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.
RCT Entities:
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.
Authors: Garth R Jacobsen; Juan S Barajas-Gamboa; Alisa M Coker; Joslin Cheverie; C Aitor Macias; Bryan J Sandler; Mark A Talamini; Santiago Horgan Journal: Surg Endosc Date: 2013-10-23 Impact factor: 4.584
Authors: Ali Akdemir; Ahmet Mete Ergenoğlu; Levent Akman; Ahmet Özgür Yeniel; Fatih Sendağ; Mehmet Kemal Oztekin Journal: J Res Med Sci Date: 2013-09 Impact factor: 1.852
Authors: Andrea Tinelli; Daniel A Tsin; Antonello Forgione; Ricardo Zorron; Giovanni Dapri; Antonio Malvasi; Tahar Benhidjeb; Radmila Sparic; Farr Nezhat Journal: J Turk Ger Gynecol Assoc Date: 2017-09-01