Transumbilical versus transvaginal retrieval of surgical specimens at laparoscopy: a randomized trial.
OBJECTIVE
We sought to compare transumbilical (TU) and transvaginal (TV) route for retrieval of surgical specimens at laparoscopy.


METHODS
Women scheduled for a laparoscopic resection of an adnexal mass were randomized to have their surgical specimen removed either through a posterior colpotomy (n = 34) or the umbilical port site (n = 32). Group allocation was concealed from patients and bedside clinicians. The primary outcome was postoperative incisional pain assessed by a 10-cm visual analog scale at 1, 3, and 24 hours after surgery.


RESULTS
TV retrieval caused less postoperative pain than TU specimen extraction at each time point (visual analog scale score at 1 hour: 2.6 ± 2.9 vs 1.2 ± 2.0, P = .03; at 3 hours: 2.4 ± 2.0 vs 1.4 ± 2.0, P = .02; and at 24 hours: 1.1 ± 1.5 vs 0.5 ± 1.4, P = .02). A higher proportion of women in the TU group than in the TV group indicated the umbilicus as the most painful area at 1 and 3 hours postoperatively. Two months after surgery, the participants scored similarly as to their overall satisfaction, cosmetic outcome, and dyspareunia upon resumption of intercourse.


CONCLUSIONS
A TV approach for specimen removal after laparoscopic resection of adnexal masses offers the advantage of less postoperative pain than TU retrieval.
Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy. fabio.ghezzi@uninsubria.it
Fabio
F
Ghezzi
Antonella
A
Cromi
Stefano
S
Uccella
Giorgio
G
Bogani
Maurizio
M
Serati
Pierfrancesco
P
Bolis
D000328:Adult; D004414:Dyspareunia / Q000453:epidemiology; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D010048:Ovarian Cysts / Q000601:surgery*; D010052:Ovariectomy; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D058994:Salpingectomy; D014472:Umbilicus; D014621:Vagina