A New Approach to Coincidental Appendectomy: The Vaginal Appendectomy

Abstract

Study Objective The objective of this video is to describe performance of a coincidental appendectomy at time of laparoscopic hysterectomy via vaginal access. This technique, the vaginal appendectomy (VagAppy), is beneficial as it allows performance of a coincidental appendectomy and specimen retrieval through the colpotomy. Design This is an observational case series of coincidental appendectomies performed via conventional “straight stick” and robotic-assisted laparoscopy. Stepwise demonstration of the vaginal appendectomy technique is provided with narrated video footage. Setting The surgeries in this video were performed in the operating room at an academic medical center. The patients were positioned in dorsal lithotomy position, and the hysterectomies were completed using 5mm ports (straight stick hysterectomy) and 8mm ports (robotic-assisted hysterectomy). Patients or Participants Women electing for total laparoscopic hysterectomy for the surgical management of endometriosis or chronic pelvic pain. Interventions Coincidental appendectomy at time of total laparoscopic hysterectomy. Measurements and Main Results No analyses were completed for this video. Conclusion Vaginal appendectomy is a feasible and efficient technique to perform coincidental appendectomy at time of laparoscopic hysterectomy using a transvaginal approach. It allows for the appendectomy to be completed with a laparoscopic stapler using small or reduced laparoscopic ports.