JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY
Online ISSN : 1884-5746
Print ISSN : 1884-9938
Case report
A case of rectal injury due to rectal insertion of a vaginal delineator during total laparoscopic hysterectomy
Shinichi HoshiTomoko TanakaTakashi HaraMegumi ShibataShoichi WatanabeTsutomu ArakiShigeo Akira
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2020 Volume 36 Issue 1 Pages 199-202

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Abstract

  We report a case of rectal injury due to accidental insertion of a vaginal delineator into the rectum during total laparoscopic hysterectomy.

  A 48-year-old nulligravid woman underwent laparoscopic hysterectomy because of excessive menstruation due to uterine fibroids. The uterine manipulator was removed before cutting the vaginal wall, and a vaginal delineator was inserted. Although there was some resistance to insertion, it was thought that the delineator was guided to the correct position under the laparoscope. We noticed accidental rectal insertion, and laparotomy was performed to repair the damaged rectum.

  The muscles of the anus relax under anesthesia, and even a vaginal delineator, which is difficult to insert without anesthesia, can be guided into the rectum easier than into the narrow vagina. Furthermore, it is difficult for the surgeon to detect incorrect insertion in laparoscopic view.

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© 2020 Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy
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