Key Frames

  • Hysterectomy via NOTES, after performing an anterior and posterior colpotomy and transsecting the sacro-uterine ligaments via classical open vaginal surgery.
  • Construction of the NOTES port: GelPOINT advanced access platform, with a 10 mm trocar for CO2 insufflation and laparoscope insertion. Two 5 mm trocars were placed for insertion of the reusable laparoscopic instruments.
  • Parametrium, the uterine arteries and the ovarian ligament, and Fallopian tube were coagulated using the bipolar forceps and subsequently transsected using the Caiman (Aescupal® Caiman® Advanced Bipolar Technology), after identification of both ureters.
  • Mesosalpinx is bilatally coagulated and transsected using the Caiman®: bilateral salpingectomy. The right salpinx is attached to the peritoneum.
  • Total hysterectomy.
  • Vaginal extraction of the uterus.
  • Closure of the vaginal vault with vaginally detached stitches.

Prof. Paolo Scollo: Hysterectomy and salpingectomy by transvaginal natural orifice transluminal endoscopic surgery (V-NOTES)

Intervention Description

We refer to this technique as vaginally assisted NOTES hysterectomy (VANH) as the first part of this procedure is performed by conventional vaginal surgery. Once the anterior and posterior peritoneum were opened, both sacro-uterine ligaments were coagulated using the bipolar forceps and subsequently transsected using the cold scissors. Construction of the NOTES port: GelPOINT advanced access platform, with a 10 mm reusable trocar for CO2 insufflation and laparoscope insertion. Two 5 mm reusable trocars were placed for insertion of the reusable laparoscopic instruments.

Parametrium, the uterine arteries and the ovarian ligament, and Fallopian tube were coagulated using the bipolar forceps and subsequently transsected using the Caiman (Aescupal® Caiman® Advanced Bipolar Technology), after identification of both ureters. Mesosalpinx is bilatally coagulated and transsected using the Caiman®: bilateral salpingectomy. Total hysterectomy. Vaginal extraction of the uterus. Extraction of the GelPOINT advanced access platform. Closure of the vaginal vault with vaginally detached stitches.

Primo Operatore

Prof. Paolo Scollo

Direttore dell’U.O. di Ginecologia e Ostetricia, A.O.E. Cannizzaro

Ospedale Cannizzaro – Catania

Contatti

Secondo Operatore

Dott. Giuseppe Scibilia

Dirigente Medico, U.O. Ginecologia e Ostetricia A.O.E. Cannizzaro

Ospedale Cannizzaro – Catania

Contatti

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