Pure transvaginal umbilical hernia repair.

Stephanie Wood, Lucian Panait, Robert L. Bell, Andrew J. Duffy, Kurt E. Roberts

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Transvaginal natural orifice transluminal endoscopic surgery (NOTES) procedures are at the forefront of minimally invasive innovation, remarkable for shorter recovery times and decreased postoperative pain [1, 2]. Most transvaginal procedures are performed as hybrid procedures [3]. To our knowledge, this is the first video depiction of a pure transvaginal umbilical hernia repair in a human. This is a 38-year-old woman, body mass index 36.4 kg/m(2), with a symptomatic port site hernia in the umbilical region after a previous laparoscopic cholecystectomy. The patient was positioned in stirrups in a steep Trendelenburg position. Sterilization of vaginal cavity was performed with 10 % povidone-iodine solution. A 2 cm transverse incision at the posterior fornix was made, and a SILS port (Covidien, North Haven, CT) was introduced. One 12 mm trocar and two 5 mm trocars were placed through SILS port. Standard straight laparoscopic instruments were used. A 12 cm round Parietex mesh (Covidien) was placed in a specimen retrieval bag and deployed into the peritoneal cavity. The mesh was extracted, unfolded in the abdominal cavity, and circumferentially fixated to the abdominal wall with an AbsorbaTack device (Covidien). The colpotomy incision was closed with a running absorbable suture. The procedure lasted 103 min and was performed on an outpatient basis. No intraoperative complications occurred. The patient was doing well and had no pain or recurrence at 2, 6, and 9 months' follow-up. Our initial experience with transvaginal ventral hernia repair in humans suggests that this procedure is feasible and safe. This approach may improve cosmesis and decrease the risk of future ventral hernias. Potential cons may include a longer operative time, mesh infection, and risk of visceral injury with a pure transvaginal approach. As transvaginal surgery evolves, techniques and devices will become increasingly refined to tackle these challenges.

Original languageEnglish (US)
Number of pages1
JournalSurgical endoscopy
Volume27
Issue number8
DOIs
StatePublished - Jan 1 2013
Externally publishedYes

Fingerprint

Umbilical Hernia
Herniorrhaphy
Ventral Hernia
Surgical Instruments
Colpotomy
Natural Orifice Endoscopic Surgery
Head-Down Tilt
Povidone-Iodine
Equipment and Supplies
Abdominal Cavity
Laparoscopic Cholecystectomy
Intraoperative Complications
Peritoneal Cavity
Abdominal Wall
Operative Time
Postoperative Pain
Running
Sutures
Body Mass Index
Outpatients

ASJC Scopus subject areas

  • Surgery

Cite this

Wood, S., Panait, L., Bell, R. L., Duffy, A. J., & Roberts, K. E. (2013). Pure transvaginal umbilical hernia repair. Surgical endoscopy, 27(8). https://doi.org/10.1007/s00464-013-2847-1

Pure transvaginal umbilical hernia repair. / Wood, Stephanie; Panait, Lucian; Bell, Robert L.; Duffy, Andrew J.; Roberts, Kurt E.

In: Surgical endoscopy, Vol. 27, No. 8, 01.01.2013.

Research output: Contribution to journalArticle

Wood, S, Panait, L, Bell, RL, Duffy, AJ & Roberts, KE 2013, 'Pure transvaginal umbilical hernia repair.', Surgical endoscopy, vol. 27, no. 8. https://doi.org/10.1007/s00464-013-2847-1
Wood, Stephanie ; Panait, Lucian ; Bell, Robert L. ; Duffy, Andrew J. ; Roberts, Kurt E. / Pure transvaginal umbilical hernia repair. In: Surgical endoscopy. 2013 ; Vol. 27, No. 8.
@article{a3349dae6a8e4a2294cb7cb6585acb28,
title = "Pure transvaginal umbilical hernia repair.",
abstract = "Transvaginal natural orifice transluminal endoscopic surgery (NOTES) procedures are at the forefront of minimally invasive innovation, remarkable for shorter recovery times and decreased postoperative pain [1, 2]. Most transvaginal procedures are performed as hybrid procedures [3]. To our knowledge, this is the first video depiction of a pure transvaginal umbilical hernia repair in a human. This is a 38-year-old woman, body mass index 36.4 kg/m(2), with a symptomatic port site hernia in the umbilical region after a previous laparoscopic cholecystectomy. The patient was positioned in stirrups in a steep Trendelenburg position. Sterilization of vaginal cavity was performed with 10 {\%} povidone-iodine solution. A 2 cm transverse incision at the posterior fornix was made, and a SILS port (Covidien, North Haven, CT) was introduced. One 12 mm trocar and two 5 mm trocars were placed through SILS port. Standard straight laparoscopic instruments were used. A 12 cm round Parietex mesh (Covidien) was placed in a specimen retrieval bag and deployed into the peritoneal cavity. The mesh was extracted, unfolded in the abdominal cavity, and circumferentially fixated to the abdominal wall with an AbsorbaTack device (Covidien). The colpotomy incision was closed with a running absorbable suture. The procedure lasted 103 min and was performed on an outpatient basis. No intraoperative complications occurred. The patient was doing well and had no pain or recurrence at 2, 6, and 9 months' follow-up. Our initial experience with transvaginal ventral hernia repair in humans suggests that this procedure is feasible and safe. This approach may improve cosmesis and decrease the risk of future ventral hernias. Potential cons may include a longer operative time, mesh infection, and risk of visceral injury with a pure transvaginal approach. As transvaginal surgery evolves, techniques and devices will become increasingly refined to tackle these challenges.",
author = "Stephanie Wood and Lucian Panait and Bell, {Robert L.} and Duffy, {Andrew J.} and Roberts, {Kurt E.}",
year = "2013",
month = "1",
day = "1",
doi = "10.1007/s00464-013-2847-1",
language = "English (US)",
volume = "27",
journal = "Surgical Endoscopy and Other Interventional Techniques",
issn = "0930-2794",
publisher = "Springer New York",
number = "8",

}

TY - JOUR

T1 - Pure transvaginal umbilical hernia repair.

AU - Wood, Stephanie

AU - Panait, Lucian

AU - Bell, Robert L.

AU - Duffy, Andrew J.

AU - Roberts, Kurt E.

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Transvaginal natural orifice transluminal endoscopic surgery (NOTES) procedures are at the forefront of minimally invasive innovation, remarkable for shorter recovery times and decreased postoperative pain [1, 2]. Most transvaginal procedures are performed as hybrid procedures [3]. To our knowledge, this is the first video depiction of a pure transvaginal umbilical hernia repair in a human. This is a 38-year-old woman, body mass index 36.4 kg/m(2), with a symptomatic port site hernia in the umbilical region after a previous laparoscopic cholecystectomy. The patient was positioned in stirrups in a steep Trendelenburg position. Sterilization of vaginal cavity was performed with 10 % povidone-iodine solution. A 2 cm transverse incision at the posterior fornix was made, and a SILS port (Covidien, North Haven, CT) was introduced. One 12 mm trocar and two 5 mm trocars were placed through SILS port. Standard straight laparoscopic instruments were used. A 12 cm round Parietex mesh (Covidien) was placed in a specimen retrieval bag and deployed into the peritoneal cavity. The mesh was extracted, unfolded in the abdominal cavity, and circumferentially fixated to the abdominal wall with an AbsorbaTack device (Covidien). The colpotomy incision was closed with a running absorbable suture. The procedure lasted 103 min and was performed on an outpatient basis. No intraoperative complications occurred. The patient was doing well and had no pain or recurrence at 2, 6, and 9 months' follow-up. Our initial experience with transvaginal ventral hernia repair in humans suggests that this procedure is feasible and safe. This approach may improve cosmesis and decrease the risk of future ventral hernias. Potential cons may include a longer operative time, mesh infection, and risk of visceral injury with a pure transvaginal approach. As transvaginal surgery evolves, techniques and devices will become increasingly refined to tackle these challenges.

AB - Transvaginal natural orifice transluminal endoscopic surgery (NOTES) procedures are at the forefront of minimally invasive innovation, remarkable for shorter recovery times and decreased postoperative pain [1, 2]. Most transvaginal procedures are performed as hybrid procedures [3]. To our knowledge, this is the first video depiction of a pure transvaginal umbilical hernia repair in a human. This is a 38-year-old woman, body mass index 36.4 kg/m(2), with a symptomatic port site hernia in the umbilical region after a previous laparoscopic cholecystectomy. The patient was positioned in stirrups in a steep Trendelenburg position. Sterilization of vaginal cavity was performed with 10 % povidone-iodine solution. A 2 cm transverse incision at the posterior fornix was made, and a SILS port (Covidien, North Haven, CT) was introduced. One 12 mm trocar and two 5 mm trocars were placed through SILS port. Standard straight laparoscopic instruments were used. A 12 cm round Parietex mesh (Covidien) was placed in a specimen retrieval bag and deployed into the peritoneal cavity. The mesh was extracted, unfolded in the abdominal cavity, and circumferentially fixated to the abdominal wall with an AbsorbaTack device (Covidien). The colpotomy incision was closed with a running absorbable suture. The procedure lasted 103 min and was performed on an outpatient basis. No intraoperative complications occurred. The patient was doing well and had no pain or recurrence at 2, 6, and 9 months' follow-up. Our initial experience with transvaginal ventral hernia repair in humans suggests that this procedure is feasible and safe. This approach may improve cosmesis and decrease the risk of future ventral hernias. Potential cons may include a longer operative time, mesh infection, and risk of visceral injury with a pure transvaginal approach. As transvaginal surgery evolves, techniques and devices will become increasingly refined to tackle these challenges.

UR - http://www.scopus.com/inward/record.url?scp=84895853410&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895853410&partnerID=8YFLogxK

U2 - 10.1007/s00464-013-2847-1

DO - 10.1007/s00464-013-2847-1

M3 - Article

C2 - 23436091

AN - SCOPUS:84895853410

VL - 27

JO - Surgical Endoscopy and Other Interventional Techniques

JF - Surgical Endoscopy and Other Interventional Techniques

SN - 0930-2794

IS - 8

ER -