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Laparoscopic hysterectomy

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https://www.readbyqxmd.com/read/28225651/robotic-surgery-a-solution-in-search-of-a-problem-a-bayesian-analysis-of-343-robotic-procedures-performed-by-a-single-surgical-team
#1
Simona Manciu, Mihnea Dragomir, Fabiana Curea, Catalin Vasilescu
BACKGROUND: Despite the obvious technical advantages, the value of robotic surgery is highly debated and its cost-effectiveness has been questioned. The aim of this article is to provide an evaluation of the outcomes of robotic surgery in comparison to conventional laparoscopy. METHODS: A decision analysis based on the Bayes' theorem and the decision tree was used. The robotic approach was compared with the laparoscopic approach for each of the pathologies discussed in this study...
February 22, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28218565/-total-laparoscopic-hysterectomy-with-the-coagulation-of-the-uterine-arteries-at-their-origin
#2
Rudolf Lampé, Csaba Móré, Ilona Fazekas, Róbert Póka
INTRODUCTION: Hysterectomy is one of the most frequently performed gynecological operations worldwide. Due to patient perceived advantages of technical development laparoscopic hysterectomy has become a widely used method. The attitude of patients, surgeons and service providers to laparoscopic procedures is not uniform, but total laparoscopic hysterectomy has prevailed due to its advantages from other types of laparoscopic hysterectomies. Coagulation of the uterine arteries at their origin during the standardized method of total laparoscopic hysterectomy provides further benefits for this procedure...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28217681/laparoendoscopic-single-site-radical-hysterectomy-for-early-stage-cervical-cancer
#3
Ju Young Park, Yoo Min Kim, Yoo-Young Lee, Tae-Joong Kim, Jeong-Won Lee, Byoung-Gie Kim, Duk-Soo Bae, Chel Hun Choi
Technical developments have made laparoendoscopic single-site (LESS) surgery increasingly more feasible for treating gynecological conditions, including cancer. However, complex surgeries such as radical hysterectomy have rarely been performed with single-port access because of technical difficulties. The majority of the difficulties are due to the inefficient retraction of tissue during dissection. Here, we report a detailed description of LESS radical hysterectomy plus pelvic lymph node dissection that was successfully performed in two patients with stage IB1 cervical cancer...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28217670/a-novel-clinicopathological-analysis-of-early-stage-ovarian-sertoli-leydig-cell-tumors-at-a-single-institution
#4
Seon Mi Nam, Jee Whan Kim, Kyung Jin Eoh, Hye Min Kim, Jung Yun Lee, Eun Ji Nam, Sunghoon Kim, Sang Wun Kim, Young Tae Kim
OBJECTIVE: To evaluate the clinical and pathologic characteristics of patients who were diagnosed with ovarian Sertoli-Leydig cell tumors (SLCTs) in a single institution. METHODS: The medical records of 11 patients who were pathologically diagnosed with SLCTs beginning in 1995 in a single institute was reviewed. RESULTS: The median patient age was 31 years (range, 16 to 70 years). Patient International Federation of Gynecology and Obstetrics stages were IA, IC, and IIB in 3 (27...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28216458/incidence-of-malignancy-and-fibroid-variants-at-surgery-for-presumed-benign-symptomatic-fibroids
#5
Monique Ramos Damasco, Pui-Wan Kiri Chan, Marnie Slonim, Woun-Eng Catarina Ang, Martin Graham Healey
STUDY OBJECTIVE: In women undergoing hysterectomy or myomectomy for benign gynecology indications, where fibroids were present, to estimate the incidence of (1) leiomyosarcoma (LMS), (2) other uterine pathology (3) the frequency of use of morcellation, both mechanical and manual in laparoscopic, vaginal and laparotomy operative routes. DESIGN: Retrospective study (Canadian Task Force classification II-3). SETTING: The Royal Women's Hospital, Melbourne Australia...
February 16, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28213057/utilization-of-sentinel-lymph-node-biopsy-for-uterine-cancer
#6
Jason D Wright, Stephanie Cham, Ling Chen, William M Burke, June Y Hou, Ana I Tergas, Vrunda Desai, Jim C Hu, Cande V Ananth, Alfred I Neugut, Dawn L Hershman
BACKGROUND: To limit the potential short and long-term morbidity of lymphadenectomy, sentinel lymph node (SLN) biopsy has been proposed for endometrial cancer. The principle of SLN biopsy relies on removal of a small number of lymph nodes that are the first drainage basins from a tumor and thus the most likely to harbor tumor cells. While the procedure may reduce morbidity, efficacy data is limited and little is known about how commonly the procedure is performed. OBJECTIVE: We examined the patterns and predictors of use of SLN biopsy and outcomes of the procedure in women with endometrial cancer who underwent hysterectomy...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28203626/diffuse-peritoneal-leiomyomatosis-status-post-laparoscopic-hysterectomy-with-power-morcellation-a-case-report-with-review-of-literature
#7
Don Nguyen, Rishi Maheshwary, Cassie Tran, Scott Rudkin, Luke Treaster
•Leiomyomatosis following laparoscopic hysterectomy with morcellation is reported.•Parasitic myomas grow in a benign fashion but may be fatal depending on location.•Fibroids are a contraindication for laparoscopic hysterectomy with morcellation.•Containment bags may address intraperitoneal spillage of malignant tissue.
February 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28184276/segregation-for-reduction-of-regulated-medical-waste-in-the-operating-room-a-case-report
#8
Helen Ki Shinn, Youngyoen Hwang, Byung-Gun Kim, Chunwoo Yang, WonJu Na, Jang-Ho Song, Hyun Kyoung Lim
One-third of all hospital-regulated medical waste (RMW) comes from the operating room (OR), and it considerably consists of disposable packaging and wrapping materials for the sterilization of surgical instruments. This study sought to identify the amount and type of waste produced by ORs in order to reduce the RMW so as to achieve environmentally-friendly waste management in the OR. We performed an initial waste segregation of 4 total knee replacement arthroplasties (TKRAs) and 1 total hip replacement arthroplasty, and later of 1 extra TKRA, 1 laparoscopic anterior resection of the colon, and 1 pelviscopy (with radical vaginal hysterectomy), performed at our OR...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28179197/laparoendoscopic-single-site-total-laparoscopic-hysterectomy-clinical-factors-that-affect-operative-times-and-techniques-to-overcome-difficulties
#9
In Cheul Jeung, Yong Seok Lee, Min Jong Song, Eun Kyung Park
STUDY OBJECTIVE: To compare surgical outcomes of patients who underwent laparoendoscopic single-site total laparoscopic hysterectomy (LESS-TLH) with operative times <150 minutes and ≥150 minutes to determine the clinical factors that influence operative times. We also describe techniques that help overcome difficulties involved in this procedure. DESIGN: Retrospective study. DESIGN: Classification: Canadian Task Force Classification II-2...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28177208/minimally-invasive-hysterectomy-for-benign-indications-an-update
#10
C Emi Bretschneider, Karl Jallad, Marie F Paraiso
Hysterectomy is one of the most commonly performed surgeries worldwide. Indication for hysterectomy is most often benign, which includes conditions such as prolapse, abnormal uterine bleeding, fibroids and pelvic pain. A broad range of surgical approaches exists for hysterectomy, ranging from open to minimally invasive techniques. Under this minimally invasive umbrella, the following techniques are included: vaginal hysterectomy (VH), laparoscopic hysterectomy (LH), and variations of those two techniques, such as laparoscopicassisted vaginal hysterectomy (LAVH), robotic-assisted hysterectomy (RH), laparo-endoscopic single-site laparoscopic hysterectomy (LESS), mini-laparoscopic hysterectomy (MLH), and natural orifice transluminal endoscopic surgery (NOTES) hysterectomy...
February 8, 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/28174387/-a-case-of-heterochronic-ovarian-metastasis-from-sigmoid-colon-cancer-after-sigmoidectomy-treated-with-capeox-that-included-bevacizumab
#11
Reiko Ono, Norihito Ise, Hiroshi Yoshioka, Wataru Iwasaki, Kimihiko Sato, Makoto Niwa
The patient was a 41-year-old woman. When she was 39 years old, she had undergone laparoscopic high anterior resection for sigmoid colon cancer without adjuvant chemotherapy. Histologically, the surgical specimen was type 2, tub2, pT4a (SE), pN0, int, INF b, ly1, v1, and pStage II. Nine months after the operation, she suffered from abdominal fullness. Laborato- rydata showed elevation of tumor markers: the CEA level was 6.48 ng/mL, the CA19-9 level was 89.70 U/mL, and the CA125 level was 662 U/mL. Computed tomographyrevealed bilateral ovarian tumors and lung and peritoneal nodules with massive ascites...
January 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28167964/safety-and-cost-considerations-during-the-introduction-period-of-laparoscopic-radical-hysterectomy
#12
A Anagnostopoulos, S Mitra, B Decruze, R Macdonald, J Kirwan
Objective. To compare the safety, efficacy, and direct cost during the introduction of laparoscopic radical hysterectomy within an enhanced recovery pathway. Methods. A 1 : 1 single centre retrospective case control study of 36 propensity matched pairs of patients receiving open or laparoscopic surgery for early cervical cancer. Results. There were no significant differences in the baseline characteristics of the two cohorts. Open surgery cohort had significantly higher intraoperative blood loss (189 versus 934 mL) and longer postoperative hospital stay (2...
2017: Obstetrics and Gynecology International
https://www.readbyqxmd.com/read/28162785/efficacy-of-ultrasound-guided-transversus-abdominis-plane-block-in-laparoscopic-hysterectomy-clinical-trial
#13
D S Guardabassi, S Lupi, R Agejas, J M Allub, G García-Fornari
OBJECTIVES: Transversus abdominis plane block is a regional anaesthesia technique that has proven to be effective for postoperative pain reduction in different abdominal surgical procedures. This study evaluated its efficacy on post laparoscopic hysterectomy pain intensity and analgesic consumption. MATERIALS AND METHODS: Randomized controlled trial which included 40 patients scheduled for laparoscopic hysterectomy, enrolled in 2 groups: transversus abdominis plane block+systemic analgesia (Group 1; n=20), versus systemic analgesia (Group 2; n=20)...
February 2, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28152961/banning-the-use-of-intracorporeal-morcellation
#14
Stephen F Rechner, Douglas M VanDrie, Ralph N Rogers
: 132 Background: In response to the FDA safety communication we banned the use of intracorporeal morcellation effective April 22(nd) 2014. Clinicians expressed frustration and a concern that an increase in the abdominal hysterectomy rate or percentage, wound complications, and length of stay would occur. Our PDCA (plan, do, check, and act) safety process reviewed these quality and safety metrics one year later. METHODS: This is a retrospective evaluation of a prospective institutional decision...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28150406/preoperative-assessment-of-factors-associated-with-difficulty-in-performing-total-laparoscopic-hysterectomy
#15
Ako Saito, Tetsuya Hirata, Kaori Koga, Masashi Takamura, Shinya Fukuda, Kazuaki Neriishi, Gia Pastorfide, Miyuki Harada, Yasushi Hirota, Osamu Wada-Hiraike, Tomoyuki Fujii, Yutaka Osuga
AIM: Our objective was to determine the preoperative factors associated with difficulty in total laparoscopic hysterectomy (TLH). METHODS: This retrospective clinical study included 157 patients who underwent TLH for leiomyoma or adenomyosis between 2009 and 2013. All patients underwent magnetic resonance imaging (MRI) before surgery. We categorized patients as 'difficult' if the operation time was > 243 min, if total blood loss was > 500 mL, or if conversion to laparotomy was necessary...
February 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28144809/comparison-of-cost-and-operative-outcomes-of-robotic-hysterectomy-compared-to-laparoscopic-hysterectomy-across-different-uterine-weights
#16
Gaby N Moawad, Elias D Abi Khalil, Paul Tyan, Michael K Shu, David Samuel, Richard Amdur, Stacey A Scheib, Cherie Q Marfori
Operative cost and outcomes between robotic and laparoscopic hysterectomy across different uterine weights. Retrospective cohort study including patients undergoing robotic and laparoscopic hysterectomy for benign disease at an Academic university hospital. One hundred and ninety six hysterectomies were identified (101 robotic versus 95 laparoscopic). Demographic and surgical characteristics were statistically equivalent. Robotic group had a higher body mass index (±SD) (32.9 ± 6.5 versus 30.4 ± 7.1, p 0...
January 31, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28134703/pneumothorax-after-laparoscopic-robotic-assisted-supracervical-hysterectomy-and-sacrocolpopexy
#17
Ashley Kim, Julia Geynisman-Tan, Christina Lewicky-Gaupp
We present a case of a patient in whom subcutaneous emphysema, pneumoperitoneum, and pneumothorax occurred on postoperative day 1 after robotic-assisted supracervical hysterectomy, bilateral salpingectomy, sacrocolpopexy, and retropubic midurethral sling placement for pelvic organ prolapse and stress urinary incontinence. This case demonstrates a rare complication of gynecologic laparoscopic procedures.
January 27, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28133328/-a-case-of-ovarian-cancer-with-lymph-node-metastasis-in-the-lesser-curvature-of-the-stomach-resected-using-laparoscopic-surgery
#18
Katsunao Tanaka, Moon Jeongho, Nobutaka Hatanaka, Masashi Inoue, Tatsuya Miyamoto, Megumi Yamaguchi, Shingo Seo, Toshihiro Misumi, Wataru Shimizu, Toshimitsu Irei, Takahisa Suzuki, Takashi Onoe, Takeshi Sudo, Yosuke Shimizu, Takao Hinoi, Hirotaka Tashiro
A 67-year-old woman, who was diagnosed with ovarian cancer with multiple metastases, underwent abdominal total hysterectomy, bilateral salpingo-oophorectomy, para-aortic lymph node dissection(b2), omental subtotal hysterectomy, and lower anterior rectal resection after receiving a combination of PTX plus CBDCA chemotherapy. Macroscopically, complete resection was achieved and histopathological examination of the resectedspecimen showedpoorly differentiatedserous adenocarcinoma. After surgery, additional chemotherapy was administered...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28121585/open-vs-minimally-invasive-hysterectomy-commercially-insured-costs-and-readmissions
#19
Kathryn Fitch, Warner Huh, Andrew Bochner
PURPOSE: To analyze commercial payer differences in the average costs and readmission rates between inpatient open hysterectomies and three types of outpatient hysterectomies: laparoscopic, laparoscopic assisted, and vaginal. DESIGN/METHODOLOGY: A retrospective claims data analysis was conducted using the 2012 and 2013 Truven Health Analytics MarketScan Commercial Claims and Encounter Database.The study was limited to women 18-64 years old who had pharmacy coverage, 12 months of commercial insurance coverage in 2012, and at least 1 month in 2013...
August 2016: Managed Care
https://www.readbyqxmd.com/read/28118169/the-k-technique-a-novel-technique-for-laparoscopic-apical-suspension-using-barbed-sutures
#20
Tarek Khalife, Rabbie K Hanna
OBJECTIVES: Hysterectomy is among the most common gynecologic procedures performed for women, second only to cesarean sections, and the proportion of it performed laparoscopically continues to increase. Addressing apical support at the time of the hysterectomy is crucial to minimizing the risk of posthysterectomy prolapse. Barriers to addressing apical support include the lack of experience in laparoscopic suturing and knot tying that require advanced skills and dexterity. The K-technique is a novel modification of the uterosacral ligament suspension procedure using the knot-less barbed suture technology, rendering suturing easier and quicker to perform...
January 24, 2017: Female Pelvic Medicine & Reconstructive Surgery
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