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Takase Y, Tomizawa N, Enokida Y, et al. A case of splenic metastasis of ovarian cancer treated with complete laparoscopic splenectomy and transvaginal specimen extraction. Surg Case Rep. 2016;2(1):26doi: 10.1186/s40792-016-0150-9.
Takase, Y., Tomizawa, N., Enokida, Y., Shiraishi, T., Katoh, R., Suto, Y., Sato, H., Muroya, K., Kurosaki, R., Kobayashi, K., Arakawa, K., Ando, T., & Takesyohi, I. (2016). A case of splenic metastasis of ovarian cancer treated with complete laparoscopic splenectomy and transvaginal specimen extraction. Surgical case reports, 2(1), 26. https://doi.org/10.1186/s40792-016-0150-9
Takase, Yoshiaki, et al. "A case of splenic metastasis of ovarian cancer treated with complete laparoscopic splenectomy and transvaginal specimen extraction." Surgical case reports vol. 2,1 (2016): 26. doi: https://doi.org/10.1186/s40792-016-0150-9
Takase Y, Tomizawa N, Enokida Y, Shiraishi T, Katoh R, Suto Y, Sato H, Muroya K, Kurosaki R, Kobayashi K, Arakawa K, Ando T, Takesyohi I. A case of splenic metastasis of ovarian cancer treated with complete laparoscopic splenectomy and transvaginal specimen extraction. Surg Case Rep. 2016 Dec;2(1):26. doi: 10.1186/s40792-016-0150-9. Epub 2016 Mar 14. PMID: 26976616; PMCID: PMC4791445.
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Surg Case Rep. 2016 Dec;2(1):26. doi: 10.1186/s40792-016-0150-9. Epub 2016 Mar 14.

A case of splenic metastasis of ovarian cancer treated with complete laparoscopic splenectomy and transvaginal specimen extraction.

Surgical case reports

Yoshiaki Takase, Naoki Tomizawa, Yasuaki Enokida, Takuya Shiraishi, Ryuji Katoh, Yujin Suto, Hiroaki Sato, Ken Muroya, Ryo Kurosaki, Katsumi Kobayashi, Kazuhisa Arakawa, Tatsumasa Ando, Izumi Takesyohi

Affiliations

  1. Maebashi Red Cross Hospital, 3-21-36 Asahi-chou, Maebashi, Gunma, 371-8511, Japan.
  2. Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, 371-0014, Japan.
  3. Maebashi Red Cross Hospital, 3-21-36 Asahi-chou, Maebashi, Gunma, 371-8511, Japan. [email protected].
  4. Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, 371-0014, Japan. [email protected].

PMID: 26976616 PMCID: PMC4791445 DOI: 10.1186/s40792-016-0150-9

Abstract

A 61-year-old woman was diagnosed with right inguinal lymph node and splenic metastasis of ovarian serous cystadenocarcinoma. We performed right inguinal lymph node dissection and total laparoscopic splenectomy in the supine position followed by transvaginal specimen extraction (TVSE). First, using three ports, we extracted the right inguinal lymph node. We repaired the posterior wall of the inguinal canal using a mesh plug. We added two ports and displaced the spleen from the retroperitoneum and lifted it using a snake retractor, disconnecting the hilum using an automatic suturing device. Next, the posterior wall of the vagina was intraperitoneally incised. And an Alexis® laparoscopic system was inserted into the vagina. The cap maintained aeroperitoneum, a collection bag was inserted in the abdominal cavity via the vagina, and the spleen was collected. When the spleen was removed from the body, partial fragmentation of the organ was required in the bag. Organ fragmentation was performed only within the bag, and we made sure not to tear the bag. The vaginal wound was laparoscopically sutured. The patient had no operative complications and was able to actively ambulate at the first day after surgery due to a slight postoperative pain. Total laparoscopic splenectomy with TVSE in the supine position may be a safe and feasible method for selected female patients. This technique enables minimally invasive surgery for female patients with splenic disease.

Keywords: Laparoscopic surgery; Natural orifice specimen extraction; Splenectomy; Transvaginal specimen extraction

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