Laparoscopic specimen extraction in vitro: preliminary experience

Utilizing Condoms in Laparoscopic Gynecologic Cancer Surgeries: A Profitable Safeguard?

Minimally invasive approach is a well-established strategy in the initial exploration or definitive management of the eligible gynecological cancers. It provides the benefits of improved surgical recovery to the patients. However, the last step of the specimen extraction through the smallest incision possible is always challenging for most of the surgeons. The in-bag retrieval of specimen needs utmost attention in most of the malignancies for the preservation of tumor integrity to avoid tumor seedling and upstaging of the disease. The various kinds of commercially available bags are already being utilized for the retrieval of specimens. However, the venture into innovative methods of development of novel and economical specimen retrieval system is desirable owing to the high cost of the commercial endobags. Here, we have described a very simple, safe, and cost-effective technique of specimen retrieval using the ETO sterilized condoms for smaller specimens' extraction in gynecological cancer surgeries.

Trocar-site hernia following laparoscopic salpingo-oophorectomy in a middle-aged Japanese woman: an initial case report after 40 years of experience at a single center and a brief literature review

Background

In gynecology, the number of laparoscopic surgeries performed has increased annually because laparoscopic surgery presents a greater number of advantages from a cosmetic perspective and allows for a less invasive approach than laparotomy. Trocar site hernia (TSH) is a unique complication that causes severe small bowel obstruction and requires emergency surgery. Its use has mainly been reported with respect to gastrointestinal laparoscopy, such as for cholecystectomy. Contrastingly, there have been few reports on gynecologic laparoscopy because common laparoscopic surgeries, such as laparoscopic salpingo-oophorectomy, are considered low risk due to shorter operative times. In this study, we report on a case of a woman who developed a TSH 5 days postoperatively following a minimally invasive laparoscopic surgery that was completed in 34 min.

Case presentation

A 41-year-old woman who had undergone laparoscopic salpingo-oophorectomy 5 days previously presented with the following features of intestinal obstruction: persistent abdominal pain, vomiting, and inability to pass stool or flatus. A computed tomography scan of her abdomen demonstrated a collapsed small bowel loop that was protruding through the lateral 12-mm port. Emergency surgery confirmed the diagnosis of TSH. The herniated bowel loop was gently replaced onto the pelvic floor and the patient did not require bowel resection. After the surgical procedure, the fascial defect at the lateral port site was closed using 2-0 Vicryl sutures. On the tenth postoperative day, the patient was discharged with no symptom recurrence.

Conclusions

The TSH initially presented following laparoscopic salpingo-oophorectomy; however, the patient did not have common risk factors such as obesity, older age, wound infection, diabetes, and prolonged operative time. There was a possibility that the TSH was caused by excessive manipulation during the tissue removal through the lateral 12-mm port. Thereafter, the peritoneum around the lateral 12-mm port was closed to prevent the hernia, although a consensus around the approach to closure of the port site fascia had not yet been reached. This case demonstrated that significant attention should be paid to the possibility of patients developing TSH. This will ensure the prevention of severe problems through early detection and treatment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-021-01528-6.