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Updated: Aug 7, 2026
Surgical Robot-Assisted Transanal Specimen Extraction Radical Sigmoidectomy Without an Auxiliary Abdominal Incision
Published on: June 13, 2025
Synchronous laparoscopic sigmoid resection and hysterectomy with transvaginal specimen removal
Stefan Breitenstein1, Konstantin J Dedes, Matthias Bramkamp
1Department of Visceral and Transplantation Surgery, University Hospital of Zurich, Zurich, Switzerland. stefan.breitenstein@usz.ch
Introduction:
Laparoscopic sigmoid resection for recurrent or complicated diverticulitis and laparoscopically assisted hysterectomy for leiomyomas of the uterus are common procedures. A synchronous combination of these two interventions with the advantage of using the vaginal stump as a route for removal of the specimen has not previously been described.
Materials And Methods:
We used a transvaginal extraction of the uterus and the colorectal segment, followed by a totally intra-abdominal circular stapler anastomosis. The procedure is performed via four trocar incisions, obviating the need for a laparotomy.
Results:
Two women suffering from diverticulitis and symptomatic uterus myomatomas were treated by combined laparoscopic sigmoid resection and laparoscopically assisted transvaginal hysterectomy. Both patients had an uneventful intraoperative course.
Discussion:
This new approach, combining two operations, is feasible and leads to almost perfect cosmetic results, cumulatively shorter hospitalization, and good patient satisfaction. Cooperation with a gynecologist as well as experience in advanced laparoscopic surgery is essential.
