1 / 13

Transvaginal Extraction: Feasible

Transvaginal Extraction: Feasible. Howard Ross, MD, FACS, FASCRS Chief, Colon and Rectal Surgery Riverview Medical Center Clinical Associate Professor of Surgery UMDNJ. Disclosures. Consultant and Course Director: Applied Medical Covidien Woke at 4 am to watch royal wedding.

myrna
Download Presentation

Transvaginal Extraction: Feasible

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Transvaginal Extraction: Feasible Howard Ross, MD, FACS, FASCRS Chief, Colon and Rectal Surgery Riverview Medical Center Clinical Associate Professor of Surgery UMDNJ

  2. Disclosures Consultant and Course Director: Applied Medical Covidien Woke at 4 am to watch royal wedding

  3. Natural Orifice Surgery

  4. 50% of Population Have a Vagina

  5. Transvaginal Extraction

  6. Transvaginal Extraction

  7. Published Results • Studies Small • Selected patients • As of February 2011: • 23 articles • 130 patients • Complications Related to Transvaginal Extraction • Rectovaginal fistula • Pelvic Seroma Diana M, Perretta S, Wall J, Costantino FA, Leroy J, Demartines N, Marescaux J. Colorectal Dis. 2011 Jun;13(6):e104-11.

  8. An Innovative Technique for ColorectalSpecimen Retrieval: A New Eraof “Natural Orifice Specimen Extraction”(N.O.S.E) • Laparoscopic restorative proctocolectomy • 7 patients 2004-2007 • Familial adenomatous polyposis with cancer • Posterior vaginal vault was opened with an ultracision shears, endobag placed in the vagina • All vaginal wounds healed • No vaginal metastasis • 1 DVT, 1 anastamotic leak Palanivelu C, Rangarajan M, Jategaonkar PA, Anand NV. Dis Colon Rectum. 2008 Jul;51(7):1120-4. Epub 2008 May 15.

  9. Transvaginal Extraction of the Specimen After TotalLaparoscopic Right Hemicolectomy WithIntracorporeal Anastomosis • First US report • 88 yr old woman, 4 cm cecal cancer • 3-cm transvaginal posterior colpotomy • No complications Franklin ME Jr, Kelley H, Kelley M, Brestan L, Portillo G, Torres J Surg Laparosc Endosc PercutanTech. 2008 Jun;18(3):294-8.

  10. Case Reports

  11. Case Controlled Study Laparoscopic Right Colectomy vs. Laparoscopic R Colectomy with natural orifice specimen extraction (NOSE) • 34 Patients Each Group • NOSE patients less pain POD 1 and POD 3 (0.01) • Visual analogue and blinded observer • Improved Cosmesis • No morbidity difference J. S. Park, G.-S. Choi, H. J. Kim, S. Y. Park and S. H. Jun British Journal of Surgery 2011; 98: 710–715

  12. Trans-Vaginal Extraction

  13. For Discussion • Patient Selection • Process to begin • IRB, Ethics • Who should try?

More Related