Abstract：
We aimed to determine whether intraoperative ultrasound is a feasible tool for visualization of the pouch of Douglas (POD) to facilitate a safe vaginal entry for direct robotic vaginal trocar insertion for pelvic floor surgery. Endovaginal ultrasound-guided needle insertion of a trocar into the POD was performed in six fresh frozen female cadavers and a live sheep animal model. Using an endovaginal probe the POD was identified as a fluid-filled space clear of bowel or adhesions, then a Veress needle was also used to confirm POD localization. Access to the POD was achieved using a robotic trocar designed for this purpose. The animal study was approved by the Ethics Committee of Asaf-Harofe hospital. Direct visualization during laparoscopy in cadavers and open cadaveric dissections confirmed safe POD entry and accurate trocar placement. This method was found feasible in the development of a safe vaginal entry in both the animal and cadaveric model, possibly negating the need for laparoscopic umbilical observation.
摘要：
我们旨在确定术中超声是否是可视化道格拉斯袋（POD）的可行工具，以促进安全的阴道进入，以直接插入用于盆底手术的机器人阴道套管针。在六个新鲜冷冻的雌性尸体和活羊动物模型中，进行了阴道超声引导下将套管针插入POD的针插入。使用阴道内探针，POD被确定为充满液体的空间，没有肠或粘连。然后使用Verress针确认POD定位。使用为此目的设计的机器人套管针来实现对POD的访问。动物研究由Asaf-Harofe医院的伦理委员会批准。在尸体腹腔镜检查和开放式尸体解剖过程中的直接可视化确认了安全的POD进入和准确的套管针放置。发现该方法在动物和尸体模型中的安全阴道进入开发中是可行的。可能不需要腹腔镜脐带观察。
