title: [INITIAL EXPERIENCE OF TRANSVAGINAL EXTRACTION OF THE KIDNEY FOLLOWING LAPAROSCOPIC NEPHRECTOMY IN OUR DEPARTMENT].
abstract: OBJECTIVE
  We report the detailed technique and results of transvaginal extraction of the kidney following laparoscopic nephrectomy.
  
  
  METHODS
  From August 2013 onward, we planned to perform transvaginal extraction of the kidney following laparoscopic nephrectomy in a total of 6 female patients. Of the 6 patients, 5 underwent the procedure. After completion of the primary laparoscopic nephrectomy and entrapping the removed kidney, the patients were placed in the supine lithotomy position. A transverse posterior colpotomy was created transvaginally at the apex of the posterior fornix. An opening was made in the peritoneum bluntly with the fingers under laparoscopic view. After the drawstring of the entrapped specimen was delivered into the vagina, the specimen was extracted intact via the vagina. When the vaginal wall was too tight for a large specimen, the incision was extended on the affected side. After removal of the specimen, the peritoneum was sutured laparoscopically, and the posterior colpotomy incision was repaired transvaginally.
  
  
  RESULTS
  Transvaginal extraction was successful in 5 patients. The mean operative time for the vaginal extraction procedure was 59 minutes. Blood loss was minimal. The mean specimen weight was 447 g (range 271 to 655 g). No intraoperative complications occurred. Postoperatively, one case needed intermittent catheterization for a few days because of temporal dysfunction of the bladder.
  
  
  CONCLUSIONS
  Transvaginal extraction is an efficacious and minimally morbid technique for removing the intact kidney after laparoscopic nephrectomy.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Akitaka
authors.initials: A
authors.lastname: Suzuki
authors.forename: Koichi
authors.initials: K
authors.lastname: Suzuki
authors.forename: Shoji
authors.initials: S
authors.lastname: Suzuki
authors.forename: Kumiko
authors.initials: K
authors.lastname: Kato
authors.forename: Ryohei
authors.initials: R
authors.lastname: Hattori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009392:Nephrectomy; D061646:Operative Time; D011183:Postoperative Complications; D014621:Vagina