title: Use of laparoscopic support to avoid laparotomy in vaginal ovarian cystectomy.
abstract: The objective of our study was to evaluate the use of a procedure for vaginal ovarian cystectomy that is supported by the option to convert to laparoscopy. The ovarian cystectomy was initially approached transvaginally, and then if impossible, completed laparoscopically. We applied this operation system to 38 patients with benign ovarian cysts. Preoperative characteristics of patients, outcomes of colpotomy and vaginal ovarian cystectomy, conversion rate from a vaginal approach to a laparoscopic procedure or a laparotomy, completion rate, operating time, blood loss, complications, and postoperative outcomes were examined. Colpotomy was successfully performed in 37 (97%) of 38 cases and vaginal ovarian cystectomy was accomplished in 35 (92%) cases. Three (8%) cases, including 1 case of failed posterior colpotomy and 2 cases of intrapelvic adhesions, were converted from a vaginal approach to a laparoscopic procedure. In all (100%) cases, cystectomy was successful without laparotomy. Support by laparoscopy preserves the minimal invasiveness of vaginal ovarian cystectomy in cases that would normally require conversion to laparotomy. Thus, this operation system is an alternative procedure to an exclusively vaginal ovarian cystectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Kanazawa University, School of Medicine, Kanazawa, Japan. masaaki@med.kanazawa-u.ac.jp
authors.forename: Masaaki
authors.initials: M
authors.lastname: Tanaka
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sagawa
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Mizumoto
authors.forename: Manabu
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Hideo
authors.initials: H
authors.lastname: Yoshimoto
authors.forename: Rena
authors.initials: R
authors.lastname: Yamazaki
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Kasai
authors.forename: Masaki
authors.initials: M
authors.lastname: Inoue
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010048:Ovarian Cysts / Q000601:surgery*