Transvaginal Versus Transabdominal Extraction of Laparoscopically-excised Specimen

Seoul National University Bundang Hospital38 enrolled

Overview

The aim of this study is to evaluate the outcomes of transvaginal natural orifice specimen extraction (NOSE) in patients who are planning multiport laparoscopic surgery for resection of solid organs including kidney, liver, stomach, adrenal gland and bladder.

Study design: This was a prospective, single center, single arm study. This clinical trial was approved by the Institutional Review Boards. Study process: All patients gave informed written consent after being informed of the details of the study. All participants underwent demographic and history taking, laboratory tests and a gynecological examination to determine whether specimen removal through vagina is possible. The patients who was adequate for this study were planned to perform multiport laparoscopic surgery and patients were subjected to transvaginal NOSE. To perform transvaginal NOSE procedure, the patients were placed in the lithotomy position with Trendelenburg position. After about 1-2cm incision at the posterior vaginal fornix, endopouch was introduced into the abdominal cavity through vaginal incision site. The specimen was placed inside a endopouch and removed through vagina. Closure of vaginal incision site was achieved by transvaginally with 2/0 absorbable suture. During the second and third visit at 1 week and 8 week, Patient and Observer Scar Assessment Scale (POSAS) was performed to assess cosmetic outcomes of scar. Subjects with sexual activity carried out Female Sexual Function Index (FSFI) questionnaire to assess sexual function at final visit which occurred at 6 months after surgery. Statistical analysis: All data are summarized as means ± standard deviation or as numbers with proportions. A p \< 0.05 was considered to indicate significance. Student's t-test and Mann-Whitney U test were conducted to compare continuous parametric variables and non-parametric variables, respectively.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Colorectal Neoplasms Urologic Neoplasms Gastrointestinal Neoplasms Neoplasms by Site

Interventions

Transvaginal natural orifice specimen extraction (NOSE)PROCEDURE

Under general anesthesia, patients who are planned to perform multiport laparoscopic surgery for resection of solid organs including kidney, liver, stomach, adrenal gland and bladder will undergo Transvaginal NOSE

Eligibility

Sex: FEMALEMin age: 20 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients who are accessible with vaginal approach * Patients scheduled for laparoscopic resection of stomach, colon, kidney and spleen for benign or malignant diseases * Patients with normal cervical cancer screening tests within the last 3 years except inflammatory findings Exclusion Criteria: * Patients without sexual intercourse * Patients who are considered unable to remove specimen through vagina due to narrow introitus in gynecological examination * Patients who are expected to have severe adhesion due to deep infiltrative endometriosis or previous pelvic surgery history * Patients with abnormal cervical cancer screening tests * Patients scheduled to perform concomitant hysterectomy

Outcomes

Primary Outcomes

Patient and Observer Scar Assessment Scale (POSAS)

Cosmetic outcomes of scar assessed by Patient and Observer Scar Assessment Scale (POSAS) 1 week and 8 weeks after surgery. The POSAS is the international validated scar assessment questionnaire that measures quality of the scar from the perspective of both patient and observer.

Time frame: 8 week

Secondary Outcomes

Female Sexual Function Index (FSFI) questionnaire

Sexual function assessment

Time frame: 6 months

Data from ClinicalTrials.gov

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