Transvaginal colonic extraction following combined hysterectomy and laparoscopic total colectomy: a natural orifice approach.

A major advantage of laparoscopic colectomy is the limited incision. We describe an innovative technique in which the entire colon is extracted transvaginally to avoid any abdominal extraction incision in a female patient with hereditary nonpolyposis colon cancer who required total colectomy and hysterectomy. This novel technical approach is feasible and safe, eliminates the need for any extraction abdominal incision, and may be considered in patients requiring concurrent abdominal colectomy and hysterectomy.