Transvaginal versus Port-Site Specimen Retrieval after Laparoscopic Myomectomy: A Systematic Review and Meta-Analysis

Abstract

Introduction: To date, there is no robust evidence suggesting whether transvaginal (TVSR) or port-site specimen retrieval (PSSR) after laparoscopic myomectomy (LM) may lead to better surgical outcomes. Considering this element, we aimed to compare surgical outcomes of TVSR versus PSSR after LM. Methods: A search (PROSPERO ID: CRD42020176490) of international databases, from 1980 to 2020, in English language, was conducted. We selected studies that included women who underwent LM with TVSR compared with PSSR. Results: We did not find significant differences for operative time (MD=-8.90 [95% CI -30.00, 12.20]; I2=87%), myoma retrieval time (MD=-1.85 [95% CI -13.55, 9.85]; I2=98%), blood loss (MD=-27.62 [95% CI -178.68, 124.43]; I2=91%), intra-operative complication rate (OR 0.51, 95% CI 0.01–23.09; I2=69%) and hospital stay (MD=-0.14 [95% CI -0.43; 0.15]; I2=64%); we found a significant lower post-operative rescue analgesics utilization in the TVSR group compared with the PSSR group (OR 0.31, 95% CI 0.16–0.61, I2=0). Conclusion: TVSR and PSSR after LM showed comparable results for operative time and surgery-related complications. However, the need of post-operative rescue analgesics was lower in women who underwent TVSR.

Effect of barbed suture versus conventional suture in laparo‐endoscopic single‐site cystectomy for ovarian mature cystic teratoma: An ambispective cohort study

“…Although different types of specimen retrieval are available, including transvaginal extraction, and have several advantages, such as less pain postoperatively 25,26 . In the present study, all specimens were in‐bag and removed through the umbilical incision.…”

“…as less pain postoperatively. 25,26 In the present study, all specimens were in-bag and removed through the umbilical incision. As the incision is relatively large and the teratoma tissue is soft (except the nodule), there is no need to add an additional incision, thus reducing the chance of infection and injury.…”

Comparison of surgical and obstetric outcomes in women with uterine leiomyomas after laparoscopic vs. abdominal myomectomy: A single-center cohort study

“…In our study, the mean hospital stay was shorter for the LM group than for the AM group, corroborating the reports of previous studies ( 13 , 24 , 25 ), thereby confirming the major advantage of the laparoscopic approach. Furthermore, a recent meta-analysis ( 26 ) which compared transvaginal retrieval and port-site specimen retrieval after LM showed comparable results in terms of intraoperative complications, hospital stay and operative time. Concerning transvaginal extraction of the surgical specimen after LM, a large case series by Laganá et al ( 27 ) demonstrated a significant increase in operative time, intraoperative blood loss and hospital stay with increasing weight of removed fibroid.…”

Validation of a deep neural network-based algorithm supporting clinical management of adnexal mass

“…In this regard, OvaWatch test should not be used to evaluate adnexal mass suspicious for adnexal torsion. Surgical diagnosis is required for adnexal torsion and appropriate surgical management is recommended ( 29 , 30 ).…”