Intraperitoneal ultrasound scan by culdotomy before laparoscopic ovarian resection: a novel approach

Laganà, Antonio Simone; Garzon, Simone; Gisone, Baldo; Casarin, Jvan; Ghezzi, Fabio

doi:10.1080/13645706.2020.1815063

Cited by 14 publications

(18 citation statements)

References 19 publications

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“…Moreover, it is inconvenient to operate by a single port or without the help of an assistant; this does not conform to the traditional laparoscopic operating habits and may increase the difficulty and risk of operation. In addition, using endobag inserted through the posterior colpotomy to remove the specimen is also an effective and feasible alternative technique, and has better a cosmetic effect (28)(29)(30). Nevertheless, transvaginal procedures cannot be performed in patients without a sexual history.…”

Section: Discussionmentioning

confidence: 99%

A Novel Multi-Port Containment System for Laparoscopic Power Morcellation to Prevent Tumoral Spread: A Retrospective Cohort Study

et al. 2022

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ObjectiveTo report a novel multi-port containment (NMC) system for laparoscopic power morcellation to prevent tumoral spread and to evaluate its safety, validity, and feasibility.MethodsThis retrospective study included women who underwent laparoscopic myomectomy (LM) between January 2014 and August 2020 at a single academic institution. The NMC system was used in the study group (n = 193); the control group underwent unprotected LM (n = 1753).ResultsAfter 1:1 propensity score matching, no significant differences in the baseline characteristics were observed between 193 matched pairs. Bag damages were detected in two cases in the study group before morcellation, and the NMC systems were replaced. There were no significant differences between the two groups in terms of the complications, total operative time, estimated blood loss, or postoperative hospitalization duration. In the study group, all operations were completed and no system rupture or leakage was observed. The median follow-up times were 21 and 54 months in the study and control groups, respectively. There was no peritoneal tissue spread in the study group. However, three (3/5, 0.6%) and six (6/1,753, 0.3%) patients in the control group experienced malignant and benign peritoneal tissue spread, respectively.ConclusionThe NMC system for laparoscopic power morcellation is valid, safe, and feasible for preventing a tumor spread.

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Section: Discussionmentioning

confidence: 99%

A Novel Multi-Port Containment System for Laparoscopic Power Morcellation to Prevent Tumoral Spread: A Retrospective Cohort Study

et al. 2022

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“…Extracorporeal cystectomy or oophorectomy for huge ovarian masses has been previously reported [ 11 , 17 , 18 , 19 , 20 ] but these reports were based on mini-laparotomy [ 17 , 18 ] or conventional laparoscopy, which needs an extension of the 5 mm or 10 mm incision of the trocar site for the removal of huge masses [ 11 , 19 , 20 , 22 ]. Recently, a novel technique was introduced for performing intraperitoneal ultrasound scans by culdotomy to guide precise laparoscopic cystectomy for complex ovarian tumors, and in this method, the tumor can be extracted within an endo bag, through the posterior colpotomy [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Fast Leak-Proof, Intraumbilical, Single-Incision Laparoscopic Ovarian Cystectomy for Huge Ovarian Masses: “Hybrid Cystectomy and Reimplantation” Method

Lee

2021

Medicina

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Background and Objectives: To introduce a new technique for fast leakage-proof, intraumbilical, single-incision laparoscopic ovarian cystectomy for huge ovarian masses (>10 cm) Materials and Methods: Seven consecutive, reproductive-aged women, including three adolescents, with huge ovarian masses (mature cystic teratoma, n = 4; endometrioma, n = 2; and mucinous cystadenoma, n = 1) who underwent transumbilical single-incision ovarian cystectomy with the new “hybrid cystectomy and reimplantation” method were included. The procedure was: (1) trans-umbilical single-incision laparoscopy; (2) inspection of the pelvic cavity and placing the mass in a laparoscopic endo-bag for cystic content leakage prevention; (3) in-bag resection using cold scissors and minimal cauterization of the cystectomy site; (4) in-bag tissue extraction; (5) rapid extracorporeal cystectomy with traction without electrocautery; (6) re-insertion of the retrieved ovarian cortex intracorporeally through the single port, and (7) intracorporeal suture of the retrieved tissue to the in situ ovary. Results: The mean patient age was 24.71 ± 6.56 (range 17–37) years and the mean maximal diameter of the masses was 17.71 ± 2.86 (range 13–22) cm. There was no case of unintended intracorporeal cyst rupture and no need for copious irrigation for washing and suctioning the leaked mass content. The mean total operating time was 76.42 ± 6.39 (range 65–85) min, the total volume of saline used for irrigation was 814.28 ± 331.35 (range 500–1500) mL, and the estimated blood loss was 107.14 ± 47.72 (range 50–200) mL. There were no perioperative complications. All patients except the two endometriosis patients had regular, normal menstruation. Conclusions: Our preliminary findings were encouraging in terms of the safety and efficiency of the new method. Future trials need to elucidate the benefits of this method in terms of fertility preservation.

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“…Moreover, in the field of gynecological surgery, it is feasible to perform mini-laparoscopy and single-site robotic surgery, where the surgical specimen can be removed at the end by in-bag transvaginal extraction instead of an external auxiliary abdominal incision. These techniques improve the cosmetic results in some gynecologic oncology surgery while ensuring complete specimen removal and good patient outcomes [ 4 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic specimen extraction in vitro: preliminary experience

Huang

Tian

et al. 2021

BMC Surg

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Background The last procedure performed by the surgeon in laparoscopic surgery is to extract the specimen through the smallest incision possible. This experiment aimed to explore the maximum diameter of specimens that can be extracted through auxiliary incisions of different lengths and shapes by in vitro physical experiments. Materials and methods We used the abdominal wall with the muscle layer, fixed on a square wooden frame, to simulate the human abdominal wall. Then, specimen extraction ports were made with circular, inverted Y-shaped and straight-line incisions of different sizes and lengths, and specimens of different sizes were made from tissues of different species. These specimens were extracted from different incisions with a force gauge. The tension value (N) was measured, and records were made of the length or diameter of the smallest auxiliary incision through which a given specimen could pass, as well as the largest specimen diameter that could pass through an incision of a given size. This experiment provides us with preliminary experience-based knowledge of how to choose the appropriate auxiliary incision for surgical specimen extraction according to the diameter of the specimen. Results The maximum diameters of specimens that could be extracted with circular ostomy diameters of 2.4, 2.7 and 3.3 cm were 4.0, 4.5 and 6.0 cm, respectively. Specimens with diameters of 6.0, 8.0 and 10.0 cm could be extracted through inverted Y-shaped incisions with a length around the umbilicus of 1 cm and an extension length of 1.0, 3.0, and 4.0 cm, respectively. Moreover, these same specimens could be extracted through inverted Y-shaped incisions with a length around the umbilicus of 2 cm and extension lengths of 0.0, 1.0 and 2.0 cm. Tough tissue specimens (made from chicken gizzards) with diameters of 1.0, 2.0, 4.0 and 6.0 cm, respectively, could be removed through straight-line incisions measuring 1.0, 2.0, 3.0 and 4.0 cm in length. Conclusion Along with preoperative imaging, surgical planning and trocar position, the shape and length of auxiliary incisions can be used to improve the extraction of specimens via laparoscopic surgery.

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Intraperitoneal ultrasound scan by culdotomy before laparoscopic ovarian resection: a novel approach

Cited by 14 publications

References 19 publications

A Novel Multi-Port Containment System for Laparoscopic Power Morcellation to Prevent Tumoral Spread: A Retrospective Cohort Study

A Novel Multi-Port Containment System for Laparoscopic Power Morcellation to Prevent Tumoral Spread: A Retrospective Cohort Study

Fast Leak-Proof, Intraumbilical, Single-Incision Laparoscopic Ovarian Cystectomy for Huge Ovarian Masses: “Hybrid Cystectomy and Reimplantation” Method

Laparoscopic specimen extraction in vitro: preliminary experience

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