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Incision, special tools aid minilaparotomy success. (Series of 30 Cases).

OB GYN News

| February 01, 2002 | Bates, Betsy | COPYRIGHT 2002 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

ORLANDO, FLA. -- Specialized tools and a properly executed incision are key in performing a minilaparotomy for large fibroid uteri or significant adnexal pathology when a vaginal hysterectomy is contraindicated, results of a feasibility study suggest.

Dr. Marco A. Pelosi II, a gynecologic surgeon in Bayonne, N.J., described the procedure at a meeting of the One Kilo Club. He said he has performed 30 minilaparotomies either in patients with uteri weighing 750 g or more or in those having very large benign cysts, he said.

Mean operating time in his feasibility study was 30 minutes, with no patient requiring a hospital stay of longer than 36 hours. Women returned to work, on average, within 12 days.

Dr. Pelosi uses a small cruciate-type incision. The 2.5- to 5-cm transverse incision is made in the abdomen, extending through skin and subcutaneous tissue. The rectus fascia and peritoneum are then incised in a vertical direction.

If there is a prior vertical incision or a high probability of malignancy, the first incision will be vertical, he said at the meeting held in conjunction with the 37th International College of Surgeons North American Federation Congress.

Soft internal and external rings of a low-cost (

"A sturdy uterine manipulator is paramount," since it will not break or dislodge during extreme uterine mobilization and elevation of the lower uterine structures, he added.

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