Laparoscopic-assisted transvaginal approach for sigmoidectomy and rectocolpopexy.
OBJECTIVE
Laparoscopic-assisted colonic resection has been well described for multiple surgical indications. This typically requires an abdominal incision for specimen removal that is associated with the majority of postoperative pain. We describe the first laparoscopic-assisted transvaginal approach for sigmoidectomy and rectocolpopexy for the treatment of rectal prolapse.


METHODS
Mobilization of the sigmoid colon was performed laparoscopically using a 12-mm vaginal port and 3 additional 5-mm abdominal ports. A laparoscopic stapler was used through the vaginal port to transect the distal sigmoid colon. The specimen was subsequently externalized through the colpotomy to complete the resection and prepare the remaining bowel for intracorporeal, end-to-end, stapled anastomosis. The colpotomy was then repaired, and the colorectal anastomosis and rectocolpopexy were completed laparoscopically.


RESULTS
Sigmoidectomy and rectocolpopexy were successfully performed laparoscopically by using a transvaginal approach without the need for an abdominal incision for specimen removal. The patient had an uncomplicated postoperative course, complained of minimal pain, and was discharged home on postoperative day 3.


CONCLUSIONS
Laparoscopic-assisted transvaginal sigmoidectomy and rectocolpopexy is a feasible option that appears to be associated with little incisional pain and rapid recovery.
Sanchez
Jaime E
JE
Division of Colon and Rectal Surgery, University of South Florida, Tampa, Florida, USA.
Rasheid
Sowsan H
SH
Krieger
Beth R
BR
Frattini
Jared C
JC
Marcet
Jorge E
JE
D000714:Anastomosis, Surgical; D012809:Colon, Sigmoid / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D012005:Rectal Prolapse / Q000601:surgery*; D017792:Surgical Stapling; D013536:Suture Techniques; D014621:Vagina