A case of rectal injury due to vaginal pipe misinsertion during total laparoscopic hysterectomy

Total laparoscopic hysterectomy (TLH) is one of the techniques feasible for the treatment of myoma. Our department has performed more than 1,000 laparoscopic hysterectomies since 2014. In our department, these surgeries are performed by a supervising doctor, operator, and a first assistant who is of...

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Main Authors: Yuki Yoshimura, Kentaro Nakayama, Kiyoka Sawada, Hitomi Yamashita, Kohei Nakamura, Tomoka Ishibashi, Masako Ishikawa, Sultana Razia, Seiya Sato, Satoru Kyo
Format: Article
Language:English
Published: IMR Press 2021-02-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/48/1/10.31083/j.ceog.2021.01.2170
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author Yuki Yoshimura
Kentaro Nakayama
Kiyoka Sawada
Hitomi Yamashita
Kohei Nakamura
Tomoka Ishibashi
Masako Ishikawa
Sultana Razia
Seiya Sato
Satoru Kyo
author_facet Yuki Yoshimura
Kentaro Nakayama
Kiyoka Sawada
Hitomi Yamashita
Kohei Nakamura
Tomoka Ishibashi
Masako Ishikawa
Sultana Razia
Seiya Sato
Satoru Kyo
author_sort Yuki Yoshimura
collection DOAJ
description Total laparoscopic hysterectomy (TLH) is one of the techniques feasible for the treatment of myoma. Our department has performed more than 1,000 laparoscopic hysterectomies since 2014. In our department, these surgeries are performed by a supervising doctor, operator, and a first assistant who is often insufficiently experienced. There are several types of injuries that can occur during laparoscopic surgery; however, cases in which the vaginal pipe is inserted incorrectly are very rare. Here, we report the case of a 47-year-old nulliparous woman who experienced a rectal injury caused by the misinsertion of a vaginal pipe into the rectum. Seven years prior, she had undergone a myomectomy for leiomyomas. Later, she developed recurrent leiomyomas and worsening hypermenorrhea; therefore, she underwent a total laparoscopic hysterectomy. During the operation, the first assistant usually inserts a vaginal pipe into the vagina when the vaginal wall is cut. In this case, when the vaginal wall was cut, the vaginal pipe was inserted into the rectum, and the rectal wall was incised, allowing communication between the rectum and vagina. The rectum was repaired with the support of a gastroenterological surgeon, and the operation was completed laparoscopically. On the 7th postoperative day, an enema was performed to confirm that no leaks were present, and feeding was restarted. The patient was discharged home on the 17th postoperative day. The current case highlights the necessity of surgeons to be aware of various factors when performing this procedure to prevent complications, even those that are rare.
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spelling doaj-art-be8795de449d43ff9ab81ddc8767142f2025-08-20T02:00:33ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632021-02-0148119419710.31083/j.ceog.2021.01.2170S0390-6663(21)00067-1A case of rectal injury due to vaginal pipe misinsertion during total laparoscopic hysterectomyYuki Yoshimura0Kentaro Nakayama1Kiyoka Sawada2Hitomi Yamashita3Kohei Nakamura4Tomoka Ishibashi5Masako Ishikawa6Sultana Razia7Seiya Sato8Satoru Kyo9Department of Obstetrics and Gynecology, Shimane University, 685-0005 Shimane, JapanDepartment of Obstetrics and Gynecology, Shimane University, 685-0005 Shimane, JapanDepartment of Obstetrics and Gynecology, Shimane University, 685-0005 Shimane, JapanDepartment of Obstetrics and Gynecology, Shimane University, 685-0005 Shimane, JapanDepartment of Obstetrics and Gynecology, Shimane University, 685-0005 Shimane, JapanDepartment of Obstetrics and Gynecology, Shimane University, 685-0005 Shimane, JapanDepartment of Obstetrics and Gynecology, Shimane University, 685-0005 Shimane, JapanDepartment of Obstetrics and Gynecology, Shimane University, 685-0005 Shimane, JapanDepartment of Obstetrics and Gynecology, Shimane University, 685-0005 Shimane, JapanDepartment of Obstetrics and Gynecology, Shimane University, 685-0005 Shimane, JapanTotal laparoscopic hysterectomy (TLH) is one of the techniques feasible for the treatment of myoma. Our department has performed more than 1,000 laparoscopic hysterectomies since 2014. In our department, these surgeries are performed by a supervising doctor, operator, and a first assistant who is often insufficiently experienced. There are several types of injuries that can occur during laparoscopic surgery; however, cases in which the vaginal pipe is inserted incorrectly are very rare. Here, we report the case of a 47-year-old nulliparous woman who experienced a rectal injury caused by the misinsertion of a vaginal pipe into the rectum. Seven years prior, she had undergone a myomectomy for leiomyomas. Later, she developed recurrent leiomyomas and worsening hypermenorrhea; therefore, she underwent a total laparoscopic hysterectomy. During the operation, the first assistant usually inserts a vaginal pipe into the vagina when the vaginal wall is cut. In this case, when the vaginal wall was cut, the vaginal pipe was inserted into the rectum, and the rectal wall was incised, allowing communication between the rectum and vagina. The rectum was repaired with the support of a gastroenterological surgeon, and the operation was completed laparoscopically. On the 7th postoperative day, an enema was performed to confirm that no leaks were present, and feeding was restarted. The patient was discharged home on the 17th postoperative day. The current case highlights the necessity of surgeons to be aware of various factors when performing this procedure to prevent complications, even those that are rare.https://www.imrpress.com/journal/CEOG/48/1/10.31083/j.ceog.2021.01.2170uterine leiomyomarectal injurytotal laparoscopic hysterectomy
spellingShingle Yuki Yoshimura
Kentaro Nakayama
Kiyoka Sawada
Hitomi Yamashita
Kohei Nakamura
Tomoka Ishibashi
Masako Ishikawa
Sultana Razia
Seiya Sato
Satoru Kyo
A case of rectal injury due to vaginal pipe misinsertion during total laparoscopic hysterectomy
Clinical and Experimental Obstetrics & Gynecology
uterine leiomyoma
rectal injury
total laparoscopic hysterectomy
title A case of rectal injury due to vaginal pipe misinsertion during total laparoscopic hysterectomy
title_full A case of rectal injury due to vaginal pipe misinsertion during total laparoscopic hysterectomy
title_fullStr A case of rectal injury due to vaginal pipe misinsertion during total laparoscopic hysterectomy
title_full_unstemmed A case of rectal injury due to vaginal pipe misinsertion during total laparoscopic hysterectomy
title_short A case of rectal injury due to vaginal pipe misinsertion during total laparoscopic hysterectomy
title_sort case of rectal injury due to vaginal pipe misinsertion during total laparoscopic hysterectomy
topic uterine leiomyoma
rectal injury
total laparoscopic hysterectomy
url https://www.imrpress.com/journal/CEOG/48/1/10.31083/j.ceog.2021.01.2170
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