Vaginal extraction of pelvic masses following operative laparoscopy.
OBJECTIVE
To investigate the clinical outcome of patients undergoing operative laparoscopy for a benign pelvic mass followed by vaginal extraction of the surgical specimen.


METHODS
Patients presenting with a suspected benign mass greater than 5 cm or an extrauterine pregnancy undergoing operative laparoscopy were considered eligible. Patients with endometriosis, pelvic inflammatory disease, and previous hysterectomy were excluded. In all cases the surgical specimen was removed through a colpotomy performed in laparoscopy at the level of the posterior vaginal fornix. Additionally, a review of the literature has been conducted to specifically address the incidence of colpotomy-related complications.


RESULTS
Sixty-three patients were included in the study. The median (range) time required to extract the freed mass to the complete suture of the colpotomy was 15 min (5-31). This time was significantly longer in patients with myomas than for others [median 21 min (range: 10-31) vs median 10 min (5-13), p<0.05]. No intra- and postoperative colpotomy related complications occurred. No patients complained dyspareunia at follow-up visits. A total of 23 studies were reviewed for a total of 501 patients and only one (0.2%) complication (severe vaginal bleeding) was directly attributable to the colpotomy.


CONCLUSIONS
Removal of a pelvic mass through a laparoscopic colpotomy is feasible, safe, and offers better cosmetic results than transabdominal extraction of the surgical specimen.
Ghezzi
F
F
Department of Obstetrics and Gynecology, University of Insubria-H. Ponte, Varese, Italy. Fabio.ghezzi@uninsubria.it
Raio
L
L
Mueller
M D
MD
Gyr
T
T
Buttarelli
M
M
Franchi
M
M
D000293:Adolescent; D000328:Adult; D001065:Appendix / Q000473:pathology / Q000601:surgery; D020884:Colpotomy / Q000379:methods; D005184:Fallopian Tube Diseases / Q000601:surgery*; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009078:Mucocele / Q000601:surgery; D010388:Pelvis / Q000473:pathology*; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000601:surgery*; D014621:Vagina / Q000601:surgery*