OBJECTIVE: To explore the differences in clinical and cosmetic efficacy between transumbilical single-port laparoscopy (TSPLS) and traditional laparoscopy for type II and III cesarean scar pregnancy (CSP). METHODS: We retrospectively included 39 patients with type II and III CSP who were admitted to Hubei Maternal and Child Health Hospital for surgical treatment between June 2018 and June 2021 and classified them into Groups A and B according to patients' wishes. Patients in Group A (n = 15) were treated with TSPLS, and those in Group B (n = 24) were treated with traditional laparoscopy. Both groups underwent CSP resection and lower uterine segment repair via plastic surgery. Based on their condition and intraoperative bleeding, the patients were treated with uterine artery preligation. The operative time, preoperative pretreatment, intraoperative blood loss, decrease in beta-human chorionic gonadotropin (β-hCG) level, postoperative vaginal bleeding time, postoperative intestinal ventilation time, length of hospital stays, complications, and scar cosmesis assessment were compared. RESULTS: The scar cosmesis score was significantly lower in Group A than in Group B (p <
0.01). No significant differences in intraoperative blood loss, absolute decrease in β-hCG level, absolute decrease in blood hemoglobin level, absolute increase in blood C-reactive protein level, postoperative vaginal bleeding time, postoperative intestinal ventilation time, length of hospital stay, and complications were observed between the two groups (p >
0.05). The operative time in the experimental group was slightly longer than that in the control group (p <
0.05). CONCLUSION: TSPLS had better cosmetic effects than traditional multi-port laparoscopy, without surgical results and postoperative recovery difference, making it valuable for clinical application.