Hybrid Transvaginal NOTES Nephrectomy: Postoperative Sexual Outcomes. A Three-center Matched Study

Butticè, Salvatore; Şener, Tarık Emre; Lucan, Valerian; Lunelli, Luca; Laganà, Antonio Simone; Vitale, Salvatore Giovanni; Netsch, Christopher; Tanıdır, Yılören; Pappalardo, Rosa; Magno, Carlo

doi:10.1016/j.urology.2016.09.023

Cited by 30 publications

(18 citation statements)

References 18 publications

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“…In subgroup analyses, in nulliparous patients (n=60), arousal, sexual desire, orgasm, and satisfaction domains had no significant differences in pre- and postoperative periods. Accordingly, the authors strongly supported the use of hybrid transvaginal NOTES nephrectomy for large renal tumors, especially in nulliparous patients, for unaltered sexual satisfaction ( 28 ).…”

Section: Investigations On Vaginal Port and Sexual Functionmentioning

confidence: 89%

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Exploring the umbilical and vaginal port during minimal invasive surgery

Tinelli

Tsin

Forgione³

et al. 2017

J Turkish German Gynecol Assoc

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This article focuses on the anatomy, literature, and our own experiences in an effort to assist in the decision-making process of choosing between an umbilical or vaginal port. Umbilical access is more familiar to general surgeons; it is thicker than the transvaginal entry, and has more nerve endings and sensory innervations. This combination increases tissue damage and pain in the umbilical port site. The vaginal route requires prophylactic antibiotics, a Foley catheter, and a period of postoperative sexual abstinence. Removal of large specimens is a challenge in traditional laparoscopy. Recently, there has been increased interest in going beyond traditional laparoscopy by using the navel in single-incision and port-reduction techniques. The benefits for removal of surgical specimens by colpotomy are not new. There is increasing interest in techniques that use vaginotomy in multifunctional ways, as described under the names of culdolaparoscopy, minilaparoscopy-assisted natural orifice surgery, and natural orifice transluminal endoscopic surgery. Both the navel and the transvaginal accesses are safe and convenient to use in the hands of experienced laparoscopic surgeons. The umbilical site has been successfully used in laparoscopy as an entry and extraction port. Vaginal entry and extraction is associated with a lower risk of incisional hernias, less postoperative pain, and excellent cosmetic results.

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Section: Investigations On Vaginal Port and Sexual Functionmentioning

confidence: 89%

“…Regarding sexual function after posterior colpotomy, Butticè et al ( 28 ) evaluated 71 patients after hybrid transvaginal (NOTES) nephrectomy. Sexual function was evaluated using the Female Sexual Function Index (FSFI) questionnaire the day prior to the operation and 3 months after.…”

Section: Investigations On Vaginal Port and Sexual Functionmentioning

confidence: 99%

Exploring the umbilical and vaginal port during minimal invasive surgery

Tinelli

Tsin

Forgione³

et al. 2017

J Turkish German Gynecol Assoc

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“…NOTES was first introduced in 2008 for cholecystectomy [6]. With reported low learning curve and lower complication, NOTES and hybrid NOTES are now applied on kidney transplantation widely and successfully [7], [8].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Nephroureterectomy in the Upper Urinary Tract Urothelial Carcinoma with Transvaginal Extraction

Hendri

Yuri

Zulfiqqar

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: The upper urinary tract urothelial carcinoma (UTUC) is a rare urological malignancy. Laparoscopic nephroureterectomy (LNU) is one of the options for minimally invasive surgery for UTUC. It has similar oncological outcomes compared to open nephroureterectomy. One of the techniques developed for specimen extraction is the transvaginal route. Transvaginal specimen extraction has advantages in the reduced risk of complications, faster recovery time, and better end result. CASE PRESENTATION: A 37-year-old woman complained of intermittent pain in her right flank for the past 2 months, with significant weight loss. No other significant symptoms occurred. Her general condition was good with a Karnofsky Performance scale index is 90. In the right periumbilical area, there was a mobile, smooth mass palpated with the size of 10 × 12 cm. There was no tenderness. The patient underwent URS and biopsy of the right ureteral mass with pathological analysis resulting in UTUC. Then, the patient underwent laparoscopic radical nephroureterectomy. CONCLUSION: Although the surgical procedure was safe for the patient and more effective in terms of less morbidity, faster healing time, and better cosmetic appearance, transvaginal extraction of the kidney needs to be further studied, particularly relating to the little experience of this new technique.

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“…As for additional strategies for nephrectomy, there are reports regarding laparoendoscopic single-site surgery (trans-umbilical and lumber) [12, 13], transumbilical multiport laparoscopic nephrectomy with specimen extraction through the vagina [14], laparoendoscopic single-site transvaginal nephrectomy [15, 16], and hybrid transvaginal NOTES nephrectomy [17]. The authors declared that these relatively novel operation modes were technically challenging but feasible and may be performed safely.…”

Section: Discussionmentioning

confidence: 99%

“…As for the laparoscopic nephrectomy realized through the complete vaginal approach or hybrid transvaginal NOTES [15–17], we think that the three-step method could be applicable in these cases. However, it will be more difficult for these cases than our reported retroperitoneal approach due to the problems caused by the surgical instruments and visual angles.…”

Section: Discussionmentioning

confidence: 99%

The methods and techniques of identifying renal pedicle vessels during retroperitoneal laparoscopic radical and partial nephrectomy

Yang

Zhou

et al. 2019

World J Surg Onc

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Background Retroperitoneal laparoscopic radical and partial nephrectomy (RLRN and RLPN) have become the preferred modes of management for renal malignancy. One of the most critical steps in the RLRN and RLPN process is to seek and control the renal pedicle. The current study focuses on introducing methods and techniques that can help quickly and accurately identify the renal pedicle vessels during RLRN and RLPN. Methods RLRNs and RLPNs were performed for 292 cases in our hospital from November 2014 to January 2017. Different measures were adopted to seek and manage bilateral renal pedicle vessels. All operation procedures were performed by the following three steps: dissection, opening, and clamping. For the left lateral, after the perirenal fat in the dorsal and lateral side was fully dissected, the kidney was pushed toward the ventral side. The renal artery was visible when opening the dense bulging connective tissue, which was located in the middle of the dorsal interior of the kidney. Then, the renal artery was clamped with a Hem-o-lok or the Bulldog clamp. For the right kidney pedicles, the inferior vena cava was first identified and then dissipated upward. When the inferior vena cava was not visible, it was often the location of the right renal artery. The treatment for the artery was the same as for the left renal artery. Relevant clinical characteristics of patients, such as operative time, intraoperative blood loss, and duration of postoperative drainage, were analyzed retrospectively. The three-step method of identifying renal pedicle vessels during retroperitoneal laparoscopic radical and partial nephrectomy was evaluated. Results All operations were successfully accomplished with satisfying results, during which the artery could be controlled quickly, and no cases were converted to open surgery due to severe bleeding of renal pedicle vessels. There were no complications involving renal vessels during the entire study. The mean operative times were (81.9 ± 19.71) min and (88.2 ± 21.28) min for RLRN and RLPN, with an average intraoperative blood loss of (91.7 ± 47.10) ml and (62.4 ± 47.45) ml, respectively. The warm ischemia time for RLPN was (19.3 ± 5.6) min. The postoperative drainage-tube was removed within (4.5 ± 1.29) d (RLRN) and (4.6 ± 1.98) d (RLPN); the mean postoperative hospital stay times were (7.0 ± 2.4) d and (5.9 ± 1.98) d, respectively. Conclusion The three-step method of identifying renal pedicle vessels during RLRN and RLPN is direct and feasible, and it may help simplify the operating procedure and improve the safety of the surgery. It may be of great practical application value in the clinical field. Electronic supplementary material The online version of this article (10.1186/s12957-019-1580-1) contains supplementary material, which is available to authorized users.

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Hybrid Transvaginal NOTES Nephrectomy: Postoperative Sexual Outcomes. A Three-center Matched Study

Cited by 30 publications

References 18 publications

Exploring the umbilical and vaginal port during minimal invasive surgery

Exploring the umbilical and vaginal port during minimal invasive surgery

Laparoscopic Nephroureterectomy in the Upper Urinary Tract Urothelial Carcinoma with Transvaginal Extraction

The methods and techniques of identifying renal pedicle vessels during retroperitoneal laparoscopic radical and partial nephrectomy

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