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Comparison between transumbilical and transvaginal morcellation of a large uterus during single-port-access total laparoscopic hysterectomy.
Obstet Gynecol Sci. 2020 May; 63(3):379-386.OG

Abstract

Objective

To compare the perioperative outcomes of transumbilical morcellation (TUM) and transvaginal morcellation (TVM) of a large uterus (≥500 g) during single-port-access total laparoscopic hysterectomy (SPA-TLH).

Methods

A total of 57 patients who underwent SPA-TLH for a large uterine myoma and/or adenomyosis (uterine weight ≥500 g) between March 2013 and July 2017 were included. For specimen retrieval, TUM was performed for 30 patients and TVM for 27 patients.

Results

Perioperative outcomes, including total operative time, tissue extraction time, extension of skin incision length, estimated volume of blood loss, changes in postoperative hemoglobin level, length of postoperative hospital stay, postoperative pain, and uterine weight, were compared between the 2 groups. No significant differences were observed in the baseline characteristics except for a history of cesarean section (TUM vs. TVM: 83.3% vs. 14.8%, P=0.002) and history of vaginal delivery (TUM vs. TVM: 6.7% vs. 88.8%, P=0.001). The total operative time, tissue extraction time, extension of skin incision length, estimated volume of blood loss, changes in postoperative hemoglobin level, length of postoperative hospital stay, and postoperative pain did not significantly differ between the two groups. The uterine weight was significantly higher for patients who underwent TUM than for those who had TVM (median [range]: 735 g [520-1,380 g] vs. 622 g [514-975 g]; P=0.042).

Conclusion

TUM during SPA-TLH is a feasible technique for extracting large uteri weighing ≥500 g. This procedure is suitable for patients without a history of vaginal delivery or a narrow vaginal cavity.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, Korea.Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, Korea.Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, Korea.Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, Korea.Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, Korea. Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32489984

Citation

Oh, Seung Ju, et al. "Comparison Between Transumbilical and Transvaginal Morcellation of a Large Uterus During Single-port-access Total Laparoscopic Hysterectomy." Obstetrics & Gynecology Science, vol. 63, no. 3, 2020, pp. 379-386.
Oh SJ, Lee SY, Kim WY, et al. Comparison between transumbilical and transvaginal morcellation of a large uterus during single-port-access total laparoscopic hysterectomy. Obstet Gynecol Sci. 2020;63(3):379-386.
Oh, S. J., Lee, S. Y., Kim, W. Y., Kang, J., Han, K. H., Lee, S. H., & Park, J. S. (2020). Comparison between transumbilical and transvaginal morcellation of a large uterus during single-port-access total laparoscopic hysterectomy. Obstetrics & Gynecology Science, 63(3), 379-386. https://doi.org/10.5468/ogs.2020.63.3.379
Oh SJ, et al. Comparison Between Transumbilical and Transvaginal Morcellation of a Large Uterus During Single-port-access Total Laparoscopic Hysterectomy. Obstet Gynecol Sci. 2020;63(3):379-386. PubMed PMID: 32489984.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison between transumbilical and transvaginal morcellation of a large uterus during single-port-access total laparoscopic hysterectomy. AU - Oh,Seung Ju, AU - Lee,Seo Young, AU - Kim,Woo Yong, AU - Kang,Jieun, AU - Han,Kyoung-Hee, AU - Lee,San-Hui, AU - Park,Ji Sun, Y1 - 2020/04/02/ PY - 2019/07/16/received PY - 2019/10/28/revised PY - 2019/11/07/accepted PY - 2020/6/4/entrez PY - 2020/6/4/pubmed PY - 2020/6/4/medline KW - Adenomyosis KW - Hysterectomy KW - Laparoscopy KW - Minimally invasive surgical procedures KW - Myoma SP - 379 EP - 386 JF - Obstetrics & gynecology science JO - Obstet Gynecol Sci VL - 63 IS - 3 N2 - Objective: To compare the perioperative outcomes of transumbilical morcellation (TUM) and transvaginal morcellation (TVM) of a large uterus (≥500 g) during single-port-access total laparoscopic hysterectomy (SPA-TLH). Methods: A total of 57 patients who underwent SPA-TLH for a large uterine myoma and/or adenomyosis (uterine weight ≥500 g) between March 2013 and July 2017 were included. For specimen retrieval, TUM was performed for 30 patients and TVM for 27 patients. Results: Perioperative outcomes, including total operative time, tissue extraction time, extension of skin incision length, estimated volume of blood loss, changes in postoperative hemoglobin level, length of postoperative hospital stay, postoperative pain, and uterine weight, were compared between the 2 groups. No significant differences were observed in the baseline characteristics except for a history of cesarean section (TUM vs. TVM: 83.3% vs. 14.8%, P=0.002) and history of vaginal delivery (TUM vs. TVM: 6.7% vs. 88.8%, P=0.001). The total operative time, tissue extraction time, extension of skin incision length, estimated volume of blood loss, changes in postoperative hemoglobin level, length of postoperative hospital stay, and postoperative pain did not significantly differ between the two groups. The uterine weight was significantly higher for patients who underwent TUM than for those who had TVM (median [range]: 735 g [520-1,380 g] vs. 622 g [514-975 g]; P=0.042). Conclusion: TUM during SPA-TLH is a feasible technique for extracting large uteri weighing ≥500 g. This procedure is suitable for patients without a history of vaginal delivery or a narrow vaginal cavity. SN - 2287-8572 UR - https://www.unboundmedicine.com/medline/citation/32489984/Comparison_between_transumbilical_and_transvaginal_morcellation_of_a_large_uterus_during_single-port-access_total_laparoscopic_hysterectomy L2 - https://ogscience.org/DOIx.php?id=10.5468/ogs.2020.63.3.379 DB - PRIME DP - Unbound Medicine ER -
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