Mini-Laparoscopy of Removal (Partial) Adnexae at the Time of Hysterectomy (original) (raw)
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Laparoscopic Hysterectomy: Revisited
Journal of SAFOG, 2014
Laparoscopic hysterectomy is an alternative to abdominal hysterectomy. Different techniques are described and illustrated. Most laparotomies for hysterectomies can be avoided by using the laparoscopic approach including cases of adhesions, adnexal masses and endometriosis. According to the expertise of the surgeon the time to perform the laparoscopic surgery can be reduced. There are many advantages of laparoscopic hysterectomy for the patient including the length of hospital stay and convalescence. Most hysterectomies currently requiring an abdominal route may be performed with laparoscopic dissection in part followed by removal of uterus vaginally.
Journal of Minimally Invasive Gynecology, 2015
(SV) trials postoperatively after their surgical procedures. Voiding trials were performed in the recovery room after outpatient cases or on the first postoperative day. For the RF method, 300 ml of sterile saline, or less if maximum cystometric capacity was achieved, was instilled. After removal of the Foley, a voided volume of 200 ml was considered sufficient to pass the trial. In the SV trial, no retrograde fill was needed and the patient had to void 150 ml at once within 6 hours. Measurement of postvoid residual volume was not standard. The primary outcome of this study was the failure rate, the percentage of women who did not meet the above criteria and required intermittent or indwelling catheterization. We also compared the percentage of women who initially passed the trial but returned for recatheterization due to urinary retention, and the rate of urinary tract infection between the groups within 6 postoperative weeks. We used student t and Chi-squared tests, and logistic regression method where appropriate for comparisons. Results: Seven hundred forty women were included in this cohort. The mean age was 57 AE 13 years; mean body mass index was 30.5 AE 7.0 kg/m 2. Of all the subjects, 60% were postmenopausal, median parity was 2 (range = 0 to 11), and 226% had a prior hysterectomy. The cohort was divided into 2 groups for comparisons: 430 women had a SV and 310 RF voiding trial. The groups were similar with respect to baseline characteristics. The failure rates were, though statistically different between the groups [87 (20.2%) and 83 (26.8%) for SV and RF methods, p = 0.046], were clinically similar. Among women who were discharged without a catheter, 5 individuals (1.2 and 1.6%, p = 0.74, not-significant between SV and RF methods, respectively) from each voiding trial group returned with urinary retention for catheter insertion. The rates of urinary tract infection rates were also similar [32 (7.4%) and 24 (7.7%), p = 0.80) for SV and RF methods, respectively] between the groups. There were no other complications attributable to voiding trial approach. Conclusion: Spontaneous voiding trial based on a first voided volume of 150 cc or greater seems to be as safe and effective as retrograde fill method for women after a pelvic floor procedure.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2001
Objective: hysterectomy for benign disorders is usually well tolerated, but complications do occur. The aim of this retrospective study is to document such complications. Patients and methods: between March 1991 and December 1998, 1604 patients (mean age: 46 years) underwent hysterectomy for benign disorders. Peroperative and early postoperative complications were recorded for the 1248 vaginal hysterectomies (8%), 190 laparoscopically assisted vaginal hysterectomies (12%), and 166 abdominal hysterectomies (10%). Results: none of the patients died. There were 15 bladder (0.9%) and one ureter injury (0.06%) with no signi®cant difference between routes. Intestinal injuries (0.6%) overall were more common when laparotomy was performed (2.4%). In 45 patients (2.8%), bleeding exceeded 500 ml. The rates were vaginal hysterectomy (2%, P < 0:001), laparotomy (6.7%), and laparoscopy (5.3%). The overall reoperation rate of 0.8% does not differ with the type of the procedure. Conclusion: Per and early postoperative complications after hysterectomy remain important and patients should be aware of them. In order to control complications and decrease the morbidity, a high-risk population should be de®ned based on the patients' history of pelvic surgery and endometriosis, on their parity and the size of their uterus. For these patients, the most appropriate route should be preferred and complications should be assessed using different tests and subsequently treated during the same procedure. #
The Journal of the American Association of Gynecologic Laparoscopists, 2003
The American Association of Gynecologic Laparoscopists (AAGL) has been conducting membership surveys since 1976. Originally, surveys were designed to evaluate only sterilization techniques. As increasingly complicated operative laparoscopic operations became more widely accepted, it was apparent that laparoscopic-assisted vaginal hysterectomy (LAVH) was the most significant surgical procedure performed by most of the membership. Since 1989 the AAGL has actively attempted to document various aspects of LAVH through surveys of its members. The first survey in 1995 attempted to gain information as to current performance of the procedure and to assess relative frequencies and complications. Dr. Barbara S. Levy, who designed the 1995 survey with Drs. Jaroslav F. Hulka and William H. Parker, wrote this instrument, which was developed with few modifications from the earlier one to allow comparisons to be made between time periods. A total of 4437 surveys were mailed to AAGL members and contained 50 questions on laparoscopy, particularly LAVH, performed from January 1, 2000, to December 31, 2000. As in all AAGL surveys, the replies were strictly anonymous and confidential so that reporting of complications might be as frank as possible.
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.