Posterior colpotomy revisited: a forgotten route for retrieving larger benign ovarian lesions following laparoscopic excision
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Although simple, ovarian cysts can be decompressed (within an impermeable pouch) following laparoscopic excision to allow lesions of up to 10 cm to be delivered safely. It is more difficult to remove solid or semi-solid ovarian tumours (such as fibromas and dermoid cysts) through this route. We present a modification of laparoscopic-assisted transvaginal retrieval of ovarian tumours through a posterior colpotomy incision (in a bag) and suggest that this is a route that allows large specimens to be retrieved safely and with minimal spillage.
Women with solid or semi-solid ovarian cysts of greater than 5 cm, undergoing operative laparoscopy, were offered the option of having the specimens delivered through a posterior colpotomy, if retrieval through the abdominal ports proved difficult.
The median specimen diameter was 6 cm (range 4–8 cm) and the median blood loss was 200 ml (range 150–250 ml). The median operating time was 50 min (range 40–90 min) with most patients being discharged within 24 h (median 18 h; range 16–21 h). There was no inadvertent spillage of cyst content or any intra or post-operative complications.
Laparoscopic-assisted transvaginal removal of these lesions (in a bag!) allows large specimens to be removed securely and with minimal spillage.
- Maiman M, Seltzer V, Boyce J (1991) Laparoscopic excision of ovarian neoplasms subsequently found to be malignant. Obstet Gynecol 77:564–565
- Chapron C, Dubuisson JB, Kadoch O, Capella-Allouc S, Vacher-Lavenu MC (1998) Laparoscopic management of organic ovarian cysts: Is there a place for frozen section diagnosis? Hum Reprod 13:324–329. doi:10.1093/humrep/13.2.324 CrossRef
- Ghezzi F, Cromi A, Bergamini V, Uccella S, Siesto G, Franchi M, Bolis P (2008) Should adnexal mass size influence surgical approach? A series of 186 laparoscopically managed large adnexal masses. BJOG 115:1020–1027. doi:10.1111/j.1471-0528.2008.01775.x CrossRef
- Pardi G, Carminati R, Ferrari M, Ferrazzi E, Bulfoni G, Marcozzi S (1995) Laparoscopically assisted vaginal removal of ovarian dermoid cysts. Obstet Gynecol 85:129–132. doi:10.1016/0029-7844(94)00309-2 CrossRef
- Teng FY, Muzsnai D, Perez R, Mazdisnian F, Ross A, Sayre J (1996) A comparative study of laparoscopy and colpotomy for the removal of ovarian dermoid cysts. Obstet Gynecol 87(6):1009–1013. doi:10.1016/0029-7844(96)00061-0 CrossRef
- Royal College of Obstetricians and Gynaecologists. Ovarian cyst in postmenopausal women. Guideline no. 34. RCOG October 2003
- Kelly HA (1896) Treatment of ectopic pregnancy by vaginal puncture. Bull Johns Hopkins Hosp 7:208
- Bradbury WC (1952) Technique of posterior colpotomy. W J Surg 60:377–386
- Daly MJ (1957) Posterior colpotomy for the diagnosis and treatment of pelvic disease. Am J Obstet Gynecol 74(3):623–628
- Tanaka M, Sagawa T, Mizumoto Y, Hashimoto M, Yoshimoto H, Yamazaki R, Kasai T, Inoue M (2008) Use of laparoscopic support to avoid laparotomy in vaginal ovarian cystectomy. J Minim Invasive Gynecol 15(3):350–354. doi:10.1016/j.jmig.2008.01.010 CrossRef
- Nezhat CR, Kalyoncu S, Nezhat CH, Johnson E, Berlanda N, Nezhat F (1999) Laparoscopic management of ovarian dermoid cysts: ten years’ experience. JSLS 3(3):179–184
- Box GN, Bessler M, Clayman RV (2009) Transvaginal access: current experience and potential implications for urologic applications. J Endourol 23(5):753–757. doi:10.1089/end.2009.0150 CrossRef
- Horgan S, Mintz Y, Jacobsen GR et al (2009) NOTES: transvaginal cholecystectomy with assisting articulating instruments. Surg Endosc May 9 (Epub ahead of printing)
- Posterior colpotomy revisited: a forgotten route for retrieving larger benign ovarian lesions following laparoscopic excision
Archives of Gynecology and Obstetrics
Volume 281, Issue 4 , pp 609-611
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Posterior colpotomy
- Industry Sectors