Posterior colpotomy: a successful retrieval route for pelvic masses following robot-assisted laparoscopic surgery.

Abstract

We report a technique of transvaginal extraction of pelvic masses or larger specimens removed during robot-assisted laparoscopic surgery in order to avoid larger port incisions and postoperatively reduce pain. Fifty women underwent a transvaginal incision to remove large pelvic masses after robot-assisted laparoscopic hysterectomies. Posterior colpotomies were performed with bagged specimens delivered into the vagina, extracted, and then closed robotically with a running suture. Vaginal extraction of pelvic masses was successful in all attempted cases and in no case was there any spillage, with an average operative time of 94.22±4.48 and no intraoperative complications. This technique can be considered efficacious and safe with minimal morbidity. We suggest a surgical set-up including vaginal-cervical Ahluwalia retractor elevator to be prepared should the specimen be too large to remove via the port site, thus giving the surgeon the opportunity to perform this procedure with ease if necessary.