Laparoscopically assisted colpotomy with the Pelosi illuminator and Visiport trocar system.

OBJECTIVE

To describe a technique for laparoscopically assisted colpotomy.

STUDY

DESIGN

The Pelosi endoscopic illuminator and Visiport trocar system were combined to perform visually guided transvaginal colpotomy. Thirty-five consecutive laparoscopic gynecologic cases necessitating cul-de-sac entry were approached with this technique.

RESULTS

The technique was performed successfully in all 35 cases without complications or technical difficulties and with an average colpotomy time of 3.5 minutes. Indications for colpotomy included removal of laparoscopic supracervical hysterectomy specimens, myomata, large adnexal cysts and large tubal pregnancy.

CONCLUSION

This colpotomy technique is quick, efficient and easy to perform. Advantages include retention of pneumoperitoneum, facilitated transvaginal insertion of instrumentation to remove pelvic masses, avoidance of an electrosurgical or laser incision, and complete visual control, which minimizes the possibility of traumatic injury to bowel and other pelvic structures.