Transvaginal specimen extraction after laparoscopic colectomy.

Abstract

Despite the advantages of laparoscopic colon surgery, the need for an incision in the abdominal wall to remove the surgical specimen is a morbidity factor. The objective of this article is to introduce transvaginal specimen extraction after laparoscopic colectomy, in order to avoid an abdominal incision. Between 2008 and 2011, 21 selected women with benign and malignant colorectal pathologies underwent laparoscopic colectomy and the extraction of the surgical specimen was done through a transvaginal access route. Of these patients, 12 had symptomatic diverticular disease, four had rectal villous adenomas, two had severe chronic constipation, and three had adenocarcinomas. We describe the surgical technique and the short-term outcomes related to the transvaginal specimen extraction. The procedure was successful in all cases. There were no immediate complications or mortality. At follow-up, between 2 and 34 months, there were no functional disorders associated with the transvaginal specimen extraction. Specimen removal of laparoscopic colectomies via the transvaginal route avoids the abdominal wall incision and its potential complications. It is feasible, safe, and simple to perform, with no additional costs, and provides excellent cosmetic results.