Total Laparoscopic Hysterectomy with a Transvaginal Tube

Several techniques of laparoscopic hysterectomies have been described, but loss of carbon dioxide (CO 2) pneumoperitoneum is still a problem when the vagina is incised and the specimen has been removed. Our technique allows maintenance of CO 2 pneumoperitoneum by inserting a silicone tube into the vagina. The McCartney tube is open at its vaginal (proximal) end and a cap covers the outer distal end. The total hysterectomy specimen, adnexa, and, if necessary, lymph nodes can be easily removed through the tube.