Using pneumovaginoscopy to perform the removal of a vaginal fibroid

Allary, M.; Agostini, Aubert; Calderon, Lisa; Miquel, Laura; Crochet, Patrice; Netter, A

doi:10.1016/j.fertnstert.2021.08.033

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…It is a minimally invasive, low risk, well tolerated and cost and time effective procedure [25]. In order to provide a better lighting and visualization of the myoma, pneumovagina can be induced through The GelPOINT V-Path, a device most often used to perform transvaginal natural orifice transluminal endoscopic surgical procedures [26]. Large fibroids or the patient's will to maintain her hymen's integrity for social concerns are matters that lean toward laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

Posterior cervico-vaginal myomectomy: a laparoscopic technique

Sleiman¹,

Ayed²,

Christoforou³

et al. 2023

It Journ Gyn Obs

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Objective. Uterine myoma is considered the most common gynaecological benign neoplasm occurring in 50-60% of women. Generally, the patients are asymptomatic, but almost a third of women with leiomyomas will require treatment due to symptoms such as heavy uterine bleeding, severe pelvic pain, bulk symptoms, dyspareunia or infertility. Cervical myomas are uncommon, with a prevalence of only 0.6%. Vaginal approach is the classical option for their removal, but when it is impossible, in some cases laparoscopy may be an alternative. This article aims to describe a safe laparoscopic technique for a complete removal of a large cervico-vaginal myoma, the removal of which was impossible with a classical vaginal approach due to its size. Description of the technique. In consideration of the myoma's size, location, characteristics and the impossible vaginal approach, the patient was considered eligible for a laparoscopic myomectomy. Followings are the main surgical steps: set up of surgical view of the intervention field; vertical posterior colpotomy; myoma's peduncle identification and incision; reduction of myoma's size with power morcellation within the vagina; extraction of the fibroid from the vagina to the peritoneal cavity through the colpotomy; completion of the power morcellator and extraction of the whole specimen; colporrhaphy; peritoneal washing. Conclusions. When the vaginal approach is not practicable, laparoscopic management of large myomas in difficult locations such as the cervico-vaginal region seems to be a feasible and a safe surgical option.

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Section: Discussionmentioning

confidence: 99%