KUMAKIRI Jiyun
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Professor |
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Article types | Case report |
Language | English |
Peer review | Peer reviewed |
Title | Safe primary approach using a micro-laparoscope via the posterior vaginal fornix for patients with previous upper laparotomy: a report of five cases. |
Journal | Formal name:The journal of obstetrics and gynaecology research Abbreviation:J Obstet Gynaecol Res ISSN code:14470756/13418076 |
Domestic / Foregin | Foregin |
Volume, Issue, Page | 36(1),pp.195-8 |
Author and coauthor | Kumakiri Jun†*, Takeuchi Hiroyuki, Kitade Mari, Kikuchi Iwaho, Kumakiri Yuko, Kuroda Keiji, Jinushi Makoto, Takeda Satoru |
Authorship | Lead author,Corresponding author |
Publication date | 2010/02 |
Summary | In order to reduce the risk of visceral injury for patients with upper abdominal adhesions, we devised an alternative to the umbilical approach. Five patients who had undergone a previous upper abdominal laparotomy and were scheduled for gynecologic laparoscopic surgeries at our hospital were evaluated. A micro-trocar was inserted via the posterior vaginal fornix and the periumbilicus was observed using a micro-laparoscope inserted in the micro-trocar. A trocar for conventional laparoscopy was inserted into the umbilicus under micro-laparoscopic observation in the cul-de-sac to avoid visceral organ adherent to the periumbilicus. Four cases had adhesions of the transverse colon, small bowel or omentum to the upper abdomen due to previous surgery; however, we were able to accomplish laparoscopic surgery without injury to adhesive organs in all patients. The micro-laparoscopic primary approach via the posterior vaginal fornix is a safe primary approach for patients who have undergone a previous upper abdominal laparotomy. |
DOI | 10.1111/j.1447-0756.2009.01095.x |
PMID | 20178551 |