Transumbilical versus transvaginal retrieval of surgical specimens at laparoscopy: A randomized trial

Fabio Ghezzi, Antonella Cromi, Stefano Uccella, Giorgio Bogani, Maurizio Serati, Pierfrancesco Bolis

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
JournalAmerican Journal of Obstetrics and Gynecology
Volume207
Issue number2
DOIs
Publication statusPublished - Aug 2012

Keywords

  • adnexal mass
  • laparoscopy
  • ovarian cyst
  • specimen removal
  • transvaginal

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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