TY - JOUR
T1 - Transumbilical versus transvaginal retrieval of surgical specimens at laparoscopy
T2 - A randomized trial
AU - Ghezzi, Fabio
AU - Cromi, Antonella
AU - Uccella, Stefano
AU - Bogani, Giorgio
AU - Serati, Maurizio
AU - Bolis, Pierfrancesco
PY - 2012/8
Y1 - 2012/8
N2 - Objective: We sought to compare transumbilical (TU) and transvaginal (TV) route for retrieval of surgical specimens at laparoscopy. Study Design: Women scheduled for a laparoscopic resection of an adnexal mass were randomized to have their surgical specimen removed either through a posterior colpotomy (n = 34) or the umbilical port site (n = 32). Group allocation was concealed from patients and bedside clinicians. The primary outcome was postoperative incisional pain assessed by a 10-cm visual analog scale at 1, 3, and 24 hours after surgery. Results: TV retrieval caused less postoperative pain than TU specimen extraction at each time point (visual analog scale score at 1 hour: 2.6 ± 2.9 vs 1.2 ± 2.0, P =.03; at 3 hours: 2.4 ± 2.0 vs 1.4 ± 2.0, P =.02; and at 24 hours: 1.1 ± 1.5 vs 0.5 ± 1.4, P =.02). A higher proportion of women in the TU group than in the TV group indicated the umbilicus as the most painful area at 1 and 3 hours postoperatively. Two months after surgery, the participants scored similarly as to their overall satisfaction, cosmetic outcome, and dyspareunia upon resumption of intercourse. Conclusion: A TV approach for specimen removal after laparoscopic resection of adnexal masses offers the advantage of less postoperative pain than TU retrieval.
AB - Objective: We sought to compare transumbilical (TU) and transvaginal (TV) route for retrieval of surgical specimens at laparoscopy. Study Design: Women scheduled for a laparoscopic resection of an adnexal mass were randomized to have their surgical specimen removed either through a posterior colpotomy (n = 34) or the umbilical port site (n = 32). Group allocation was concealed from patients and bedside clinicians. The primary outcome was postoperative incisional pain assessed by a 10-cm visual analog scale at 1, 3, and 24 hours after surgery. Results: TV retrieval caused less postoperative pain than TU specimen extraction at each time point (visual analog scale score at 1 hour: 2.6 ± 2.9 vs 1.2 ± 2.0, P =.03; at 3 hours: 2.4 ± 2.0 vs 1.4 ± 2.0, P =.02; and at 24 hours: 1.1 ± 1.5 vs 0.5 ± 1.4, P =.02). A higher proportion of women in the TU group than in the TV group indicated the umbilicus as the most painful area at 1 and 3 hours postoperatively. Two months after surgery, the participants scored similarly as to their overall satisfaction, cosmetic outcome, and dyspareunia upon resumption of intercourse. Conclusion: A TV approach for specimen removal after laparoscopic resection of adnexal masses offers the advantage of less postoperative pain than TU retrieval.
KW - adnexal mass
KW - laparoscopy
KW - ovarian cyst
KW - specimen removal
KW - transvaginal
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U2 - 10.1016/j.ajog.2012.05.016
DO - 10.1016/j.ajog.2012.05.016
M3 - Article
C2 - 22704765
AN - SCOPUS:84864412508
VL - 207
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
SN - 0002-9378
IS - 2
ER -