Transumbilical multiport laparoscopic nephrectomy with specimen extraction through the vagina

Area of Science:

• Urology
• Minimally Invasive Surgery
• Gynecologic Endoscopy

Background:

• Transumbilical multiport laparoscopic nephrectomy (TMLN) is a minimally invasive surgical approach.
• Transvaginal specimen extraction offers a scarless approach for specimen removal.

Purpose of the Study:

• To evaluate the initial experience with TMLN combined with transvaginal specimen extraction.
• To assess the safety, feasibility, and outcomes of this combined surgical technique.

Main Methods:

• Five married, parous female patients underwent TMLN with transvaginal specimen extraction.
• Data collected included surgical, pathological, and perioperative outcomes.
• Sexual function was assessed using the Female Sexual Function Index, and cosmetic results were evaluated with the Patient Scar Assessment Questionnaire and Scoring System (PSAQ).

Main Results:

• All procedures were successfully completed with acceptable operative times and minimal blood loss.
• Patients experienced a mean postoperative hospital stay of 4.8 days.
• No alterations in sexual function were reported, and improved cosmetic results were confirmed by PSAQ scores.

Conclusions:

• TMLN with transvaginal specimen extraction is a feasible and safe option for select female patients.
• This technique represents a step towards natural orifice transluminal endoscopic surgery (NOTES).
• It serves as an intermediate procedure to facilitate broader clinical acceptance of NOTES.