title: Laparoscopic appendectomy: a gynecological approach.
abstract: The removal of surgical specimen at operative laparoscopy through an incision of the posterior fornix is frequently performed for the removal of pelvic masses of the internal genital tract. We present a technique for the removal of the appendix through a laparoscopic colpotomy. Eight patients who underwent laparoscopy for a suspected pelvic or adnexal disease and intraoperatively found to be affected by an appendicular disease were included in the present series. After intrabdominal dissection, the appendix was removed from the abdomen transvaginally through a laparoscopic colpotomy. The median range of the operation was 45 minutes (range 25-95). There were no intraoperative complications. The postoperative hospitalization period ranged from 2 to 7 days. Vaginal spotting was present in one case and lasted 24 hours. At follow-up visit, no patients complained of pelvic pain or dyspareunia. Vaginal wall induration was not found in any of the patients at pelvic examination. The removal of the appendix through a posterior colpotomy after laparoscopic appendectomy is simple, safe, feasible, well tolerated, and can be considered a valid alternative to other methods.
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria-Del Ponte Hospital, Varese, Italy. fabio.ghezzi@uninsubria.it
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
authors.forename: Luigi
authors.initials: L
authors.lastname: Raio
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mueller
authors.forename: Massimo
authors.initials: M
authors.lastname: Franchi
mesh_terms: D000291:Adnexal Diseases / Q000601:surgery*; D000328:Adult; D001062:Appendectomy / Q000379:methods*; D002429:Cecal Diseases / Q000601:surgery*; D020884:Colpotomy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome