Vaginal evisceration after hysterectomy: the repair by a laparoscopic and vaginal approach with a omental flap.
BACKGROUND
Vaginal evisceration is generally repaired by vaginal or abdominal route. We describe two cases of vaginal evisceration using a combined laparoscopic and vaginal approach employing an omental flap.


METHODS
Case 1: A radical abdominal hysterectomy was performed in a premenopausal patient for a FIGO IB1 cervical cancer. Four months later, she was found to have a vaginal cuff dehiscence which was repaired by a vaginal approach. Two months later, she had a vaginal cuff evisceration which was repaired using a combined laparoscopic and vaginal approach employing an omental flap with good success. Case 2: A postmenopausal woman who underwent an abdominal hysterectomy and pelvic lymphadenectomy for a FIGO IB endometrial cancer was noted to have a vaginal evisceration two months after primary surgery. This was also successfully repaired using a combined laparoscopic and vaginal approach employing an omental flap.


CONCLUSIONS
The combined laparoscopic and vaginal approach with omental flap is effective for repair of a vaginal cuff dehiscence with bowel evisceration. The addition of laparoscopy provides an opportunity for inspection of the small bowel, the peritoneal toilet, and mobilization of an omental flap.
Narducci
F
F
Centre Oscar Lambret, Centre Régional de Lutte Contre le Cancer, 3 rue F Combemale BP307, 59020, Lille cedex, France. f-narducci@o-lambret.fr
Sonoda
Y
Y
Lambaudie
E
E
Leblanc
E
E
Querleu
D
D
D000328:Adult; D000368:Aged; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D010535:Laparoscopy / Q000379:methods; D009852:Omentum / Q000601:surgery; D013524:Surgical Flaps; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D014621:Vagina / Q000601:surgery*