8189 “Failed CS-BS” a Role for vNOTES in Patient with 4 Prior Cesarean Sections and Severe Adhesive Disease Desiring Sterilization

Abstract

Study Objective To demonstrate the utility of vNOTES for opportunistic bilateral salpingectomy for permanent sterilization after failed attempt at bilateral tubal ligation at the time of previous Cesarean section. Design Stepwise demonstration with narrated video footage. Setting vNOTES opportunistic bilateral salpingectomy for permanent sterilization after failed bilateral tubal ligation during previous Cesarean section. Patients or Participants 31-yo G4P3013 with 4 prior Cesarean sections desiring permanent sterilization, BMI 38. Interventions During previous Cesarean section, bilateral adnexa unable to be accessed due to dense adhesions from previous surgeries. Patient to have vNOTES instead of conventional laparoscopy. Measurements and Main Results Patient underwent a successful vNOTES bilateral salpingectomy, with pathology confirming bilateral fallopian tubes. Conclusion vNOTES bilateral salpingectomy is a reasonable alternative to conventional laparoscopy in patients with severe adhesive disease. To demonstrate the utility of vNOTES for opportunistic bilateral salpingectomy for permanent sterilization after failed attempt at bilateral tubal ligation at the time of previous Cesarean section. Stepwise demonstration with narrated video footage. vNOTES opportunistic bilateral salpingectomy for permanent sterilization after failed bilateral tubal ligation during previous Cesarean section. 31-yo G4P3013 with 4 prior Cesarean sections desiring permanent sterilization, BMI 38. During previous Cesarean section, bilateral adnexa unable to be accessed due to dense adhesions from previous surgeries. Patient to have vNOTES instead of conventional laparoscopy. Patient underwent a successful vNOTES bilateral salpingectomy, with pathology confirming bilateral fallopian tubes. vNOTES bilateral salpingectomy is a reasonable alternative to conventional laparoscopy in patients with severe adhesive disease.