The Culdotomy Two U Procedure for Vaginal Ovarian Cystectomy

Tanaka, Masaaki; Sagawa, Tetsuya; Hashimoto, Manabu; Mizumoto, Yasunari; Yamazaki, Rena; Myojo, Subaru; Inoue, Masaki
June 2011
Surgical Innovation;Jun2011, Vol. 18 Issue 2, p114
Academic Journal
When transvaginal removal of ovarian cysts is performed successfully, the procedure compares favorably with laparoscopy in terms of invasiveness. However, the approach into peritoneal cavity has been laborious. The objective was to evaluate feasibility of an ultrasound-guided culdotomy using a newly developed umbrella needle. New culdotomy was performed on 36 patients with ovarian cysts. Each cyst was directly punctured by the needle from vagina under ultrasound guidance. The vaginal walls on both sides of the needle were incised with an electric scalpel. Through the wound, cyst was exteriorized and enucleated. Preoperative characteristics of patients, outcome, operating time, blood loss, complications, and cyst histology were analyzed. Culdotomy was performed successfully in all cases. Operating time was less than 10 minutes and blood loss was less than 10 mL. There were no culdotomy-associated complications. Culdotomy assisted by ultrasound imaging and an umbrella needle is a simple, safe, and reliable method for vaginal ovarian cystectomy.


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