Mini-Laparoscopy of Removal (Partial) Adnexae at the Time of Hysterectomy (original) (raw)
Mini-laparoscopic total hysterectomy: A case report
Journal of Turkish Society of Obstetric and Gynecology, 2014
Hysterectomy is one of the most common gynecological procedures in the world and because of well-known many advantages such as shorter hospital stay and faster recovery, decreased postoperative pain and better cosmetic results laparoscopic aproach is being widely performed. One of these current procedures is minilaparoscopic total hysterectomy. To the best of our knowledge, this case is the first minilaparoscopic total hysterectomy case in our country performed to a patient diagnosed with uterin fibroid. In this case report we evaluated the technique, advantages and disadvantages of the minilaparoscopic hysterectomy.
Journal of evolution of medical and dental sciences, 2014
BACKGROUND: The Laparoscope is a precise diagnostic tool. Laparoscopy represents a considerable advance in the early and accurate diagnosis and management of pelvic pathologic conditions. Laparoscopy now provides the gynecologist valuable information necessary for the choice of treatment in case of adnexal pathology. The present study carried out with the objective to evaluate the role of laparoscopy in diagnosis of adnexal pathology and management of it. METHODOLOGY: The present prospective study carried among women attending outpatient department of gynecology having Adnexal pathology at tertiary care center located in Maharashtra over the period of two years. The data analyzed for frequency distributions showing number and percentages were generated for each identified variables. RESULTS: Total 32 laparoscopies were performed in patients who attended the gynecology department over a period of 2 years. The majority having suspected ectopic pregnancy (37.5%) & ovarian cyst (37.5%).The majority of patients came with history of abdominal pain (62.5%) and lump in abdomen (21.87%). Most common laparoscopic procedure carried out for tubal ectopic pregnancies in study was salpingectomy (55.50%) and Cystectomy (53%) was done for ovarian mass. Difficulties encountered during laparoscopic procedure were removal of large adnexal masses (3.1%) and misplaced IUCD (3.1%).The complication observed was drainage of cyst (6.2%)during intraoperative while pain in abdomen (25%), vomiting (9%) post-operative procedure of laparoscopy. CONCLUSION: The study concludes for evaluation and management of adnexal pathology laparoscopy should be considered the method of choice as it offers the advantages of fewer postoperative adhesions, reduced pain, technically feasible, safe, and better cosmetic results.
Laparoscopic Hysterectomy: A Minimally Invasive Approach to Gynecological Surgery
Hysterectomy, the surgical removal of the uterus, is a common procedure performed to address various gynecological conditions. Over the years, laparoscopic hysterectomy has gained prominence as a preferred approach due to its numerous advantages, including reduced postoperative pain, shorter hospital stays, and faster recovery. This abstract provides an overview of the key aspects of laparoscopic hysterectomy, encompassing patient selection, surgical techniques, outcomes, and recent advancements. Patient selection plays a pivotal role in achieving successful outcomes in laparoscopic hysterectomy. The abstract discusses criteria for selecting appropriate candidates, taking into account factors such as the indication for surgery, uterine size, and patient preferences. It underscores the importance of individualized treatment plans and comprehensive preoperative evaluation. The surgical techniques employed in laparoscopic hysterectomy, including laparoscopic-assisted vaginal hysterectomy (LAVH), total laparoscopic hysterectomy (TLH), and robotic-assisted laparoscopic hysterectomy, are detailed to provide a comprehensive understanding of the procedure. The abstract highlights the benefits of laparoscopy, including smaller incisions, reduced postoperative pain, and quicker recovery times. Clinical outcomes associated with laparoscopic hysterectomy are also discussed, focusing on improved patient satisfaction, shorter recovery times, and lower rates of complications. Potential complications and their management are addressed, emphasizing the significance of surgical expertise in minimizing adverse events. Furthermore, recent advancements in laparoscopic hysterectomy, such as the use of advanced energy devices, enhanced imaging modalities, and innovative suturing techniques, are highlighted. These innovations have contributed to enhancing the precision and success rates of the procedure while minimizing potential risks. In conclusion, laparoscopic hysterectomy has emerged as a highly effective and minimally invasive approach to address a wide range of gynecological conditions. This abstract provides an overview of the key aspects and recent advancements in this field, underlining its potential to significantly improve patient outcomes and the overall experience of women undergoing hysterectomy.
Laparoscopic vs vaginal hysterectomy for benign pathology
American Journal of Obstetrics and Gynecology, 2009
The objective of the study was to compare length of stay, blood loss, operative time, and pain of laparoscopic and vaginal hysterectomy. STUDY DESIGN: This was a prospective, randomized, controlled comparison between vaginal (VH) and laparoscopic (LH) hysterectomy among 60 consecutive patients with a uterine volume of 300 mL or less and without uterine prolapse. Patients were followed up for 12 months. RESULTS: The groups were significantly different for mean operative time (VH: 81 Ϯ 30 minutes; LH: 99 Ϯ 25 minutes; P ϭ .033) and blood loss (LH: 83 Ϯ 57 mL; VH: 178 Ϯ 149 mL; P ϭ .004). Bilateral adnexectomy was performed when preoperatively planned in 73% of cases of the vaginal arm, whereas it was always performed in the laparoscopic arm (P ϭ .045). Postoperative pain on day 0 and the number of days of analgesic request were higher in the vaginal group (P ϭ .023 and P ϭ .017, respectively). LH was associated with a reduced hospital stay (LH: 2.7 Ϯ 0.5 days; VH: 3.2 Ϯ 0.6 days; P Ͻ .001).There were no differences between the groups at the follow-up. CONCLUSION: Laparoscopic hysterectomy results in a shorter hospital stay, less blood loss, and less postoperative pain compared with vaginal hysterectomy.
Salpingectomy at the Time of Hysterectomy for Benign Indications
Obstetrics & Gynecology, 2014
Given that a significant percentage of high-grade serous cancers develop in the fallopian tube, it has been suggested that salpingectomy may prevent some of these malignancies. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists guidelines recommend prophylactic salpingectomy to be discussed with or offered to patients undergoing hysterectomy for benign indications. This study compares rates of salpingectomy at the time of hysterectomy for benign indications across different surgical approaches among Australian and New Zealand gynaecologists. Data were collected via SurgicalPerformance, a web-based surgical outcomes review and feedback software used by independent gynaecologic surgeons. Of 11 477 hysterectomy records available, 6608 were eligible for analysis. Rates of salpingectomy at vaginal hysterectomy (13%) were significantly lower (P < 0.001) compared to open abdominal (65%), laparoscopic (70%), laparoscopic-assisted vaginal (78%), or robotic hysterectomies (73%) and also lower than in hysterectomies converted to an open abdominal approach (73%).
Laparoscopic pelvic adnexal surgery in Nobel Medical College
Nepal Journal of Obstetrics and Gynaecology, 2021
Aim: To share early experience of gynaecological laparoscopic surgeries for adnexal masses in Nobel Medical College and Teaching Hospital (NMCTH). Methods: This is a observational descriptive study in the Department of Obstetrics and Gynaecology of Nobel Medical College, Biratnagar for one year in 2019-2020. All the patients undergoing laparoscopic pelvic surgeries for adnexal masses were analysed for indication, type of procedure, complications and histopathological diagnosis. Results: A total of 123 laparoscopic surgeries were performed. Preoperative diagnosis in most of the cases was adnexal mass followed by adnexal evaluation for subfertility. The common surgical procedure was cystectomy followed by salpingo-oophorectomy in 80% of cases. The most common histopathological diagnosis was mature cystic teratoma (42; 34%) followed by endometriosis (29; 23.8%) and cystadenoma (25; 20.3%). Conclusions: Adnexal evaluation and surgical treatment were performed with laparoscopy. The commo...
Mini-lap hysterectomy revisited with new concepts and technical modifications
International Journal of Surgery, 2011
Aim: To introduce technical modifications in the performance of mini-lap hysterectomy and report our experience. Patients and Methods: Between March 2006 and March 2008, two hundred patients with benign uterine disorders requiring hysterectomy underwent mini-lap hysterectomy in a prospective study. The surgical approach was carried out via a 4e5 cm midline incision 1.5 cms above the symphysis pubis. The mean (range) age was 46 (39e66) years. All procedures were completed successfully without any major complications, though three patients needed extension of the incision as in conventional open total abdominal hysterectomy. Results: The mean (range) operative time was 30 (20e63) min and the average blood loss was 20 ml. The mean (range) hospital stay was 30 (20e50) h. All patients returned back to routine work within 1 week of surgery. The mean (range) follow-up was 10 (7e20) months. Conclusions: 1. Mini-lap hysterectomy is an effective, minimally invasive surgical procedure with a low morbidity rate and a short hospital stay. It may well serve as an alternative to the conventional abdominal or laparoscopic hysterectomy in areas which lack these facilities. 2. It can be performed with the use of simple instruments thereby reducing the expenses. 3. The concept can help in learning and performing this procedure easily and safely.
No. 377-Hysterectomy for Benign Gynaecologic Indications
Journal of Obstetrics and Gynaecology Canada, 2019
WHAT'S NEW? 1. Hysterectomy for benign indications should preferably be approached by either vaginal or laparoscopic routes. 2. Same-day discharge protocols following minimally invasive hysterectomy are safe. 3. Correction of anemia (hemoglobin <120 g/L) is indicated to reduce morbidity and mortality in the perioperative period. 4. Opportunistic salpingectomy can be considered at the time of hysterectomy. KEY MESSAGES 1. Minimally invasive hysterectomy (vaginal and laparoscopic) is associated with fewer complications than laparotomy. 2. Hysterectomy for benign indications should preferably be approached by either vaginal or laparoscopic routes. 3. Urinary tract injuries are comparable among surgical approaches to hysterectomy. 4. Women with normal ovarian cancer risk should be counselled about negative health implications linked to bilateral oophorectomy. 5. Patients with endometriosis undergoing hysterectomy should have full excision of other local endometriotic lesions.