Ovarian Cystectomy by Vaginal Natural Orifice Transluminal Endoscopic Surgery at 12 Weeks of Pregnancy: A Case Report
Kotone Suzuki, Mai Shimura, Ayaka Yukimori, Hana Ueda, Rena Maeda, Satomi Arakawa, Mari Ishizaka, Riho Sato, Asumi Mishina, Yoshiko Arata, Tatsuya Matsunaga, Yuka OiAbstract
We report a rare case of bilateral ovarian tumor resection using vaginal natural orifice transluminal endoscopic surgery (vNOTES) at 12 weeks of gestation. A 33-year-old primigravida presented with two cystic ovarian masses, wherein bilateral mature teratomas were suggested based on magnetic resonance imaging. Given the risks associated with the masses during pregnancy, vNOTES was the preferred surgical approach. The tumors were extracorporeally resected after aspiration through the posterior vaginal fornix. The postoperative course was uneventful, without complications. The patient delivered vaginally at 40 weeks without severe perineal injury. vNOTES enabled safe and direct access to the tumors without uterine manipulation or abdominal incisions. vNOTES offers advantages including reduced postoperative pain, shorter operative time and hospital stay, and lower complication rates compared with conventional transabdominal laparoscopy. In addition, during pregnancy, accessing lesions in the Douglas pouch and minimizing postoperative uterine contractions might be particularly useful.