A Novel Approach to Combined Vaginal and Laparoscopic Gynecological Surgery.
Benign
Colpotomy
Gynecology
Laparoscopy
Transvaginal
Journal
JSLS : Journal of the Society of Laparoendoscopic Surgeons
ISSN: 1938-3797
Titre abrégé: JSLS
Pays: United States
ID NLM: 100884618
Informations de publication
Date de publication:
Historique:
entrez:
18
5
2019
pubmed:
18
5
2019
medline:
8
8
2019
Statut:
ppublish
Résumé
In this case series, we propose a novel approach to combined vaginal and laparoscopic surgery in which a posterior colpotomy and 2 5-mm abdominal incisions are used to perform benign gynecological procedures. We seek to assess the safety and feasibility of this technique in difficult surgical candidates such as those with obesity or prior laparotomies, as well as to detail intra- and postoperative complications associated with the procedure. We collected demographic, clinical, intra-operative, and postoperative data on 45 women who underwent a combined vaginal and laparoscopic gynecological surgery for benign indications by a single surgeon between February 2013 and August 2017. From February 2013 through August 2017, 45 women underwent a combined vaginal and laparoscopic surgery at 2 institutions. Procedures included adnexal surgery (n = 32, 71%), and total hysterectomy (n = 13, 29%). Of patients who underwent adnexal surgery, two had minor postoperative complications. No patients had major complications. In addition, no patients had postoperative vaginal infections or pelvic abscesses, and there were no readmissions within 30 days after the procedures. Our proposed combined vaginal and laparoscopic approach to benign gynecological surgery can be utilized in difficult surgical candidates including those with obesity, nulliparous patients, and those with prior abdominal surgery. Our data has shown that this approach is safe and effective.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
In this case series, we propose a novel approach to combined vaginal and laparoscopic surgery in which a posterior colpotomy and 2 5-mm abdominal incisions are used to perform benign gynecological procedures. We seek to assess the safety and feasibility of this technique in difficult surgical candidates such as those with obesity or prior laparotomies, as well as to detail intra- and postoperative complications associated with the procedure.
METHODS
METHODS
We collected demographic, clinical, intra-operative, and postoperative data on 45 women who underwent a combined vaginal and laparoscopic gynecological surgery for benign indications by a single surgeon between February 2013 and August 2017.
RESULTS
RESULTS
From February 2013 through August 2017, 45 women underwent a combined vaginal and laparoscopic surgery at 2 institutions. Procedures included adnexal surgery (n = 32, 71%), and total hysterectomy (n = 13, 29%). Of patients who underwent adnexal surgery, two had minor postoperative complications. No patients had major complications. In addition, no patients had postoperative vaginal infections or pelvic abscesses, and there were no readmissions within 30 days after the procedures.
CONCLUSION
CONCLUSIONS
Our proposed combined vaginal and laparoscopic approach to benign gynecological surgery can be utilized in difficult surgical candidates including those with obesity, nulliparous patients, and those with prior abdominal surgery. Our data has shown that this approach is safe and effective.
Identifiants
pubmed: 31097905
doi: 10.4293/JSLS.2019.00006
pii: JSLS.2019.00006
pmc: PMC6464071
pii:
doi:
Types de publication
Case Reports
Langues
eng
Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Déclaration de conflit d'intérêts
Conflicts of Interest: The authors does not cite any conflicts of interest.
Références
J Reprod Med. 2002 Oct;47(10):849-53
pubmed: 12418070
JSLS. 2007 Jan-Mar;11(1):24-9
pubmed: 17651552
Endoscopy. 2007 Oct;39(10):913-5
pubmed: 17968809
BJOG. 2009 Feb;116(3):465-6
pubmed: 19187388
Arch Gynecol Obstet. 2010 Apr;281(4):609-11
pubmed: 19543903
Surg Endosc. 2011 Jul;25(7):2308-15
pubmed: 21301884
Am J Obstet Gynecol. 2012 Aug;207(2):112.e1-6
pubmed: 22704765
Wideochir Inne Tech Maloinwazyjne. 2011 Dec;6(4):236-41
pubmed: 23255986
J Minim Invasive Gynecol. 2013 Sep-Oct;20(5):583-90
pubmed: 23623269
Ann Surg. 2015 Mar;261(3):451-8
pubmed: 24108196
J Minim Invasive Gynecol. 2014 Sep-Oct;21(5):818-24
pubmed: 24681063
JSLS. 2015 Apr-Jun;19(2):null
pubmed: 25901107
Fertil Steril. 2018 Feb;109(2):366
pubmed: 29246560