Transvaginal phase of laparoscopic radical hysterectomy

Köhler, Christian; Jacob, Anna; Schneider, Viola; Schneider, Achim; Plaikner, Andrea

doi:10.1136/ijgc-2019-001139

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…This surgical procedure may also be considered for other gynecological malignancies such as cervical and upper third vaginal sarcomas. As previously reported, 4 the standardization of step-by-step surgical techniques can enhance surgical learning, particularly in the case of complex procedures.…”

Section: Gynecological Cancermentioning

confidence: 64%

How to avoid peritoneal tumor spillage during total abdominal hysterectomy in uterine cancers with cervical invasion

Leray

Ángeles

Daix

et al. 2021

Int J Gynecol Cancer

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Section: Gynecological Cancermentioning

confidence: 64%

How to avoid peritoneal tumor spillage during total abdominal hysterectomy in uterine cancers with cervical invasion

Leray

Ángeles

Daix

et al. 2021

Int J Gynecol Cancer

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“…There are the risks of bleeding so much and entering the vaginal cavity during this procedure. Kohler et al showed in a multicenter analysis that oncologic outcomes of combined vaginal‐LRH with transvaginal closure of the vaginal cuff were similar to those of open RH reported in the LACC trial 8 . In their transvaginal approach, the vaginal cuff was closed by continuous sutures after clamping the vaginal mucosa with a 6 straight Kocher clamp.…”

Section: Discussionmentioning

confidence: 91%

A simple technique of vaginal cuff closure to prevent tumor cell spillage in laparoscopic radical hysterectomy for uterine cervical cancer

Deura

Kanamori

Nagasawa

et al. 2021

Asian J Endoscop Surgery

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Introduction The Laparoscopic Approach to Cervical Cancer (LACC) trial, a prospective randomized phase III clinical trial reported in 2018, unexpectedly showed inferior oncologic outcomes in laparoscopic radical hysterectomy (LRH) for cervical cancer compared with those in open surgery. It was proposed that the spillage of tumor cells into the peritoneal cavity might cause the inferiority of LRH. It has been suggested, based on retrospective studies, that transvaginal closure of the vaginal cuff before the colpotomy part of the surgery may prevent this. Materials and Surgical Technique Before starting colpotomy, we closed the vaginal cuff transvaginally. After the assessment of the cutline of the vagina, the vaginal mucosa is pulled at the eight sites using the sutures. The four pairs of sutures on the diagonal line are ligated. A purse string suture is additionally placed on the vaginal mucosa to close the vaginal cuff completely. After that, we start the intracorporeal colpotomy using a vaginal pipe. Discussion Our technique is simple and quick. The blood loss during the transvaginal procedures is minimal. The use of the vaginal pipe helps keep the vaginal cuff closed during the colpotomy. Our technique may be an alternative to the conventional approach closing the vaginal cuff.

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