title: Transvaginal specimen removal after laparoscopic distal pancreatic resection.
abstract: OBJECTIVE
  Transvaginal specimen removal has been introduced 20 years ago but then abandoned. With the advent of transvaginal interventions following the introduction of natural orifice transluminal endoscopic surgery, renewed interest was generated for hybrid procedures with minimal access for the intervention and use of transvaginal (TV) specimen removal. We present the first such series after laparoscopic distal pancreatectomy.
  
  
  METHODS
  In seven subsequent women (median age 48 years) with body and tail pancreatic tumors undergoing laparoscopic distal pancreatectomy, the new method of TV specimen removal was applied. The patients' data and the technical successes as well as intra- and postprocedural complications were recorded prospectively. The patients were followed after discharge for gynecological examination.
  
  
  RESULTS
  Specimen removal consisting of the pancreas and spleen in five and the pancreas only in two cases was technically successful; no intraoperative complications were encountered. Postoperative complications consisted of one case of intra-abdominal hemorrhage and one case of pancreatic fistula, attributable to the resection and not to TV specimen removal. Gynecological follow-up was normal in all seven patients.
  
  
  CONCLUSIONS
  The technique of TV specimen removal is feasible and safe also after laparoscopic distal pancreatectomy. It may help to further diminish the access trauma of laparoscopic pancreatic surgery.
authors.affiliation: Department of Surgery, Israelitisches Krankenhaus, Orchideenstieg 14, 22297, Hamburg, Germany, hamid@mofid.de.
authors.forename: Hamid
authors.initials: H
authors.lastname: Mofid
authors.forename: Alice
authors.initials: A
authors.lastname: Emmermann
authors.forename: Margret
authors.initials: M
authors.lastname: Alm
authors.forename: Carsten
authors.initials: C
authors.lastname: Zornig
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D020884:Colpotomy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D013156:Splenectomy / Q000379:methods*; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery*