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Laparoscopy after delivery

Eric Leblanc, Fabrice Narducci, Lucie Bresson, Delphine Hudry
OBJECTIVE: To explore the feasibility of an oncologically acceptable management for an intermediate-risk endometrial cancer (EC) in an elderly, using the combination of transvaginal single-port laparoscopy and sentinel node policy. METHODS: For this 85-years old patient, BMI 32kg/m(2), with IB grade 2 endometrioid EC, a single vaginal approach was attempted [1] to perform a total hysterectomy, bilateral salpinago-oophorectomy and pelvic node assessment guided by SND [2]...
October 13, 2016: Gynecologic Oncology
Ramy Girshally, Cedric Demtröder, Nurettin Albayrak, Jürgen Zieren, Clemens Tempfer, Marc A Reymond
BACKGROUND: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a novel drug delivery system able to induce regression of peritoneal metastasis (PM) in the salvage situation. The aim of this study was to determine the clinical characteristics, tumor histology, and extent of disease of the patients having undergone cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) after "neoadjuvant" PIPAC. METHODS: This study was performed at a single institution, tertiary center...
September 27, 2016: World Journal of Surgical Oncology
Mana Iida, Hiroshi Ishikawa, Makio Shozu
We report a case of spontaneous parasitic leiomyoma in a 30-year-old post-partum woman. A subserosal leiomyoma had been noted at the first trimester screening, and she had experienced persistent abdominal pain during her previous pregnancy. She was referred to hospital with severe abdominal pain at 7 months after delivery. We detected a homogenous solid tumor that resembled the subserosal leiomyoma but was completely detached from the uterus. On laparoscopy the vascularization of the tumor was supplied from the omentum, which was tightly adherent to the tumor...
September 19, 2016: Journal of Obstetrics and Gynaecology Research
Pei-Shen Huang, Bor-Ching Sheu, Su-Cheng Huang, Wen-Chun Chang
UNLABELLED: STUDY  OBJECTIVE: Intraligamental myomas (IMs) represent 6% to 10% of all uterine myomas. An IM growing from the lateral uterine wall into the broad ligament often presents as a large pelvic mass without symptoms. Removing a large IM can be difficult because of the limited operative field and poses challenges during conventional laparoscopic surgical approaches. The risk of injury to the ureter and uterine artery during myomectomy is greater than that during other types of myoma...
September 2016: Journal of Minimally Invasive Gynecology
Paweł Radwan, Adam Abramik, Jacek Wilczyński, Michał Radwan
OBJECTIVES: The aim of the study was autotransplantation of cryopreserved ovarian tissue to a patient suffering from premature ovarian failure caused by aggressive oncological therapy. MATERIAL AND METHODS: A 28-year-old woman, GII PI, was diagnosed with invasive adenocarcinoma of the cervix at 18 weeks of gestation. At 31 weeks of gestation, a cesarean section was performed, resulting in the delivery of a healthy male newborn, followed by simultaneous, radical hysterectomy with bilateral salpingo-oophorectomy and lymphadenectomy...
2016: Ginekologia Polska
R Fabbri, R Vicenti, M Macciocca, N A Martino, M E Dell'Aquila, G Pasquinelli, A M Morselli-Labate, R Seracchioli, R Paradisi
STUDY QUESTION: Which is the best method for human ovarian tissue cryopreservation: slow freezing/rapid thawing (SF/RT) or vitrification/warming (V/W)? SUMMARY ANSWER: The conventional SF/RT protocol used in this study seems to better preserve the morpho-functional status of human cryopreserved ovarian tissue than the used open carrier V/W protocol. WHAT IS KNOWN ALREADY: Cryopreservation of human ovarian tissue is generally performed using the SF/RT method...
August 2016: Human Reproduction
Ahmed Namazov, Leonti Grin, Michael Volodarsky, Eyal Anteby, Ofer Gemer
STUDY OBJECTIVE: To show the possibility of laparoscopic management of uterine rupture. DESIGN: Video with explanations. SETTING: In the medical management with misoprostol for termination of pregnancy at any time the risk of uterine rupture may be possible. The risk is likely higher in women with a previous uterus surgery. In a systematic review of available studies, the risk of rupture was .28% among women with a prior cesarean delivery who were undergoing second-trimester misoprostol-induced abortion, meaning if 414 women with a history of cesarean delivery were given misoprostol for second-trimester abortion, 1 would experience uterine rupture...
September 2016: Journal of Minimally Invasive Gynecology
Bulent Urman, Tonguc Arslan, Sertan Aksu, Cagatay Taskiran
STUDY OBJECTIVE: To demonstrate the technique of laparoscopic repair of a large cesarean scar defect (isthmocele). DESIGN: Case report (Canadian Task Force classification III). SETTING: Cesarean scar defect, also known as an isthmocele, is the result of incomplete healing of the isthmic myometrium after a low transverse uterine incision performed for cesarean section. Although mostly asymptomatic, it may cause menstrual abnormalities (typically postmenstrual spotting), chronic pelvic pain, and secondary infertility...
September 2016: Journal of Minimally Invasive Gynecology
Adrianna Skrajna, Krzysztof Cendrowski, Habib Alkhalayla, Włodzimierz Sawicki
Heterotopic pregnancy is the coexistence of living or dead intrauterine pregnancy, single or multiple, and extrauterine pregnancy located in the oviduct, ovary, uterine corner, cervix or peritoneal cavity. This condition is very rare (1:30 000 pregnancies). Nevertheless, in the latter years because of the development and accessibility of assisted reproductive techniques, the incidence of heterotopic pregnancies increased to 1:100 of pregnancies. The aim of this report is to present a case of early recognized intrauterine and extrauterine pregnancy...
September 2012: Journal of Ultrasonography
Pawel Basta, Wojciech Kolawa, Klaudia Stangel-Wójcikiewicz, Janina Schwarz
OBJECTIVE: The aim of the study was to evaluate the possibility of conception and the course of pregnancy in women with cervical cancer (FIGO IA and IB1), who underwent fertility-sparing surgical management, i.e. surgical conization or radical vaginal trachelectomy with laparoscopic lymphadenectomy. MATERIAL AND METHODS: A total of 80 patients treated surgically due to cervical cancer constituted the study group. Out of them, 65 (85%) women underwent surgical conization (43--FIGO IA1 and 25--FIGO IA2), and 12 (15%) women underwent radical vaginal trachelectomy with laparoscopic lymphadenectomy (9--FIGO IA2 and 3--FIGO lB1)...
September 2015: Ginekologia Polska
Jean Goupil, Pierre-Jean Marcellin, Shafey Elahee, Alexy Choffel, Malik Boukerrou
A 27-year-old woman underwent a first vaginal delivery at our institution. She returned four days after delivery, presenting with abdominal pain and an unexplained drop in her hemoglobin value, without external bleeding. The initial computed tomography abdominal scan revealed an isolated diffuse hemoperitoneum. A laparoscopy did not find the cause of bleeding. A second computed tomography scan, performed 15 days later, revealed hemoperitoneum associated with a false aneurysm of the right uterine artery. Treatment consisted of embolization of the uterine arteries, with clinical success...
January 2016: Journal of Obstetrics and Gynaecology Research
Pietro Gambadauro, Vincenzo Campo, Sebastiano Campo
Endometriosis is a tricky albeit common disease whose management largely relies on laparoscopy. We have studied the operative times of laparoscopic endometrioma surgery in order to assess their predictability and possible predictors. One hundred forty-eight laparoscopies were included, with a median operative time of 70 minutes (mean 75.14; 95% CI: 70.03-80.24). Half of the cases had a duration within 15-20 minutes above or below the median (IQR: 55-93.75), but the whole dataset ranged from 20 to 180 minutes, and the standard deviation was relatively large (31...
2015: Minimally Invasive Surgery
Moira Baeriswyl, Kyle R Kirkham, Christian Kern, Eric Albrecht
BACKGROUND: Previous meta-analyses of the transversus abdominis plane (TAP) block have examined a maximum of 12 articles, including fewer than 650 participants, and have not examined the effect of ultrasound-guided techniques specifically. Recently, many trials that use ultrasound approaches to TAP block have been published, which report conflicting analgesic results. This meta-analysis aims to evaluate the analgesic efficacy of ultrasound-guided TAP blocks exclusively for all types of abdominal surgeries in adult patients...
December 2015: Anesthesia and Analgesia
Dae Hyung Lee
Retained surgical gauze that was left inside the patient during a surgical procedure is called gossypiboma or textiloma. It is a rare complication of surgery commonly seen after abdominal operations. The symptoms of gossypiboma are non-specific, such as pain, palpable mass and fever, which make clinical diagnosis difficult. We present a case of young female athlete patient with right lower quadrant (RLQ) pain for 1 month, caused by surgical gauze which was retained from previous cesarean delivery performed 24 yr ago...
August 2015: Journal of Exercise Rehabilitation
Blanka Vavrinkova, Tomas Binder
This paper describes a case of uterine torsion not only around the long, but also the horizontal axis, diagnosed post-operatively. The patient was 28-years-old, II/I in the 34th week of her gravidity. She was admitted due to amniotic fluid leak. Due to unsuccessful delivery induction using prostaglandins, a caesarean section was indicated to end the gravidity. Uterine torsion 180° around the longitudinal axis and 90° around the transversal axis was diagnosed during the surgery. The uterine wound was treated in accordance with guidelines and the patient was dismissed in a good condition...
2015: Neuro Endocrinology Letters
Yuqing Chen, Huashan Liu, Jiayu Gu, Shuzhong Yao
OBJECTIVE: To investigate the therapeutic effect and safety of cerclage placed in pregnancy via laparoscopy (CPL) in the first trimesteror in non-pregnant phase (CNL). METHODS: A total of 134 cervical insufficiency patients who were treated with cervical cerclage were included. All the patients were divided into 3 groups. CPL group: 43 cases were treated with cerclage placed in pregnancy via laparoscopy in the first trimester, of which 26 cases received termination of pregnancy...
2015: International Journal of Clinical and Experimental Medicine
Jay M Berman, Jay M Bolnick, Rodolfo Robles Pemueller, José G Garza Leal
OBJECTIVE: To report reproductive outcomes in women who underwent radiofrequency volumetric thermal ablation (RFVTA) of symptomatic uterine fibroids. STUDY DESIGN: Retrospective analysis of fibroid characteristics, treatment parameters, and pregnancy outcomes of 6 subjects in 3 prospective trials of laparoscopic ultrasound-guided RFVTA. RESULTS: Despite the requirement that women enrolled in the RFVTA studies did not desire current or future childbearing and were to continue contraception, 6 subjects conceived at between 3...
May 2015: Journal of Reproductive Medicine
Satoshi Tanimura, Hiroshi Funamoto, Takashi Hosono, Yasushi Shitano, Masao Nakashima, Yuka Ametani, Takashi Nakano
AIM: The aim of the present study was to assess the efficacy of endoscopic repair for secondary infertility caused by post-cesarean scar defect (PCSD). Our investigation focused on the validity of new diagnostic criteria and selection methods. MATERIAL AND METHODS: The subjects were 22 women with secondary infertility due to PCSD with retention of bloody fluid in the uterine cavity. Women with a residual myometrial thickness of ≥ 2.5 mm and an anteflexed or straight uterus underwent hysteroscopic surgery, while all others underwent laparoscopic repair...
September 2015: Journal of Obstetrics and Gynaecology Research
Mohamad S Mahmoud, Farr R Nezhat
STUDY OBJECTIVE: To describe our technique for the repair of a cesarean section uterine scar defect after removal of an ectopic pregnancy from the scar in a patient desiring future pregnancies. DESIGN: Step-by-step explanation of the procedure using video (Canadian Task Force classification III). SETTING: Uterine scar dehiscence/defect is a known complications of multiple cesarean deliveries that can result in abnormal bleeding, infertility, and cesarean scar ectopic pregnancy...
November 2015: Journal of Minimally Invasive Gynecology
Kristina H Lewis, Fang Zhang, David E Arterburn, Dennis Ross-Degnan, Matthew W Gillman, J Frank Wharam
IMPORTANCE: There is conflicting evidence about how different bariatric procedures impact health care use. OBJECTIVE: To compare the impact of laparoscopic adjustable gastric banding (AGB) and laparoscopic Roux-en-Y gastric bypass (RYGB) on health care use and costs. DESIGN, SETTING, AND PARTICIPANTS: Retrospective interrupted time series with comparison series study using a national claims data set. The data analysis was initiated in September 2011 and completed in January 2015...
August 2015: JAMA Surgery
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