title: Synchronous laparoscopic sigmoid resection and hysterectomy with transvaginal specimen removal.
abstract: 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.
authors.affiliation: Department of Visceral and Transplantation Surgery, University Hospital of Zurich, Zurich, Switzerland. stefan.breitenstein@usz.ch
authors.forename: Stefan
authors.initials: S
authors.lastname: Breitenstein
authors.forename: Konstantin J
authors.initials: KJ
authors.lastname: Dedes
authors.forename: Matthias
authors.initials: M
authors.lastname: Bramkamp
authors.forename: Thomas
authors.initials: T
authors.lastname: Hess
authors.forename: Marco
authors.initials: M
authors.lastname: Decurtins
authors.forename: Pierre-Alain
authors.initials: PA
authors.lastname: Clavien
mesh_terms: 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