title: A Simple Approach to Specimen Retrieval via Posterior Colpotomy Incision.
abstract: BACKGROUND
  Posterior colpotomy incision for specimen retrieval is infrequently used in gynecologic laparoscopic surgery unless a concomitant hysterectomy is performed. We aim to describe a simple and unique technique for creating the colpotomy incision and to describe intraoperative and postoperative outcomes.
  
  
  METHODS
  Fifty patients underwent adnexal specimen retrieval through a posterior colpotomy incision. After devascularization and detachment of the adnexal specimen, the posterior cul-de-sac was visualized. The colpotomy incision was created by introducing a 12- or 15-mm laparoscopic trocar through the vagina into the posterior vaginal fornix under direct visualization. Specimens were placed into laparoscopic bags and removed through the vagina. The colpotomy incision was closed vaginally. Charts were reviewed for intraoperative and postoperative outcomes.
  
  
  RESULTS
  Twenty-nine women underwent adnexal surgery for an adnexal mass, 14 women underwent surgery for pelvic pain, and 7 women underwent adnexal surgery for primary prevention of malignancy. The specimens removed ranged in size from 2 to 16 cm (mean 5.7). The mean time patients were under anesthesia was 103 minutes (SD 57.3). There were no operative complications related to the colpotomy incision and no cases of postoperative vaginal cellulitis or pelvic infection were reported. Only 1 woman with a prior vaginal delivery reported dyspareunia postoperatively.
  
  
  CONCLUSIONS
  This simple technique for posterior colpotomy incision can easily be added to the gynecologic surgeon's armamentarium and can be safely used for most women.
authors.affiliation: Department of Obstetrics and Gynecology, Bridgeport Hospital, Yale New Haven Health Systems, Bridgeport, CT.
authors.forename: Lindsay E
authors.initials: LE
authors.lastname: Clark
authors.affiliation: Department of Obstetrics and Gynecology, Bridgeport Hospital, Yale New Haven Health Systems, Bridgeport, CT.
authors.forename: Gulden
authors.initials: G
authors.lastname: Menderes
authors.affiliation: Department of Obstetrics and Gynecology, Bridgeport Hospital, Yale New Haven Health Systems, Bridgeport, CT.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Tower
authors.affiliation: Department of Obstetrics and Gynecology, Bridgeport Hospital, Yale New Haven Health Systems, Bridgeport, CT.
authors.forename: Dan-Arin
authors.initials: DA
authors.lastname: Silasi
authors.affiliation: Department of Obstetrics and Gynecology, Bridgeport Hospital, Yale New Haven Health Systems, Bridgeport, CT.
authors.forename: Masoud
authors.initials: M
authors.lastname: Azodi
mesh_terms: D000290:Adnexa Uteri / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020884:Colpotomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D055815:Young Adult
keywords: Adnexal surgery; Posterior colpotomy; Specimen retrieval