Transvaginal contained tissue extraction after laparoscopic myomectomy: a cohort study

Area of Science:

• Gynecology
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Laparoscopic myomectomy is a common procedure for uterine fibroids.
• Specimen extraction and morcellation can pose challenges and risks.
• Minimally invasive techniques aim to reduce patient morbidity.

Purpose of the Study:

• To describe the technique of transvaginal contained extraction of surgical specimens after laparoscopic myomectomy.
• To report the perioperative outcomes and safety of this method.
• To evaluate its efficacy as an alternative to intracorporeal morcellation.

Main Methods:

• Retrospective analysis of prospectively collected data from two Italian referral centers.
• Inclusion of consecutive patients undergoing laparoscopic myomectomy.
• Description of transvaginal specimen retrieval using a retrieval bag via posterior colpotomy, with extracorporeal morcellation if needed.

Main Results:

• 316 women underwent transvaginal specimen retrieval with enclosed manual morcellation.
• No intraoperative complications related to extraction or morcellation.
• Low rates of postoperative complications (0.6% haemoperitoneum, 5.1% fever), with no pelvic infections or vaginal dehiscence at 30-day follow-up.

Conclusions:

• Transvaginal contained extraction of fibroid specimens is a safe and efficient procedure.
• This technique is a valuable minimally invasive alternative to intracorporeal morcellation.
• It offers a favorable safety profile for patients undergoing laparoscopic myomectomy.