This document discusses removing ovarian tumors vaginally. It presents data from a study of 297 patients who underwent surgery for ovarian tumors from 2009 to 2013. 43 tumors were removed vaginally. Vaginal removal was found to have less blood loss, fewer complications like bowel or ureteric injuries, less pain, and no wound infections compared to abdominal removal, while having similar operative times. The conclusion is that with experience, vaginal surgery can remove even large ovarian tumors with fewer complications than abdominal surgery.

1. REMOVAL OF OVARIAN TUMOURS VAGINALLY
AUTHOR- DR. ASHOK R. ANAND
INTRODUCTION
Vaginal Surgery is the art of surgery.
 Vaginal surgeries are painless scar less least
invasive, even large tumors can also be removed
vaginally.
In our study, we have removed very large ovarian
tumors vaginally after excluding malignancy.
AIMS & OBJECTIVES
To remove ovarian tumours vaginally .
To compare the results with that of abdominal approach
in relation with operative time, blood loss, intra and
postoperative complications, pain and hospital stay.
MATERIALS & METHODS
All the women with ovarian tumours were subjected
for USG, CT scan &/or MRI scan to know whether tumour
is unilateral or bilateral ,cystic, solid cystic or solid,
presence or absence of ascites & for the presence of
metastasis.
Doppler studies to study the vascularity of tumour.
Tumour markers like CA-125, CEA, AFP or B-hCG.
Frozen section was arranged in all.
SELECTION CRITERIA
Women with benign ovarian neoplasms of any size
(Cystic) & semisolid or solid with less than 14cms &
clinically no adhesions.
 Women requiring hysterectomy along with ovarian
tumour were chosen for vaginal removal.
OBSERVATIONS
Period of study: 2009 to 2013
Total no. of patients operated: 297
Patients with OVARIAN MALIGNANCIES :36
Patients with BORDERLINE TUMOURS: 9
Patients with BENIGN SOLID TUMOURS:27
Patients with BENIGN CYSTIC TUMOURS:182
Patients OPERATED VAGINALLY: 43
No tumour removed vaginally had malignancy on
histopathology.
CONCLUSIONS
Practise makes the person perfect.
With more and more experience with NDVH, we are
more competent & confident to perform different and
difficult surgeries vaginally
We are vaginal surgeons.
If we start doing whatever is necessary and then do what
is possible, we can do amazing things.
We must aim for the targets that are further higher
faster than anything ever done before.
In simple terms it would mean trying to do our jobs a
little bit better than we did yesterday.
Always be ready to walk that extra mile.
ABDOMINAL VAGINAL
BLOOD LOSS 300-400 ML 100-150 ML
OPERATIVE TIME 1.5- 2 HR 1.5- 2 HR
BOWEL INJURY 5 NIL
URETERIC INJURY 3 NIL
BLADDER INJURY 3 NIL
WOUND INFECTION 11 NIL
PAIN MORE LESS