Retroperitoneal Myolipoma Excision Via vNOTES

Document Type

Conference Proceeding

Publication Date

11-1-2023

Publication Title

J Minim Invasive Gynecol

Abstract

Study Objective: To illustrate the excision of a retroperitoneal myolipoma via VNOTES (vaginal natural orifice transluminal endoscopic surgery). Design: Stepwise demonstration of surgical technique with narrated video footage. Setting: Myolipoma is a rare benign soft tissue tumor composed of smooth muscle cells and adipocytes. It can occur in different locations including the retroperitoneal space, abdominal cavity, pericardium and spinal cord. Retroperitoneal myolipoma can be misdiagnosed radiologically as ovarian teratoma due to the adipose tissue component and location in the pelvis. Techniques used until now by gynecologic surgeons for retroperitoneal mass resection were either classic laparoscopy or laparotomy. This video highlights the vaginal approach. Patients or Participants: 65-year-old female who presented with right flank pain. Pelvic ultrasound and MRI revealed a 7 × 6 × 4 cm pelvic mass concerning for right ovarian dermoid. Interventions: VNOTES approach for resection of retroperitoneal mass with concomitant bilateral salpingoophorectomy. Measurements and Main Results: The key surgical steps are as follows: • Review of pelvic anatomy from VNOTES perspective. • Identification of retroperitoneal mass. • Techniques to increase surgical exposure from vaginal approach. • Dissection of retroperitoneal space with care to avoid the ureter. • Resection of myolipoma. Conclusion: This video demonstrates that with appropriate identification of key anatomical landmarks and surgical technique, vNOTES is a feasible procedure for retroperitoneal mass excision.

Volume

30

Issue

11

First Page

S62

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