Date of Award

January 2018

Document Type


Degree Name

Medical Doctor (MD)



First Advisor

Masoud Azodi


Study Objective: To study the safety, feasibility and patient satisfaction of posterior colpotomy technique as a port site and to retrieve specimen in benign gynecology.

Design: Retrospective chart review (Canadian Task Force Classification II-2) and retrospective survey administration and validation.

Settings: Two tertiary care hospitals, one academic and one community setting.

Patients: Fifty-four (54) women who underwent adnexal surgery with/without hysterectomy for benign indications from February 2013 till August 2017.

Interventions: The procedures were performed via conventional laparoscopy. Posterior colpotomy was the intervention of interest and was utilized to minimize abdominal incision sites/numbers for better cosmesis.

Main Results: Average patient age was 53.6 ± 10.0 years and BMI was 27.8 ± 6.2 kg/m2. Parity ranged from 0 to 7. Forty-six percent (46%) of the patients had prior abdominal or pelvic surgery (25/54). Procedures included unilateral/ bilateral salpingectomy and oophorectomy (63%); unilateral/ bilateral salpingectomy only (4%), or laparoscopic-assisted vaginal hysterectomy (LAVH) (33%). Four percent (4%) of women had a colpotomy incision only (2/54), and a vast majority (83%) of women had two abdominal incisions and a colpotomy incision (45/54). The abdominal incision size was 5 mm in 98% of the patients. Operative time was 78 ± 32 minutes and estimated blood loss (EBL) was 53 ± 120 mL. Length of hospital stay (LOS) was 0.7 ± 0.7 days. Total specimen weight was 80 ± 77 g. There were no major intra-operative or post-operative complications. In addition, no patients had postoperative vaginal infections or pelvic abscesses. There were no readmissions in 30 days. Thirty-two patients (59%) filled out the satisfaction survey at 4-week postoperative visit. They were either very satisfied (84%) or satisfied (16%) with surgical results.

Conclusion: Minimally invasive gynecologic surgeons should consider using posterior colpotomy in order to minimize the number and size of abdominal incisions when performing benign gynecologic surgery.


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