Abstract
Background
Despite the advantages of laparoscopic colon surgery, the need for an incision in the abdominal wall to remove the surgical specimen is a morbidity factor. The objective of this article is to introduce transvaginal specimen extraction after laparoscopic colectomy, in order to avoid an abdominal incision.
Methods
Between 2008 and 2011, 21 selected women with benign and malignant colorectal pathologies underwent laparoscopic colectomy and the extraction of the surgical specimen was done through a transvaginal access route. Of these patients, 12 had symptomatic diverticular disease, four had rectal villous adenomas, two had severe chronic constipation, and three had adenocarcinomas. We describe the surgical technique and the short-term outcomes related to the transvaginal specimen extraction.
Results
The procedure was successful in all cases. There were no immediate complications or mortality. At follow-up, between 2 and 34 months, there were no functional disorders associated with the transvaginal specimen extraction.
Conclusion
Specimen removal of laparoscopic colectomies via the transvaginal route avoids the abdominal wall incision and its potential complications. It is feasible, safe, and simple to perform, with no additional costs, and provides excellent cosmetic results.
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References
Noel JK, Fahrbach K, Estok R et al (2007) Minimally invasive colorectal resection outcomes: short-term comparison with open procedures. J Am Coll Surg 204:291–307
Hackert T, Uhl W, Buchler M (2002) Specimen retrieval in laparoscopic colon surgery. Dig Surg 19:502–506
Harrel AG (2005) Minimally invasive abdominal surgery: lux et varitas past, present and future. Am J Surg 190:239–243
Delvaux G, Devroey P, De Waele B, Willems G (1993) Transvaginal removal of gallbladders with large stones after laparoscopic cholecystectomy. Surg Laparosc Endosc 3:307–309
Gill I, Cherullo E, Meraney A (2002) Vaginal extraction of the intact specimen following laparoscopic radical nephrectomy. J Urol 167(1):238–241
Vereckzie A (2009) Transvaginal extraction of the laparoscopically removed spleen. Surg Endosc 17:157–162
Redwine D, Koning M, Sharpe DR (1996) Laparoscopically assisted transvaginal segmental resection of the rectosigmoid colon for endometriosis. Fertil Steril 65(1):193–197
Kim J, Shim M, Kwun K (1996) Laparoscopic-assisted transvaginal resection of the rectum. Dis Colon Rectum 39(5):582–583
Wilson JI, Dogiparthi KK, Hebblethwaite N, Clarke MD (2007) Laparoscopic right hemicolectomy with posterior colpotomy for transvaginal specimen retrieval. Colorectal Dis 9:662–668
Franklin ME, Kelley H, Kelley M et al (2008) Transvaginal extraction of the specimen after total laparoscopic right hemicolectomy with intracorporeal anastomosis. Surg Laparosc Endosc Percutan Tech 18(3):294–298
Dozois EJ, Larson DW, Dowdy SC et al (2008) Transvaginal colonic extraction following combined hysterectomy and laparoscopic total colectomy: a natural orifice approach. Tech Coloproctol 12:251–254
Palanivelu C, Rangarajan M, Jategaonkar PA, Anand NV (2008) An innovative technique for colorectal specimen retrieval: a new era of “natural orifice specimen extraction” (N.O.S.E.). Dis Colon Rectum 51(7):1120–1124
McKenzie S, Baek JH, Wakabayashi M et al (2010) Totally laparoscopic right colectomy with transvaginal specimen extraction: the authors’ initial institutional experience. Surg Endosc 24(8):2048–2052
Del Frate G (1996) Vaginal and abdominal hysterectomy: comparison and perspectives. Minerva Gynecol 48:181–191
Paraiso MF (2006) Rectocele repair: a randomized trial of the three surgical techniques including graft augmentation. Obstet Gynecol 195:1762–1771
Roovers JP, van der Bom JG, van der Vaart CH et al (2005) A randomized comparison of post operative pain, quality of life, and physical performance during the first six weeks after abdominal or vaginal surgery correction of the uteri. Neurourol Urodyn 24:334–340
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Torres, R.A., Orban, R.D., Tocaimaza, L. et al. Transvaginal Specimen Extraction After Laparoscopic Colectomy. World J Surg 36, 1699–1702 (2012). https://doi.org/10.1007/s00268-012-1528-x
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DOI: https://doi.org/10.1007/s00268-012-1528-x