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vNOTES hysterectomy using the lateral window technique in case of a ventrofixed uterus following previous cesarean sections: A video article. | LitMetric

vNOTES hysterectomy using the lateral window technique in case of a ventrofixed uterus following previous cesarean sections: A video article.

J Gynecol Obstet Hum Reprod

Department of Obstetrics and Gynecology, CHU Charles Nicolle, Rouen University, 76000 Rouen, France; Université Paris Cité, INSERM U1153, Obstetrical Perinatal and Pediatric Epidemiology (EPOPé) Research Team, Center for research in Epidemiology and statistic (CRESS), Paris, France.

Published: February 2024

AI Article Synopsis

Article Abstract

vNOTES uses the vagina as the surgical channel for endoscopy and achieves improved cosmesis compared to conventional laparoscopy as there are no abdominal incisions. Ventrofixation of the uterus to the abdominal wall following previous cesarean sections further adds to the surgeon's concern of bladder injury. In such cases, a modification of the technique is proposed: introducing the vNOTES port first, before the opening of the vesico-uterine peritoneal folds, thus carried out under endoscopic view. Medial anterior vesico-uterine adhesions are identified and circumscribed by creating a lateral window in the broad ligament on both sides. This allows the cutting of adhesions under endoscopic view to minimize the risk of bladder injuries. The aim of this technical note is to present this modification of the surgical technique for vNOTES hysterectomy in case of ventrofixed uterus.

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Source
http://dx.doi.org/10.1016/j.jogoh.2023.102709DOI Listing

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