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Displaying One Session

On Demand Hall

Session Type
Surgical Film Cinema
Room
On Demand Hall
Date
08/30/2021

TRANSVAGINAL ENDOSCOPIC RESECTION (TVER) OF INVASIVE VAGINAL LESION (ID 197)

Abstract

Abstract Body

OBJECTIVE: This video demonstrates a novel surgical technique for excision of an invasive vaginal lesion using a single port laparoscopic access device.

STUDY METHODS: A 31 year old female with a history of SLE on azathioprine presented with recurrent HSIL of cervix. A LEEP showed microinvasion measuring 2 mm and a vaginal fornix biopsy showed HSIL, but was clinically suspicious for invasion. The patient underwent a transvaginal endoscopic resection (TVER) of the lesion for diagnostic purposes.

A single port laparoscopic access device was used for colpo-pneumo-occlusion. The endoscope was inserted into the vagina, and the 1.5 cm lesion was resected with margins of 5 mm under direct visualization using monopolar cautery. The mucosa edges were reapproximated with V-lock suture.

RESULTS: Pathology showed squamous mucosa with high-grade vaginal intraepithelial neoplasia and a focal area of invasion (with depth of invasion <1 mm). The patient tolerated the procedure well and was discharged from Day Surgery without any postoperative complications.

CONSLUSION: Transvaginal endoscopic resection for superficially invasive vaginal lesions can be performed safely and provide accurate diagnosis with excellent visualization.

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