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Related Experiment Video

Updated: Jun 12, 2025

Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
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Extraction Laparotomy for Specimen Retrieval Does Not Alter Same-Day Discharge Plans.

Marla E Scott1, Dani Ashak1, Wilkin F Muñoz Orozco1

  • 1Kaiser Permanente Southern California, Fontana, California.

Journal of Minimally Invasive Gynecology
|September 21, 2024
PubMed
Summary

Extraction laparotomy (EL) for intact specimen removal in minimally invasive surgery (MIS) for gynecologic malignancies does not adversely affect same-day discharge (SDD) feasibility or safety. Patients undergoing EL can safely achieve SDD without increased risks.

Keywords:
Gynecologic surgeryMinimally invasive surgerySpecimen removal

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Area of Science:

  • Gynecologic Oncology
  • Minimally Invasive Surgery
  • Surgical Outcomes

Background:

  • Minimally invasive surgery (MIS) is increasingly used for gynecologic malignancies.
  • Extraction laparotomy (EL) may be necessary for intact specimen removal during MIS.
  • The impact of EL on same-day discharge (SDD) feasibility and safety is not well-established.

Purpose of the Study:

  • To evaluate if extraction laparotomy (EL) for intact specimen removal impacts the feasibility or safety of same-day discharge (SDD).
  • To compare SDD rates, complications, readmission, and follow-up between patients undergoing EL and those who did not after MIS for gynecologic malignancies.

Main Methods:

  • Retrospective, single-institution study.
  • Compared 67 patients undergoing EL with 134 age-matched controls who had MIS for gynecologic malignancy.
  • Assessed SDD rates, pain scores, length of stay, 30-day readmission, emergency department visits, and patient contact.

Main Results:

  • SDD rates were similar: 83% for EL vs. 87% for no EL (p = .39).
  • No significant differences in pain scores, length of stay, readmission rates, or unscheduled patient contact.
  • EL was associated with higher specimen weight, estimated blood loss, and longer surgery time, but did not predict SDD.

Conclusions:

  • Minimally invasive surgery patients requiring extraction laparotomy can safely achieve same-day discharge.
  • SDD is feasible and safe for these patients, with no increased risk of complications or readmission.