Clinical analysis of 10 cases of ovarian cystectomy via transvaginal natural orifice transluminal endoscopic surgery

Abstract

Objective To evaluate the feasibility, safety and postopterative outcomes of transvaginal natural orifice transluminal endoscopic surgery(NOTES) ovarian cystectomy. Methods 10 patients underwent NOTES ovarian cystectomy between Sept. to Dec.2017 in Shanghai First Maternity and Infant Health Hospital, were retrospectively analyzed. A 2.5 cm colpotomy was made and a port was inserted into the pouch of vagina. A pneumoperitoneum was created and the conventional laparoscopy ovarian cystectomy steps were followed. The perioperative data were analyzed as follows: the size of ovarian cyst, the operation time, the drop in the hemoglobin , the blood loss, the postoperative visual analog scale(VAS) pain score, the time for postoperative bowel movement , the length of the hospitalization. Results One patient with bilateral ovarian teratoma and polycystic ovary syndrome was converted to traditional laparoscopy surgery due to difficult stitching because of active hemorrhage. There were no noticeable complications during or after operation. The other 9 cases were accomplished. The mean operation time was 78.3 min.The mean drop of hemoglobin level was 18.3 g/L. The mean blood loss was 23.3 ml.The mean vas score was 0.55 at 24 h after operation. The mean time for postoperative bowel movement was 17.5 hours. The mean length of hospitalization was 4.7 days. Conclusions The patients feeled mild pain after NOTES , and the procedure resulted in cosmetic advantages. With appropriate case selection and adroit surgical technique, the NOTES ovarian cystectomy seems to be a safe and feasible approach. Key words: Transvaginal; Natural orifice transluminal endoscopic surgery; Ovarian cystectomy