Posterior colpotomy (colpotomia posterior) with inflammation of the uterine appendages and neoplasms in them

In 1892, in The Doctor, I published my first article the removal of the uterine appendages and their neoplasms through the vagina. In this article, on the basis of my clinical observations, I recommended for some cases a new surgical method for removing large appendages of the uterus and their neoplasms through the posterior fornix. This article of mine caused only one critical note by Dr. Tipyakov in the same "Doctor" in which he spoke out against this operation. I replied to this article with a second article, also in Physician for the same 1892, in which I proved with new clinical observations the relevance and superiority of this operation before gluttony in certain cases. Then, until 1895, no attention was paid to my proposal, and only from that time, when the question of vaginae fixatio uteri began to be developed in German literature, and then when prof. Dhrssen's proposal to remove uterine appendages and some neoplasms of the uterus using colpotomiae anterior, since that time the question of the significance of colpotomiae anterior et posterior for removing diseased uterine appendages and their neoplasms has become fashionable on the pages of the special medical press. At the present time, the literature on this issue is quite large and I will not expound it here, since this issue will be examined in detail in a special work of my friend Dr. P. Ya. Teplov, which will soon appear in print. I currently wish only to summarize my clinical data on posterior colpotomia.

“Vaginal Delivery”: A Novel Extraction Route for Large Renal Calculi Encountered During Laparoscopic Pyeloplasty

Background: To describe a simple, novel stone extraction technique using the transvaginal route for large renal calculi encountered during laparoscopic/robotic pyelolithotomy. Methods: After a standard approach laparoscopic pyelolithotomy in a patient with a large (42 × 36 mm) pelvic calculus, Anderson-Hynes pyeloplasty was performed. A transverse posterior colpotomy was performed laparoscopically with the assistance of the Colpassist Vaginal Positioning Device (Boston Scientific) and the calculus was extracted, intact, through the vagina with the aid of an endoscopic retrieval bag. The vaginal incision was then closed intra-corporeally. A systematic review on the topic was also performed. Results: The stone was removed in its entirety through an occult vaginal incision. There were no complications reported and the patient was stone free at follow-ups. Conclusions: This simple, novel technique is an easily reproducible method, for the removal of large urinary calculi during either traditional laparoscopic or robotic-assisted laparoscopic stone surgery in the appropriate female patient. It avoids the need for additional abdominal incisions or complex techniques involving lithotripsy which may be more complicated and time consuming. All previously published stone extraction techniques for large calculi (greater than 20 mm) within this systematic review are also critically appraised.