Laparoscopic Supracervical Hysterectomy and Sacrocervicopexy with Extraction of the Surgical Specimen by the Posterior Colpotomy for the Treatment of Uterine Prolapse

Abstract

infundibulopelvic (IP) ligament. Once the ureterolysis was completed on the right pelvic sidewall, the IP ligament was skeletonized and a vascular clip was attempted to be placed for hemostasis. During the placement of the clip, intravenous leiomyomas were visualized to be protruding through the ovarian vein. The intravenous leiomyomas were then extracted from the vessel by utilizing the robotic graspers. Attention was paid not to dislodge the leiomyomas into the vein. Firm and steady pressure was applied during the surgical extraction of the specimen from the right ovarian vein. Measurements/Results: The procedure was uncomplicated and was successfully completed robotically. Patient was discharged home on postoperative day one. Computed tomography did not reveal any remaining intravenous leiomyomatosis and echocardiography was negative for any pathology. Conclusions: Intravenous leiomyomatosis is a rare phenomenon which can occur in patients with leiomyomatous uterus. It can be managed laparoscopically in experienced hands with excellent surgical outcomes. Attention should be paid in order not to dislodge the intravenous specimen, which would otherwise lead to catastrophic complications.