Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) for prophylactic bilateral salpingo-oophorectomy.


Journal

Surgical oncology
ISSN: 1879-3320
Titre abrégé: Surg Oncol
Pays: Netherlands
ID NLM: 9208188

Informations de publication

Date de publication:
Dec 2020
Historique:
received: 25 05 2020
revised: 01 07 2020
accepted: 21 07 2020
pubmed: 28 8 2020
medline: 9 10 2021
entrez: 27 8 2020
Statut: ppublish

Résumé

Prophylactic bilateral salpingo-oophorectomy (BSO) is an important option for reducing the risk of developing ovarian and fallopian tube cancers in women with a hereditary ovarian cancer syndrome. Conventional laparoscopy is generally preferable since it is associated with less morbidity compared to laparotomy. Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) is an emerging surgical approach that offers several advantages over conventional laparoscopy including reduced postoperative pain, low rate of surgical site infections, fast patient recuperation and better cosmetic outcome [1-6]. The objective of this video is to demonstrate a surgical technique for vNOTES BSO. This is a Stepwise demonstration of the vNOTES for prophylactic BSO with narrated video footage. The diameter of Alexis is 7 cm and we used the GelPOINT V-path transvaginal access platform (Applied Medical, Rancho Santa Margarita, CA). A 52-year-old carrier of BRCA1 mutation. The patient was selected to be operated on via a vaginal port. The video presents some tips and tricks to aid the surgeon to perform this surgery in a safe and timely manner, using the vaginal GEL POINT system and vNOTES technique. vNOTES for prophylactic BSO via a vaginal port is a feasible technique with promising cosmetic results. This technique allows surgeon to expose the ureter well and lower the risk of ureteric injury. Additionally, this approach avoids abdominal wall vessels injury associated with the trocar insertion. Currently, as a result of certain technical limitations, such as when performing BSO without a hysterectomy, there has been a tendency to employ the vaginal access less frequently. In this video presentation, we demonstrate the feasibility of laparoscopic BSO via vNOTES whilst leaving the uterus intact.

Sections du résumé

BACKGROUND BACKGROUND
Prophylactic bilateral salpingo-oophorectomy (BSO) is an important option for reducing the risk of developing ovarian and fallopian tube cancers in women with a hereditary ovarian cancer syndrome. Conventional laparoscopy is generally preferable since it is associated with less morbidity compared to laparotomy. Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) is an emerging surgical approach that offers several advantages over conventional laparoscopy including reduced postoperative pain, low rate of surgical site infections, fast patient recuperation and better cosmetic outcome [1-6]. The objective of this video is to demonstrate a surgical technique for vNOTES BSO.
METHODS METHODS
This is a Stepwise demonstration of the vNOTES for prophylactic BSO with narrated video footage. The diameter of Alexis is 7 cm and we used the GelPOINT V-path transvaginal access platform (Applied Medical, Rancho Santa Margarita, CA).
RESULTS RESULTS
A 52-year-old carrier of BRCA1 mutation. The patient was selected to be operated on via a vaginal port. The video presents some tips and tricks to aid the surgeon to perform this surgery in a safe and timely manner, using the vaginal GEL POINT system and vNOTES technique.
CONCLUSIONS CONCLUSIONS
vNOTES for prophylactic BSO via a vaginal port is a feasible technique with promising cosmetic results. This technique allows surgeon to expose the ureter well and lower the risk of ureteric injury. Additionally, this approach avoids abdominal wall vessels injury associated with the trocar insertion. Currently, as a result of certain technical limitations, such as when performing BSO without a hysterectomy, there has been a tendency to employ the vaginal access less frequently. In this video presentation, we demonstrate the feasibility of laparoscopic BSO via vNOTES whilst leaving the uterus intact.

Identifiants

pubmed: 32846269
pii: S0960-7404(20)30338-8
doi: 10.1016/j.suronc.2020.07.006
pii:
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

79-80

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

Auteurs

Motti Goldenberg (M)

Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel.

Yechiel Z Burke (YZ)

Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel.

Emad Matanes (E)

Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. Electronic address: l_lior@rambam.health.gov.il.

Lior Lowenstein (L)

Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.

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Classifications MeSH