Department of Obstetrics and Gynaecology, Del Ponte Hospital, University of Insubria, Varese, Italy.
Department of Obstetrics and Gynaecology, Evangelical Hospital, 'Villa Betania', Naples, Italy.
BJOG. 2018 Feb;125(3):367-373. doi: 10.1111/1471-0528.14720. Epub 2017 Jun 14.
To describe the technique and report perioperative outcomes of transvaginal contained extraction of surgical specimens at laparoscopic myomectomy.
Retrospective analysis of prospectively collected data.
Two Italian referral centres for gynaecological minimally invasive surgery.
Consecutive patients who underwent laparoscopic myomectomy.
Tissue extraction was accomplished following laparoscopic myomectomy in a specimen retrieval bag via a posterior colpotomy incision. If morcellation was necessary, this was performed extracorporeally, using a scalpel within the specimen retrieval pouch, whose edges were exteriorised through the vaginal introitus.
Intra- and postoperative complications.
A total of 316 women underwent transvaginal specimen retrieval with enclosed manual morcellation. The mean myomectomy specimen weight was 154 ± 128 g, and the mean operative time was 79 ± 26 minutes. No intraoperative complications occurred related to the specimen extraction or morcellation technique, or from rupture of the retrieval bag. Two (0.6%) women had a haemoperitoneum that spontaneously resolved and 16 (5.1%) had fever postoperatively. The final pathological diagnosis was benign in all cases. At the 30-day follow-up, no pelvic infection, vaginal dehiscence, or complaints of dyspareunia were recorded.
Contained transvaginal extraction of fibroid specimens can be performed safely and efficiently in most women undergoing laparoscopic myomectomy. This technique represents a valuable minimally invasive alternative to intracorporeal morcellation.
Transvaginal contained morcellation at laparoscopic myomectomy is a valuable alternative to intracorporeal morcellation.
描述经阴道腔内取出腹腔镜子宫肌瘤剔除术标本的技术，并报告围手术期结果。
前瞻性收集数据的回顾性分析。
意大利两家妇科微创外科转诊中心。
连续接受腹腔镜子宫肌瘤剔除术的患者。
通过后阴道切开术，在标本回收袋中完成腹腔镜子宫肌瘤剔除术后的组织提取。如果需要进行粉碎，则在标本回收袋内使用手术刀进行体外粉碎，将边缘从阴道入口引出。
术中及术后并发症。
共有 316 名妇女接受了经阴道标本回收和封闭性手动粉碎。子宫肌瘤剔除标本的平均重量为 154±128g，平均手术时间为 79±26 分钟。没有发生与标本取出或粉碎技术相关的术中并发症，也没有发生回收袋破裂的情况。2 名（0.6%）妇女发生自发性血腹，16 名（5.1%）妇女术后发热。所有病例的最终病理诊断均为良性。在 30 天随访时，未记录到盆腔感染、阴道裂开或性交困难的情况。
在大多数接受腹腔镜子宫肌瘤剔除术的妇女中，安全有效地进行腔内纤维瘤标本取出是可行的。这种技术代表了一种有价值的微创替代方法，可替代体内粉碎。
经阴道腔内粉碎在腹腔镜子宫肌瘤剔除术中是一种有价值的体内粉碎替代方法。
