Peritoneal Contamination Uncommon During Transvaginal Cholecystectomy

Pratibh Vemulapalli, MD, Harvey C Rainville, MD, Emanuel Agaba, MD, Diego Camacho, MD, Scott Chudnoff, MD. Montefiore Medical Center and Albert Einstein College of Medicine

Background: The transvaginal laparoscopic approach to performing abdominal surgery requires the placement of a port in the vaginal canal. There is concern about intraabdominal contamination of the peritoneal cavity with vaginal flora. Currently the only documented studies on the subject consist of animal models. We propose that with a standard surgical preoperative preparation there is no risk of contamination.

Methods: This is a prospective study of 5 consecutive patients with symptomatic cholelithiasis who underwent transvaginal laparoscopic cholecystectomy. All patients’ abdomen and vaginal canal were prepped with standard povodine scrub followed by aqueous povodine solution. Pre and post procedure cultures of the vagina and the peritoneal fluid were then taken to assess the presence of intraabdominal contamination.

Results: Culture results demonstrated no cross contamination of vaginal organisms into the peritoneal cavity. In one case there was post procedure growth of E coli in the peritoneal cavity that was not present in the vaginal culture and was likely derived from biliary spillage that occurred during transvaginal extraction of the gallbladder.

Conclusion: The transvaginal laparoscopic approach provides a safe method of performing cholecystectomy without significant risk of peritoneal contamination with vaginal organisms.

Session: Emerging Technology Poster
Program Number: ETP099
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