Comparison between transumbilical and transvaginal morcellation of a large uterus during single-port-access total laparoscopic hysterectomy
ObjectiveTo compare the perioperative outcomes of transumbilical morcellation (TUM) and transvaginal morcellation (TVM) of a large uterus (≥500 g) during single-port-access total laparoscopic hysterectomy (SPA-TLH).MethodsA total of 57 patients who underwent SPA-TLH for a large uterine myoma and/or...
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| Format: | Article |
| Language: | English |
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Korean Society of Obstetrics and Gynecology
2020-05-01
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| Series: | Obstetrics & Gynecology Science |
| Subjects: | |
| Online Access: | http://ogscience.org/upload/pdf/ogs-63-379.pdf |
| _version_ | 1818929570024259584 |
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| author | Seung Ju Oh Seo Young Lee Woo Yong Kim Jieun Kang Kyoung-Hee Han San-Hui Lee Ji Sun Park |
| author_facet | Seung Ju Oh Seo Young Lee Woo Yong Kim Jieun Kang Kyoung-Hee Han San-Hui Lee Ji Sun Park |
| author_sort | Seung Ju Oh |
| collection | DOAJ |
| description | ObjectiveTo compare the perioperative outcomes of transumbilical morcellation (TUM) and transvaginal morcellation (TVM) of a large uterus (≥500 g) during single-port-access total laparoscopic hysterectomy (SPA-TLH).MethodsA total of 57 patients who underwent SPA-TLH for a large uterine myoma and/or adenomyosis (uterine weight ≥500 g) between March 2013 and July 2017 were included. For specimen retrieval, TUM was performed for 30 patients and TVM for 27 patients.ResultsPerioperative outcomes, including total operative time, tissue extraction time, extension of skin incision length, estimated volume of blood loss, changes in postoperative hemoglobin level, length of postoperative hospital stay, postoperative pain, and uterine weight, were compared between the 2 groups. No significant differences were observed in the baseline characteristics except for a history of cesarean section (TUM vs. TVM: 83.3% vs. 14.8%, P=0.002) and history of vaginal delivery (TUM vs. TVM: 6.7% vs. 88.8%, P=0.001). The total operative time, tissue extraction time, extension of skin incision length, estimated volume of blood loss, changes in postoperative hemoglobin level, length of postoperative hospital stay, and postoperative pain did not significantly differ between the two groups. The uterine weight was significantly higher for patients who underwent TUM than for those who had TVM (median [range]: 735 g [520–1,380 g] vs. 622 g [514–975 g]; P=0.042).ConclusionTUM during SPA-TLH is a feasible technique for extracting large uteri weighing ≥500 g. This procedure is suitable for patients without a history of vaginal delivery or a narrow vaginal cavity. |
| first_indexed | 2024-12-20T03:46:54Z |
| format | Article |
| id | doaj.art-c43a6831b7554c4dbd447e713b96c5a5 |
| institution | Directory Open Access Journal |
| issn | 2287-8572 2287-8580 |
| language | English |
| last_indexed | 2024-12-20T03:46:54Z |
| publishDate | 2020-05-01 |
| publisher | Korean Society of Obstetrics and Gynecology |
| record_format | Article |
| series | Obstetrics & Gynecology Science |
| spelling | doaj.art-c43a6831b7554c4dbd447e713b96c5a52022-12-21T19:54:35ZengKorean Society of Obstetrics and GynecologyObstetrics & Gynecology Science2287-85722287-85802020-05-0163337938610.5468/ogs.2020.63.3.3798533Comparison between transumbilical and transvaginal morcellation of a large uterus during single-port-access total laparoscopic hysterectomySeung Ju Oh0Seo Young Lee1Woo Yong Kim2Jieun Kang3Kyoung-Hee Han4San-Hui Lee5Ji Sun Park6Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, .KoreaDepartment of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, .KoreaDepartment of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, .KoreaDepartment of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, .KoreaDepartment of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, .KoreaDepartment of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, .KoreaDepartment of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, .KoreaObjectiveTo compare the perioperative outcomes of transumbilical morcellation (TUM) and transvaginal morcellation (TVM) of a large uterus (≥500 g) during single-port-access total laparoscopic hysterectomy (SPA-TLH).MethodsA total of 57 patients who underwent SPA-TLH for a large uterine myoma and/or adenomyosis (uterine weight ≥500 g) between March 2013 and July 2017 were included. For specimen retrieval, TUM was performed for 30 patients and TVM for 27 patients.ResultsPerioperative outcomes, including total operative time, tissue extraction time, extension of skin incision length, estimated volume of blood loss, changes in postoperative hemoglobin level, length of postoperative hospital stay, postoperative pain, and uterine weight, were compared between the 2 groups. No significant differences were observed in the baseline characteristics except for a history of cesarean section (TUM vs. TVM: 83.3% vs. 14.8%, P=0.002) and history of vaginal delivery (TUM vs. TVM: 6.7% vs. 88.8%, P=0.001). The total operative time, tissue extraction time, extension of skin incision length, estimated volume of blood loss, changes in postoperative hemoglobin level, length of postoperative hospital stay, and postoperative pain did not significantly differ between the two groups. The uterine weight was significantly higher for patients who underwent TUM than for those who had TVM (median [range]: 735 g [520–1,380 g] vs. 622 g [514–975 g]; P=0.042).ConclusionTUM during SPA-TLH is a feasible technique for extracting large uteri weighing ≥500 g. This procedure is suitable for patients without a history of vaginal delivery or a narrow vaginal cavity.http://ogscience.org/upload/pdf/ogs-63-379.pdfadenomyosishysterectomylaparoscopyminimally invasive surgical proceduresmyoma |
| spellingShingle | Seung Ju Oh Seo Young Lee Woo Yong Kim Jieun Kang Kyoung-Hee Han San-Hui Lee Ji Sun Park Comparison between transumbilical and transvaginal morcellation of a large uterus during single-port-access total laparoscopic hysterectomy Obstetrics & Gynecology Science adenomyosis hysterectomy laparoscopy minimally invasive surgical procedures myoma |
| title | Comparison between transumbilical and transvaginal morcellation of a large uterus during single-port-access total laparoscopic hysterectomy |
| title_full | Comparison between transumbilical and transvaginal morcellation of a large uterus during single-port-access total laparoscopic hysterectomy |
| title_fullStr | Comparison between transumbilical and transvaginal morcellation of a large uterus during single-port-access total laparoscopic hysterectomy |
| title_full_unstemmed | Comparison between transumbilical and transvaginal morcellation of a large uterus during single-port-access total laparoscopic hysterectomy |
| title_short | Comparison between transumbilical and transvaginal morcellation of a large uterus during single-port-access total laparoscopic hysterectomy |
| title_sort | comparison between transumbilical and transvaginal morcellation of a large uterus during single port access total laparoscopic hysterectomy |
| topic | adenomyosis hysterectomy laparoscopy minimally invasive surgical procedures myoma |
| url | http://ogscience.org/upload/pdf/ogs-63-379.pdf |
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