Synchronous laparoscopic sigmoid resection and hysterectomy with transvaginal specimen removal.
BACKGROUND
Laparoscopic sigmoid resection for recurrent or complicated diverticulitis and laparoscopically assisted hysterectomy for leiomyomas of the uterus are common procedures. A synchronous combination of these two interventions with the advantage of using the vaginal stump as a route for removal of the specimen has not previously been described.


METHODS
We used a transvaginal extraction of the uterus and the colorectal segment, followed by a totally intra-abdominal circular stapler anastomosis. The procedure is performed via four trocar incisions, obviating the need for a laparotomy.


RESULTS
Two women suffering from diverticulitis and symptomatic uterus myomatomas were treated by combined laparoscopic sigmoid resection and laparoscopically assisted transvaginal hysterectomy. Both patients had an uneventful intraoperative course.


CONCLUSIONS
This new approach, combining two operations, is feasible and leads to almost perfect cosmetic results, cumulatively shorter hospitalization, and good patient satisfaction. Cooperation with a gynecologist as well as experience in advanced laparoscopic surgery is essential.
Breitenstein
Stefan
S
Department of Visceral and Transplantation Surgery, University Hospital of Zurich, Zurich, Switzerland. stefan.breitenstein@usz.ch
Dedes
Konstantin J
KJ
Bramkamp
Matthias
M
Hess
Thomas
T
Decurtins
Marco
M
Clavien
Pierre-Alain
PA
D000328:Adult; D004238:Diverticulitis / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy / Q000379:methods*; D018231:Leiomyomatosis / Q000601:surgery*; D008875:Middle Aged; D012810:Sigmoid Diseases / Q000601:surgery*; D014594:Uterine Neoplasms / Q000601:surgery*; D014621:Vagina