An Alternative System for Transvaginal Removal of Dermoid Cyst and a Comparative Study with Laparoscopy

Tanaka, Masaaki; Sagawa, Tetsuya; Yamazaki, Rena; Myojo, Subaru; Dohi, Satoshi; Inoue, Masakí

doi:10.1177/1553350611411492

Cited by 6 publications

(13 citation statements)

References 36 publications

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“…In recent years, transvaginal approach for the removal of benign adnexal masses [9][10][11] as well as ultrasound-guided aspiration techniques, 12 have significantly modified the treatment options for selected cases of adnexal masses. The greatest benefit of transvaginal surgery is that it results in no surgical scarring to the abdominal skin.…”

Section: Discussionmentioning

confidence: 99%

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Transvaginal natural orifice transluminal endoscopic surgery for adnexal masses

Yang

Hur

et al. 2013

J of Obstet and Gynaecol

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Aim: Natural orifice transluminal endoscopic surgery (NOTES) is currently a very important topic for surgeons. This study aimed to describe the initial clinical experience of transvaginal NOTES for adnexal masses and investigate its feasibility and surgical outcome. Methods: We performed transvaginal NOTES in seven patients with adnexal masses through a 2-cm incision in the posterior vaginal fornix. A transvaginal NOTES system comprising a wound protractor and a surgical glove with sheaths was used. Resection was performed according to the method of standard laparoscopic adnexal surgery. The adnexal mass was removed via the incision of the posterior vaginal fornix after complete resection. Results: Since June 2011, seven patients have undergone transvaginal NOTES for adnexal masses. All cases were completed successfully without conversion to standard laparoscopic approach. The median age of the patients was 48 years (range, 36-60) and the median body mass index was 23.6 (range, 20.4-25.3). The median tumor size was 6 cm (range, 3.7-6.7). The median operative time was 45 min (range, 40-80). The estimated blood loss was minimal (range, 5-300 mL). The median postoperative hospital stay was 2 days (range, 1-3). No postoperative complications were observed at follow-up. All the patients were very satisfied with the cosmetic result. Conclusion:The findings show transvaginal NOTES with our method to be a feasible, safe and effective surgical technique that results in excellent cosmesis. It may be an alternative technique for the treatment of properly selected female patients with adnexal masses. More experience and instrumental improvement suitable for transvaginal NOTES are needed.

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Section: Discussionmentioning

confidence: 99%

“…After at least 3 months, patients were evaluated concerning cosmetic satisfaction, dyspareunia and any possible negative experiences. The mean follow-up duration was 8 months (range, [3][4][5][6][7][8][9][10][11][12][13].…”

Section: Patientsmentioning

confidence: 99%

Transvaginal natural orifice transluminal endoscopic surgery for adnexal masses

Yang

Hur

et al. 2013

J of Obstet and Gynaecol

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“…We recently reported that vaginal ovarian cystectomy to treat a dermoid cyst was equivalent to laparoscopic cystectomy with respect to invasiveness (13). All transvaginal cystectomies were completed without intra-operative complications, and there were no differences in operating time, blood loss, and postoperative infection between the two procedures.…”

Section: Introductionmentioning

confidence: 96%

“…On the first page of the questionnaire, the age of the patient (in 5-year intervals), the postoperative follow-up period (in 6-month intervals), and the histology of each cyst were already entered. The questionnaire Laparoscopically supported vaginal ovarian cystectomy is a newly proposed operative approach, in which the ovarian cystectomy is initially approached transvaginally; in rare cases in which a vaginal approach is impossible due to failed culdotomy, intrapelvic adhesions, or uncontrolled bleeding, laparoscopy is used to complete the operation (10,13).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of transvaginal peritoneal surgery in young female patients

et al. 2013

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“…Ultrasonography is widely used during surgery to visualize lesions or critical vessels lying deep within organs, including the liver, 26 prostate and kidney, 27 and heart, 28 and in neurosurgery 29 and gynecological surgery. 30 These fields benefit from surgical navigation systems that combine laparoscopic vision with computed tomography, magnetic resonance imaging, or ultrasonographic images. 31–35 However, simultaneous interlacing during surgery is currently not possible because of deformation and dislocation of organs 35 by the surgical maneuver itself and the effect of gravity.…”

Section: Discussionmentioning

confidence: 99%

Small-Incision Laparoscopy-Assisted Surgery Under Abdominal Cavity Irrigation in a Porcine Model

Igarashi

Ishii

Aoe

et al. 2016

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: Laparoscopic and robot-assisted surgeries are performed under carbon dioxide insufflation. Switching from gas to an isotonic irrigant introduces several benefits and avoids some adverse effects of gas insufflation. We developed an irrigating device and apparatus designed for single-incision laparoscopic surgery and tested its advantages and drawbacks during surgery in a porcine model.Materials and Methods: Six pigs underwent surgical procedures under general anesthesia. A 30-cm extracorporeal cistern was placed over a 5–6-cm abdominal incision. The abdomen was irrigated with warm saline that was drained via a suction tube placed near the surgical field and continuously recirculated through a closed circuit equipped with a hemodialyzer as a filter. Irrigant samples from two pigs were cultured to check for bacterial and fungal contamination. Body weight was measured before and after surgery in four pigs that had not received treatments affecting hemodynamics or causing diuresis.Results: One-way flow of irrigant ensured laparoscopic vision by rinsing blood from the surgical field. Through a retroperitoneal approach, cystoprostatectomy was successfully performed in three pigs, nephrectomy in two, renal excision in two, and partial nephrectomy in one, under simultaneous ultrasonographic monitoring. Through a transperitoneal approach, liver excision and hemostasis with a bipolar sealing device were performed in three pigs, and bladder pedicle excision was performed in one pig. Bacterial and fungal contamination of the irrigant was observed on the draining side of the circuit, but the filter captured the contaminants. Body weight increased by a median of 2.1% (range, 1.2–4.4%) of initial weight after 3–5 hours of irrigation.Conclusions: Surgery under irrigation is feasible and practical when performed via a cistern through a small abdominal incision. This method is advantageous, especially in the enabling of continuous and free-angle ultrasound observation of parenchymal organs. Adverse effects of abdominal irrigation need further assessment before use in humans.

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An Alternative System for Transvaginal Removal of Dermoid Cyst and a Comparative Study with Laparoscopy

Cited by 6 publications

References 36 publications

Transvaginal natural orifice transluminal endoscopic surgery for adnexal masses

Transvaginal natural orifice transluminal endoscopic surgery for adnexal masses

Evaluation of transvaginal peritoneal surgery in young female patients

Small-Incision Laparoscopy-Assisted Surgery Under Abdominal Cavity Irrigation in a Porcine Model

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