Patient preferences of cosmesis for abdominal incisions in gynecologic surgery.

Journal Article (Journal Article)

STUDY OBJECTIVE: To estimate patient preferences insofar as the cosmetic appeal of abdominal incisions used for hysterectomy. We hypothesized that the laparoendoscopic single-site surgery (LESS) incision would be preferred cosmetically to traditional multiport laparoscopic incisions and open abdominal incisions via Pfannenstiel, vertical midline, or horizontal mini-laparotomy. DESIGN: Prospective comparative study (Canadian Task Force classification II-2). SETTING: Two gynecology clinics at Duke University Medical Center in Durham, North Carolina. PATIENTS: Seventy-three women including 50 consecutive women from a private specialty clinic and 23 consecutive women from a resident indigent care clinic. INTERVENTIONS: A brief questionnaire was distributed that assessed preferences via ranking and by using a visual analog scale. Patients were also asked to rate the importance of 4 factors in their decision making: size, location, and number of incisions, and perceived recovery time. Descriptive statistics, t tests, Wilcoxon rank-sum tests, and χ(2) tests were used to compare continuous or categorical values. MEASUREMENTS AND MAIN RESULTS: Overall, the LESS incision was the most preferred incision according to most common choice and visual analog scale scores. In the private clinic, the LESS incision was preferred most often, with 53% of women (39/73) ranking it as their first choice. In the resident clinic, the horizontal mini-laparotomy incision was preferred most often, with 27% of women (20/73) ranking it their first choice. Neither the demographic factors nor any of the factors in decision making explained the difference between the clinics. CONCLUSION: The LESS incision was most preferred in this study. However, the horizontal mini-laparotomy incision and the traditional laparoscopic with low lateral incisions were also highly preferred. Patient perception of the "visibility" of abdominal incisions may be the distinguishing issue to explain the difference in the preferences between the clinics and the differences between the present study and previously published studies of cosmetic preferences.

Full Text

Duke Authors

Cited Authors

  • Yeung, PP; Bolden, CR; Westreich, D; Sobolewski, C

Published Date

  • January 2013

Published In

Volume / Issue

  • 20 / 1

Start / End Page

  • 79 - 84

PubMed ID

  • 23312246

Electronic International Standard Serial Number (EISSN)

  • 1553-4669

Digital Object Identifier (DOI)

  • 10.1016/j.jmig.2012.09.008


  • eng

Conference Location

  • United States