Application of Pneumoperitoneum Free Transvaginal Natural Orifice Endoscopic Surgery in Ectopic Pregnancy and Related Factors of Operation Time

Yali ZHOU; Hongyun LIAO; Yanjie SHEN; Yiqun DUAN; Lu JIN; Yixian YU; Yanhua LI; Xueyi LV; Chuan WANG; Chao ZHANG

doi:10.12259/j.issn.2095-610X.S20221223

Volume 43 Issue 12

Dec. 2022

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Article Navigation > Journal of Kunming Medical University > 2022 > 43(12): 125-130

Yali ZHOU, Hongyun LIAO, Yanjie SHEN, Yiqun DUAN, Lu JIN, Yixian YU, Yanhua LI, Xueyi LV, Chuan WANG, Chao ZHANG. Application of Pneumoperitoneum Free Transvaginal Natural Orifice Endoscopic Surgery in Ectopic Pregnancy and Related Factors of Operation Time[J]. Journal of Kunming Medical University, 2022, 43(12): 125-130. doi: 10.12259/j.issn.2095-610X.S20221223

Citation:

Yali ZHOU, Hongyun LIAO, Yanjie SHEN, Yiqun DUAN, Lu JIN, Yixian YU, Yanhua LI, Xueyi LV, Chuan WANG, Chao ZHANG. Application of Pneumoperitoneum Free Transvaginal Natural Orifice Endoscopic Surgery in Ectopic Pregnancy and Related Factors of Operation Time[J]. Journal of Kunming Medical University, 2022, 43(12): 125-130. doi: 10.12259/j.issn.2095-610X.S20221223

Citation:

Yali ZHOU, Hongyun LIAO, Yanjie SHEN, Yiqun DUAN, Lu JIN, Yixian YU, Yanhua LI, Xueyi LV, Chuan WANG, Chao ZHANG. Application of Pneumoperitoneum Free Transvaginal Natural Orifice Endoscopic Surgery in Ectopic Pregnancy and Related Factors of Operation Time[J]. Journal of Kunming Medical University, 2022, 43(12): 125-130. doi: 10.12259/j.issn.2095-610X.S20221223

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Application of Pneumoperitoneum Free Transvaginal Natural Orifice Endoscopic Surgery in Ectopic Pregnancy and Related Factors of Operation Time

doi: 10.12259/j.issn.2095-610X.S20221223

Dept. of Gynecology，1st People’s Hospital，Kunming City， Kunming Yunnan 650011，China

Received Date: 2022-10-14
Available Online: 2022-11-24
Publish Date: 2022-12-25

Abstract

Abstract

Objective To investigate the application of pneumoperitoneum transvaginal natural orifice endoscopic surgery in ectopic pregnancy and the related factors affecting the operation time in the initial stage. Methods A total of 23 patients who were admitted to Kunming First People’s Hospital from July 2020 to November 2021, with stable vital signs, indicating for ectopic pregnancy surgery, and estimated internal bleeding < 800 mL, were selected as the study subjects. v-NOTES pregnancy tubal resection without air was performed. Another 23 patients who underwent peritoneal porous peritoneoscope tubal resection were selected as the control group. Results 23 patients in observation group were successfully resected without complications such as infection and rectal injury. The operation time of observation group was significantly longer than that of control group （P < 0.001）. There was no significant difference in postoperative exhaust time and hospital stay between the observation group and the control group （P > 0.05）. The NRS score and the first time out of bed after operation in the observation group were lower than those in the control group, and the differences were statistically significant （P < 0.05）. Further analysis of the operation time of pregnancy tubal resection under v-NOTES showed that the operation time under the laparoscope was significantly longer than the time of establishing the approach and suturing the vaginal mucosa, and the difference was statistically significant （P < 0.001）, and the time of laparoscopic operation gradually shortened with the increase of the number of cases undergoing surgery. The time to establish the approach and suture the vaginal mucosa was different according to the previous delivery mode, and those with a history of vaginal delivery had the shortest time, （P > 0.05）and the difference was not statistically significant. Conclusion v-NOTES salpingectomy is safe and effective for the surgical treatment of ectopic pregnancy. Patients with stable vital signs, less pelvic effusion, and no severe pelvic adhesions should be selected for surgery. Pneumoperitoneum v-NOTES reduces the difficulty of surgery by avoiding the risk of pneumoperitoneum, and is beneficial to intraoperative anesthesia management. It increases the safety of surgery by avoiding the use of disposable port, which does not increase the economic burden of patients, and is suitable for primary hospitals. The initial operation time was correlated with the patient’s previous delivery history, the volume of pelvic effusion, and the number of surgical cases.
- Gasless,
- Transvaginal natural orifice endoscopic surgery,
- Ectopic pregnancy,
- Fallopian tube resection,
- Operation time

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References(14)

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