Posterior colpotomy for the retrieval of ovarian specimens in laparoscopy: a large case series

Effective tissue retrieval techniques continue to be a challenge in laparoscopic surgery. We aimed to determine the safety and efficacy of ovarian specimen retrieval via posterior colpotomy. This is a large case series study conducted in a large district general hospital. All patients in our unit who had ovarian specimens retrieved via posterior colpotomy over a 6-year period were included for analysis. A retrospective case notes review was performed. Information was collected on patient demographics, risk of malignancy indices, radiological size of the ovarian specimen, surgical spillage, postoperative complications, hospital stay duration, final histology results, gynaeoncology multidisciplinary meeting outcomes, and the eventual outcome on further intervention and survival. The main outcome measure was complication from posterior colpotomy. The secondary outcome was intra-abdominal surgical spillage and their subsequent outcomes. A total of 240 cases of posterior colpotomy tissue retrieval were analysed. There was one case of vault infection. Of 240 cases, 194 (81 %) were achieved without surgical spill and 46/240 cases (19 %) had surgical spillage. From the group of women with surgical spillage, there were no cases of chemical peritonitis. Seven women had borderline pathology and one woman had a malignant pathology (grade 1 endometrioid adenocarcinoma). All of the women who had borderline or malignant pathology remained disease-free at 2 years from the time of initial surgery. With appropriate preoperative assessments, posterior colpotomy is a safe and effective method of ovarian specimen retrieval in laparoscopy.