Management and Outcome of Rectal Injury During Gynecologic Laparoscopic Surgery

Jo, Eun Ju; Lee, Yoo-Young; Kim, Tae-Joong; Choi, Chel Hun; Lee, Jeong‐Won; Bae, Duk-Soo; Kim, Byoung-Gie

doi:10.1016/j.jmig.2012.10.008

Cited by 10 publications

(12 citation statements)

References 17 publications

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“…The peritoneum is soft, moist, has good elasticity, and is similar to normal vaginal mucosa in function and form. The smooth surface and its ability to secrete mucus, defend, and undergo self-repair making it a promising cover for an artificial vagina [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: Peritoneal vaginoplasty by Luohu I and Luohu II technique: a comparative study of the outcomes

Le¹,

Wang²,

Shan³

et al. 2015

Eur J Med Res

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BackgroundSurgical vaginoplasty is the standard treatment for women suffering from Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome. This study compares the advantages and disadvantages of Luohu I technique or its modification, Luohu II technique.MethodsWomen with MRKH syndrome undergoing laparoscopic peritoneal vaginoplasty using either the Luohu I (N = 145) or Luohu II (N = 155) technique were recruited. We compare the effectiveness of the Luohu II and one of Luohu I. Sexual satisfaction was checked by Female Sexual Function Index.ResultsThere was no significant difference in the mean operation time, volume of intraoperative blood loss, time for the first passage of gas, sexual satisfaction (and hospital stay for patients in either group (P > 0.05). But patients in the Luohu II group had a significantly lower incidence of complications than patients in the Luohu I group. All patients had vaginal depths more than 9 cm over 3 months post-surgery.ConclusionsCompared with the traditional Luohu I laparoscopic peritoneal vaginoplasty, the Luohu II operation is easier to perform and causes less damage to the bladder and rectum. The physiological and anatomical features of the artificial vagina resemble the normal vagina in both techniques.

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Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: Peritoneal vaginoplasty by Luohu I and Luohu II technique: a comparative study of the outcomes

Le¹,

Wang²,

Shan³

et al. 2015

Eur J Med Res

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show abstract

“…Although laparoscopic surgery provides a wider view of the surgical field than open surgery, rectal microdamage during surgery may be difficult to recognize. In a previous study, two (13%) of 15 accidental rectal injuries were not recognized until after surgery 9 . One of the patients in that report developed a rectovaginal fistula with persistent ileus that required open segmental resection 30 days after the primary laparoscopy.…”

Section: Discussionmentioning

confidence: 88%

“…Using a rectal probe during the rectal shaving procedure is recommended to decrease the risk of complications. Some surgeons recommend placement of other intrarectal devices, such as a dilator, bougie and balloon, for better visualization of the rectal wall 8–10 . Out of 506 patients who have undergone laparoscopic surgery for endometriosis at our hospital from 2009 to 2019, three (0.6%) have sustained bowel injury and two (0.4%) have developed a pelvic abscess.…”

Section: Discussionmentioning

confidence: 99%

“…Rectal injury should be identified during surgery to allow primary repair and prevent serious complications, which tend to persist and eventually require diverting colostomy 8 . There has been a report of a rectal injury measuring less than 3 cm being safely repaired by a skilled laparoscopic gynecologic surgeon without postoperative complications 9 …”

Section: Discussionmentioning

confidence: 99%

“…Intraoperative air leak tests are easy to use and useful for detecting rectal defects. A wet air leak test is considered positive when air is insufflated through the rectal catheter after filling the pelvis with saline solution and air bubbles are observed 7,9 . The leakage of blue dye method can also be used 7 .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Successful detection of rectal injury during laparoscopic surgery using a rectal probe in a patient with deep endometriosis

Yoriki

Izumi

Mari

et al. 2020

J of Obstet and Gynaecol

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Laparoscopic surgery has become the gold standard treatment for endometriosis. Surgical treatment of deep endometriosis with colorectal involvement is challenging. It requires complete surgical excision of lesions despite a high risk of complications that include rectal injury, rectovaginal fistula and pelvic abscess. An intraoperative air leak test allows detection of rectal injury and reduces postoperative complications. We report a case of successful management of rectal injury during laparoscopic surgery using a rectal probe even though air leak tests were negative. A 45‐year‐old woman with severe endometriosis and rectal involvement underwent total laparoscopic hysterectomy combined with rectal shaving. A pinhole injury that reached the rectal muscularis layer without breaching the mucosal layer was identified using a rectal probe after negative air leak tests. The injury was repaired uneventfully. Our experience suggests that using a rectal probe could be helpful for early detection and safe repair of rectal injury during surgery.

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Injury to the Rectum During Pelvic Surgery

Feingold

Jafari

2019

Colorectal Surgery Consultation

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Management and Outcome of Rectal Injury During Gynecologic Laparoscopic Surgery

Cited by 10 publications

References 17 publications

RETRACTED ARTICLE: Peritoneal vaginoplasty by Luohu I and Luohu II technique: a comparative study of the outcomes

RETRACTED ARTICLE: Peritoneal vaginoplasty by Luohu I and Luohu II technique: a comparative study of the outcomes

Successful detection of rectal injury during laparoscopic surgery using a rectal probe in a patient with deep endometriosis

Injury to the Rectum During Pelvic Surgery

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