In-Bag extraction tissue through the middle part incision of posterior vagina in laparoscopic myomectomy：a large retrospective study

Background: To describe the outcomes of in-bag extraction tissue through the middle part incision of posterior vagina in laparoscopic myomectomy. Methods: This was a retrospective study of patients with laparoscopic myomectomy who underwent the middle part incision of posterior vagina to extraction tissue in bag between January 2016 and December 2022. We collected and analyzed data about patients’ characteristics, main indication for surgery, and intra- and postoperative complications.There were 37 cases of vaginal delivery of pregnant women after operation, and there was no laceration of the incision of the posterior wall of the vagina after delivery. Results: A total of 511women underwent transvaginal specimen retrieval after laparoscopic myomectomy (mean largest myoma diameter: 8.44 ± 3.56cm; mean specimen weight: 789.23 ± 276.97g; mean operative time: 129.01 ± 53.13minutes; mean blood loss: 175.99 ± 210.96 mL). Within 30-days, no fever, infection, or vaginal bleeding, and the vaginal incisions healed well after 30 days of outpatient review.There was no incisional hernia, pelvic infection and vaginal adhesions during follow-up 3 months after operation. Conclusions: The middle part incision of posterior vagina and in-bag transvaginal extraction can be considered a feasible technique at laparoscopic myomectomy.