A Simple Gasless Direct Suturing Technique to Achieve Ovarian Hemostasis During Transvaginal Natural Orifice Transluminal Endoscopic Surgery Ovarian Cystectomy.
J Laparoendosc Adv Surg Tech A
; 31(9): 1046-1050, 2021 Sep.
Article
em En
| MEDLINE
| ID: mdl-33121358
ABSTRACT
Background:
Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) was introduced in 2012, but the technique is not yet widely used for ovarian cystectomy. We aim to introduce a new gasless ovarian hemostatic suturing technique for ovarian cystectomy using vNOTES.Methods:
We conducted a prospective study using a novel technique for vNOTES ovarian cystectomy. Our vNOTES port (a wound retractor and a disposable glove) was inserted transvaginally through a posterior colpotomy. After ovarian cystectomy, removal of the glove created a gasless state. Hemostatic suturing of the ovary was performed through a vaginal speculum inserted through the wound retractor, under direct observation.Results:
Twenty ovarian cystectomies were performed through vNOTES at our institution between June 2019 and February 2020. The mean patient age was 34.2 years (range, 24-51 years). Four patients (20%) underwent bilateral cystectomy and 16 patients (80%) underwent unilateral cystectomy. The mean operative time was 58.7 minutes (bilateral, 57.5 minutes; unilateral, 58.9 minutes), and the mean ovarian hemostatic suturing time was 4.3 minutes (bilateral, 5 minutes; unilateral, 4.1 minutes). Ten patients (50%) received additional medication for pain control within 30 minutes of surgery. All patients were discharged within 24 hours, and 11 were discharged within 12 hours.Conclusion:
The gasless hemostatic suturing technique for vNOTES, using a speculum to observe the suturing process, is easy to perform and allows for rapid ovarian hemostasis.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Ovário
/
Cirurgia Endoscópica por Orifício Natural
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article