Safe Trocar Placement by Transvaginal Endoscopic Insertion in Robot‐Assisted Surgery for Endometrial Cancer With Umbilical Incisional Hernia and Prior Mesh Repair: Two Case Reports
We report two cases of endometrial cancer with umbilical incisional hernia or prior mesh repair, in which robot‐assisted surgery was safely performed using transvaginal laparoscope insertion. Both patients had prior abdominal surgeries, and preoperative imaging raised concerns about adhesions or mesh near the umbilicus, making conventional trocar insertion risky. A laparoscope was inserted via the posterior vaginal fornix, allowing real‐time intra‐abdominal visualization and safe port placement under direct vision. In one case, mesh and adhesions were confirmed at the umbilicus. In the other, no adhesions were found within the hernia sac despite being suspected preoperatively, whereas dense adhesions were identified at Palmer's point, which could not be fully characterized by imaging alone. These cases highlight the limitations of relying solely on imaging and underscore the utility of intraoperative visual assessment. Transvaginal scope insertion offers a simple, reproducible method to enhance trocar safety. To our knowledge, no previous reports have described this technique used solely for observation in robot‐assisted surgery for endometrial cancer.
No keywords indexed for this article. Browse by subject →
Roland W. Luijendijk, Wim C.J. Hop, M. Petrousjka van den Tol et al.
- Published
- Jan 01, 2026
- Vol/Issue
- 19(1)
- License
- View
Department of Obstetrics and Gynecology Iwate Medical University Shiwa Iwate Japan
Department of Obstetrics and Gynecology Iwate Medical University Shiwa Iwate Japan
You May Also Like
Tan To Cheung, Ka Wing Ma · 2018
40 citations
T Kimura, T Mori · 2010
28 citations
Megumi Sasaki, Yasumitsu Hirano · 2022
25 citations
Shoji Shimada, Yoshiaki Hara · 2016
15 citations
Hidefumi Shiroshita, Masafumi Inomata · 2024
14 citations