Culdoscopy—Useful or Useless?

Lane, E

doi:10.1002/j.1879-3479.1980.tb00303.x

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Finally, during the study period we gradually modified the technique of entering the cul-de-sac, starting with blind insertion using the Veress needle and culminating in the use of an optical cannula which allowed insertion under direct vision. Although advocates of ''blind entry'' report a low rate of rectal injury at culdoscopy (Lane 1980;Brosens et al 1999;Watrelot et al 1999;Gordst et al 2002;Cicinelli et al 2001), we feel much more comfortable using a technique which provides visual control; a similar approach is already used in laparoscopy (Melzer et al 1995). During insertion with the optical cannula, it is possible to identify retroperitoneal connective tissue and fat, and subsequent entry into the peritoneal cavity is immediately obvious.…”

Section: Discussionmentioning

confidence: 93%

One stop fertility clinic

Magos

Al-Khouri

Scott

et al. 2005

Journal of Obstetrics and Gynaecology

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Section: Discussionmentioning

confidence: 93%

One stop fertility clinic

Magos

Al-Khouri

Scott

et al. 2005

Journal of Obstetrics and Gynaecology

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“…In culdoscopy the pelvic organs were visualized without insufflation and with the patient in knee–elbow position. The technique was used to search for causes of pelvic pain and infertility, and for diagnosing adnexal masses [ 5 ].…”

Section: Surgical Techniquesmentioning

confidence: 99%

The anatomical limits of the posterior vaginal vault toward its use as route for intra-abdominal procedures

et al. 2008

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Background The use of natural openings for abdominal surgery started at the beginning of the 21th century. A transDouglas endoscopic device has been designed to perform most of the intra-abdominal operations in women through the pouch of Douglas. The posterior vaginal vault is limited in size and could be damaged by an oversized instrument. This study investigates the optimal dimensions of the instrument by measuring the limiting factor in the passage. Methods In ten female embalmed bodies the transversal and sagittal diameter of the fornix posterior vaginalis was measured by two observers. The pouch of Douglas was filled to its maximal capacity with mouldable latex through an open abdomen. By internal vaginal examination the connective tissue borders of the fornix posterior were palpated and the impression in the cast was measured. The mean value of these two diameters was evaluated in this study. The level of agreement between the observers was calculated.Results The mean fornix posterior diameter was 2.6 cm (standard deviation, SD 0.5 cm) with a range of 2.0-3.4 cm. The mean difference between the two observers of all measurements was 0.08 cm (not significant). Both observers had an acceptable intraobserver variation. The interobserver agreement was excellent. Conclusion Instruments with dimensions within the measured limits can be used safely for intra-abdominal operations via the natural orifice of the vagina.Keywords Fornix vaginalis Á Pouch of Douglas Á Natural orifice surgery The 19th century was the era of the laparotomy. Endoscopy was developed in the 20th century. The use of the natural openings for abdominal surgery started at the beginning of the 21st century. Instruments have been designed in order to perform most of the intra-abdominal operations in women through the pouch of Douglas. In order to find the optimal dimensions of this instrument, the limiting factor in the passage through the vagina into the abdominal cavity, the fornix vaginalis, has to be measured. AnatomyThe fornix vaginalis is formed anatomically by the vagina around the cervix uteri. It is most spacious dorsally, where

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