Bladder safety during natural orifice transluminal endoscopic surgery hysterectomy in the patients with extensive vesicouterine adhesion

Tanitra Tantitamit, Teerayut Temtanakitpaisan, Chyi Long Lee*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

3 Scopus citations

Abstract

Adhesion at the vesicouterine fold presents a great challenge when performing hysterectomy through transvaginal natural orifice transluminal endoscopy surgery (NOTES) in women with a history of cesarean section. An attempt to lyse adhesions often prolongs the procedure and may inadvertently result in cystostomy. The purpose of this report is to demonstrate a safe technique for the lysis of vesicouterine adhesions during NOTES hysterectomy. We present the cases of two patients with a history of cesarean section. Severe adhesions at the vesicouterine peritoneum were encountered in both cases, and one patient had an extensive adhesion involving lower half of the uterus. Although the lateral approach is sufficient in most cases, it does not allow a surgeon to approach the peritoneal cavity if there is extensive adhesion. In cases such as these, direct dissection of the adhesion on the uterus is required.

Original languageEnglish
Pages (from-to)129-131
Number of pages3
JournalGynecology and Minimally Invasive Therapy
Volume8
Issue number3
DOIs
StatePublished - 01 07 2019

Bibliographical note

Publisher Copyright:
© 2019 Gynecology and Minimally Invasive Therapy.

Keywords

  • Bladder injury
  • cesarean section
  • hysterectomy
  • natural orifice transluminal endoscopy surgery

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