Department of Gynecologic Oncology - AC Camargo Cancer Center, Brazil.
Department of Gynecologic Oncology - AC Camargo Cancer Center, Brazil.
J Gynecol Obstet Hum Reprod. 2021 Jan;50(1):101911. doi: 10.1016/j.jogoh.2020.101911. Epub 2020 Sep 12.
VNOTES is a novel technique that allows access to the pelvic-abdominal cavity through the vagina. Myomectomy can be performed by vNOTES even through anterior cul-de-sac incision and for selected cases of uterine malformation. Here we present a 29-years-old patient with a complaint about pelvic discomfort. Pelvic examination revealed an 8 cm palpable mass in the right iliac region. The magnetic resonance exam revealed a bicornuate uterus attached to a subserosal fibroid that was 7.7 × 6.6 × 6.0 cm in size. The fibroid was positioned anteriorly to the uterus so the vNOTES approach was indicated through the anterior cul-de-sac. The surgery was performed without any complication and the patient was discharged the next day. The final pathological analysis confirmed uterine leiomyoma and the patient had a good postoperative evaluation. In Conclusion, vNOTES myomectomy may be feasible for selected patients even with uterine malformation.
VNOTES 是一种通过阴道进入盆腔-腹腔的新技术。即使通过阴道前穹窿切口，vNOTES 也可进行子宫肌瘤切除术，对于某些特定类型的子宫畸形也适用。在此，我们报告一位 29 岁患者，主诉盆腔不适。盆腔检查发现右侧骼窝区可触及 8cm 大小的包块。磁共振成像检查显示双角子宫，附着于浆膜下肌瘤，大小为 7.7×6.6×6.0cm。肌瘤位于子宫前方，因此选择经阴道前穹窿入路行 vNOTES。手术过程顺利，患者于次日出院。最终的病理分析证实为子宫平滑肌瘤，患者术后恢复良好。总之，即使存在子宫畸形，vNOTES 子宫肌瘤切除术也可能适用于某些特定患者。
