Southeastern Gynecologic Oncology, Saint Joseph's Medical Group, 980 Johnson Ferry Rd, Ste # 900, Atlanta, GA, 30342, USA.
J Robot Surg. 2012 Dec;6(4):277-82. doi: 10.1007/s11701-011-0306-3. Epub 2011 Aug 30.
We report a technique of transvaginal extraction of pelvic masses or larger specimens removed during robot-assisted laparoscopic surgery in order to avoid larger port incisions and postoperatively reduce pain. Fifty women underwent a transvaginal incision to remove large pelvic masses after robot-assisted laparoscopic hysterectomies. Posterior colpotomies were performed with bagged specimens delivered into the vagina, extracted, and then closed robotically with a running suture. Vaginal extraction of pelvic masses was successful in all attempted cases and in no case was there any spillage, with an average operative time of 94.22 ± 4.48 and no intraoperative complications. This technique can be considered efficacious and safe with minimal morbidity. We suggest a surgical set-up including vaginal-cervical Ahluwalia retractor elevator to be prepared should the specimen be too large to remove via the port site, thus giving the surgeon the opportunity to perform this procedure with ease if necessary.
我们报告了一种经阴道取出盆腔肿块或在机器人辅助腹腔镜手术后切除的较大标本的技术，以避免更大的端口切口，并在术后减轻疼痛。五十名女性在机器人辅助腹腔镜子宫切除术后接受了经阴道切口以取出大的盆腔肿块。在后阴道切开术时，将装有标本的袋子送入阴道，取出，然后用连续缝合机器人关闭。所有尝试的病例均成功经阴道取出盆腔肿块，无任何溢出，平均手术时间为 94.22 ± 4.48 分钟，无术中并发症。这种技术具有最小的发病率，被认为是有效和安全的。我们建议，如果标本太大而无法通过端口取出，则准备阴道-宫颈 Ahluwalia 牵开器提升器，以便在必要时为外科医生提供轻松进行此手术的机会。
