The Culdotomy Two U Procedure for Vaginal Ovarian Cystectomy

Abstract

When transvaginal removal of ovarian cysts is performed successfully, the procedure compares favorably with laparoscopy in terms of invasiveness. However, the approach into peritoneal cavity has been laborious. The objective was to evaluate feasibility of an ultrasound-guided culdotomy using a newly-developed umbrella needle. New culdotomy was performed on 36 patients with ovarian cysts. Each cyst was directly punctured by the needle from vagina under ultrasound guidance. The vaginal walls on both sides of the needle were incised with an electric scalpel. Through wound, cyst was exteriorized and enucleated. Preoperative characteristics of patients, outcome, operating time, blood loss, complications, and cyst histology were analyzed. Culdotomy was performed successfully in all cases. Operating time was less than 10 minutes and blood loss was less than 10 ml. There were no culdotomy-associated complications. Culdotomy assisted by ultrasound imaging and an umbrella needle is a simple, safe, and reliable method for vaginal ovarian cystectomy.

Evaluation of transvaginal peritoneal surgery in young female patients

“…For the entry into the intraperitoneal cavity, the new culdotomy techniques named Culdotomy 2U and Culdotomy 4S2U were used (11,12). Normally distributed data were reported as the mean ± standard deviation, whereas skewed data were reported as the median with range.…”

An Alternative System for Transvaginal Removal of Dermoid Cyst and a Comparative Study with Laparoscopy

“…In the latter group, an umbrella Hakko needle was a guide for the entry into intraperitoneal cavity 10, 24 . After a vaginal ultrasound probe with a needle guide was inserted into the vagina, the ovarian cyst was directly punctured under ultrasound This culdotomy procedure was named Culdotomy 2U 24 .…”

“…Transvaginal M Tanaka new transvaginal ovarian cystectomy page 5 ultrasound was used to identify a safe route into the cul-de-sac and this culdotomy procedure showed a high success rate 10,23, 24 . In addition, to remove the dependency on laparotomy if the vaginal approach failed, we adopted a system in which a laparoscopic system was available if needed 25 .…”

“…After a vaginal ultrasound probe with a needle guide was inserted into the vagina, the ovarian cyst was directly punctured under ultrasound This culdotomy procedure was named Culdotomy 2U 24 . In cases in which the ovarian cyst was a short distance from the cul-de-sac, we adopted the Culdotomy 4S2U of whom provided informed consent prior to participating in the study.…”

“…In the last 27 of the 35 cases, the latest culdotomy procedures were adopted 10, 24 . Transvaginal ultrasonography visualised the safe vaginal area for entry into the cul-de-sac and a newly developed umbrella Hakko needle guided for the correct incision of the vaginal wall.…”