 5-, 10-, and 15-mm port sites at each time point (24 and 72 hours) (P < .05); the score elevated as the size of the incision increased. Pain was significantly lower at the umbilical port sites at 24 hours than in the left lower abdominal port sites with incisions of the same (10 mm) size (P = .013) and also significantly lower in the right lower abdominal port sites than in the left lower abdominal port sites with incisions of the same (5 mm) size (P = .041). Specimen extraction port significantly affected the 24-hour pain intensity, while specimen extraction port, surgical time, and previous abdominal surgery affected the 72-hour pain intensity. CONCLUSIONS The size of port sites is the most important factor related to port-specific pain.