The Fresh Frozen Cadaveric Study of Direct Pouch of Douglas Laparoscopic and Robotic Trocar Insertion for Vaginal Natural Orifice Transluminal Endoscopic Surgery.

Journal of Minimally Invasive Gynecology
Jonia AlshiekS Abbas Shobeiri

Abstract

To determine the distances and angles that assure a safe entry into the pouch of Douglas (POD) during blind laparoscopic and robotic trocar entry. Trocars were inserted into the POD of 4 intact fresh frozen female pelves. Cadaveric dissection was performed, and the distance from the POD to the sacrum at rest and with maximal pressure to POD with the trocar was measured. In addition, the optimal angle for trocar insertion and entry was evaluated. Inova Advanced Simulation and Technology Evaluation Center. Fresh frozen cadavers with intact reproductive organs. Vaginal POD trocar insertion. Measurements were recorded from the sacrum to the POD at rest and from the sacrum to the hymen with trocar pressure. The dissection demonstrated correct trocar placement in the POD of human cadaveric specimens. The mean distances from the sacrum to the hymen, the sacrum to the POD, and the sacrum to the POD with pressure were 18.75 cm, 9.75 cm, and 7.25 cm, respectively. After the deployment of the trocar, the tip was observed to be 2 cm below the cervix in the POD. The mean trocar angle to clear the sacral promontory and the neurovascular structures without injury to the uterus was 25° to 40° from the horizontal plane and 15° to 30° from the c...Continue Reading

References

Aug 1, 1994·American Journal of Obstetrics and Gynecology·M B Harris, D L Olive
Mar 23, 2011·Journal of Minimally Invasive Gynecology·Su-Yen KhongAlan Lam
Nov 20, 2012·BJOG : an International Journal of Obstetrics and Gynaecology·S Abbas ShobeiriL H Quiroz
Jul 23, 2014·JAMA : the Journal of the American Medical Association·Jason D WrightDawn L Hershman
May 27, 2015·Journal of Minimally Invasive Gynecology·Jan Baekelandt
Jul 26, 2017·Current Opinion in Gastroenterology·Joern BernhardtPeter N Meier
Jan 1, 2017·Gynecology and Minimally Invasive Therapy·Naoyuki Yoshiki
Oct 27, 2018·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Mathew LeonardiGeorge Condous
May 1, 2019·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Le Chi ChiuGeorge Condous

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Citations

Sep 20, 2021·Anatomical Sciences Education·Yong Keun Song, Dong Hyun Jo

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