Vulvar reconstruction in vulvar cancer: “lotus petal” suprafascial flap
Abstract
The purposes of this study are to demonstrate our experience in using the “lotus petal” suprafascial flap and to evaluate the postoperative complications. During the period ranging from July 2012 to March 2015, nine patients diagnosed with primary or recurrent vulvar cancer have undergone radical vulvectomy followed by reconstructive surgery. Seventeen lotus petal suprafascial flap surgeries were performed. The average age of the patients was 79 years. No intraoperative complications were reported. The surgery length was 180 min with an estimated blood loss of 400 cc. Severe postoperative ...
Source: Gynecological Surgery - September 10, 2015 Category: OBGYN Source Type: research
Minimally invasive management of 14–16-week abdominal ectopic with hemoperitoneum: an emergency laparoscopic procedure
Abstract
Since the first laparoscopic cholecystectomy on a pregnant lady in 1991, a plethora of articles and case studies have been published addressing laparoscopy and their role in pregnancy. The Royal College of Obstetricians and Gynecologists Green-top Guidelines recommends laparoscopic surgery as the preferred approach in early ectopic tubal pregnancies. Laparoscopic versus laparotomy management of abdominal ectopic is a traumatic experience both on physical and emotional levels. The case study was a 36-year-old gravida 2 para 0 patient, previously normal pregnant lady, in which the follow-up ultraso...
Source: Gynecological Surgery - August 20, 2015 Category: OBGYN Source Type: research
Laparoscopic excision of a solitary retroperitoneal neurofibroma in the pelvis
(Source: Gynecological Surgery)
Source: Gynecological Surgery - July 31, 2015 Category: OBGYN Source Type: research
Abstracts of Oral, Poster and Video Presentations British Society for Gynaecological Endoscopy Silver Jubilee Meeting ‘Preparing for a Golden Era’ Central Hall Westminster, London 4 th & 5 th June 2015
(Source: Gynecological Surgery)
Source: Gynecological Surgery - July 27, 2015 Category: OBGYN Source Type: research
Preliminary report of experience with gynaecologic laparoscopy in Ogbomoso, Nigeria
This study presents a pioneer experience with laparoscopic procedures in Gynaecological unit of the Bowen University Teaching Hospital (BUTH), Ogbomoso, Nigeria. Consecutive patients who had laparoscopic procedures from May 2014 to April 2015 were prospectively studied. There were 52 GLs, making up 28.1 % of the 185 gynaecologic surgeries over the study period. The patients’ ages ranged from 18 to 50 years (mean age = 32.6 ± 6.0 years). Eighteen (34.6 %) of the GLs were emergencies, whereas 34 (63.4 %) were elective. Fifteen patients (28.8 %) had only diagnostic laparoscopy for various gynaecological condi...
Source: Gynecological Surgery - July 22, 2015 Category: OBGYN Source Type: research
Long-term clinical outcomes of repeat hysteroscopic endometrial ablation after failed hysteroscopic endometrial ablation
Abstract
The study aims to describe patient characteristics, uterine cavity shape and histopathology, complications, and long-term clinical outcomes of women who failed hysteroscopic rollerball or loop endometrial ablation (HEA) and subsequently consented to repeat hysteroscopic endometrial ablation (RHEA), and is a retrospective cohort study (Canadian Task Force classification II-2). The study was conducted in the university-affiliated teaching hospital. Patients included women who failed primary hysteroscopic endometrial ablation (PHEA, n = 183) and subsequently underwent RHEA by the senior author (...
Source: Gynecological Surgery - July 20, 2015 Category: OBGYN Source Type: research
Hysteroscopic morcelation of large type II myoma
(Source: Gynecological Surgery)
Source: Gynecological Surgery - July 17, 2015 Category: OBGYN Source Type: research
Natural orifice transluminal endoscopic surgery (NOTES) salpingectomy for ectopic pregnancy: a first series demonstrating how a new surgical technique can be applied in a low-resource setting
We report on five patients who underwent a vNOTES salpingectomy between September 2014 and February 2015. All procedures were successfully performed, without conversion to multi-incision laparoscopy or laparotomy. This demonstrates that it is possible to perform a vNOTES salpingectomy without any financial investment in expensive ports, disposable instruments or sealing devices (Video 1). Patient and perioperative data were analysed (Table 1). NOTES salpingectomy is a novel technique requiring further validation. It could be a less invasive alternative to a laparoscopic salpingectomy. A better cosmetic result, by avoiding ...
Source: Gynecological Surgery - July 10, 2015 Category: OBGYN Source Type: research
First-generation endometrial ablation revisited: retrospective outcome study—a series of 218 patients with premenopausal dysfunctional bleeding
Abstract
Premenopausal dysfunctional bleeding (PDB) is a common medical problem. Surgery is typically performed after the failure of a medical approach. Surgical options include endometrial ablation techniques or a hysterectomy. The aims of our study are to measure the outcome parameters of first-generation endometrial ablations (fgEA) and to identify patient-related prognostic factors. We included all fgEAs performed between September 2001 and December 2011 at the General Hospital of Turnhout, Belgium (n = 218). The outcome was defined by the need for a postoperative therapy (group 1—no therapy; gr...
Source: Gynecological Surgery - July 9, 2015 Category: OBGYN Source Type: research
Total laparoscopic hysterectomy for non-puerperal uterine inversion: anatomical and operative considerations
We present a case of non-puerperal uterine inversion in a pre-menopausal woman treated by total laparoscopic hysterectomy. We discuss the challenges we encountered due to the distorted pelvic anatomy and conclusions drawn from a literature review. The article is accompanied by relevant video material. A high level of suspicion is required for the diagnosis of non-puerperal uterine inversion. Morcellation techniques should be avoided due to the potential for malignancy. Where myomectomy is performed vaginally, the possibility of uterine rupture should be taken into account. Management by total laparoscopic hysterectomy has ...
Source: Gynecological Surgery - July 1, 2015 Category: OBGYN Source Type: research
Delivery and pregnancy outcome in women with bowel resection for deep endometriosis: a retrospective cohort study
Abstract
Endometriosis affects women in reproductive age and can involve bowel in 6–12 % of the patients. In case of bowel occlusion or deep pain, radical laparoscopic endometriosic surgery associated with bowel resection is recommended. The purpose of this study was to analyze the conception rate, the obstetric complications, and the pregnancy outcome. This is a retrospective study; we investigated 51 patients with deep endometriosis who underwent surgical treatment with bowel resection during the period between 2000 and 2007. Among the 30 patients who gave birth to at least one live child after surge...
Source: Gynecological Surgery - June 20, 2015 Category: OBGYN Source Type: research
Adnexectomy by poor man’s transvaginal NOTES
Abstract
The purpose of this study was to demonstrate the feasibility and safety of adnexectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for benign adnexal masses. Conventional, reusable laparoscopic instruments were used, inserted through aninexpensive, self-constructed single port device. Between November 2013 and November 2014, 20 adnexectomies by vNOTES were performed by a single surgeon (BJ). Only conventional, reusable laparoscopic instruments were used. The self-constructed single port device was made by assembling a surgical glove, a wound protector, one reusable 10...
Source: Gynecological Surgery - June 17, 2015 Category: OBGYN Source Type: research
Broad ligament defects as a cause of chronic pelvic pain
We report a case of a woman with chronic right-sided pelvic pain with an unusual combination of broad ligament defects and associated terminal ileum and caecum herniation. Reduction of the hernia and closure of the defects at laparoscopy resulted in resolution of the patient’s painful symptoms. Review of the literature suggests that, although rare, such defects should be considered in the differential diagnosis of persistent pelvic pain. Where found incidentally, broad ligament defects should be repaired in order to prevent sinister complications such as bowel obstruction and strangulation. (Source: Gynecological Surgery)
Source: Gynecological Surgery - June 8, 2015 Category: OBGYN Source Type: research
Extensive peritoneal lavage decreases postoperative C-reactive protein concentrations: a RCT
Abstract
Although extensive lavage is useful in peritoneal infections as diverticulitis, the extent of peritoneal lavage that should be used at the end of surgery is unclear. A randomised controlled trial comparing standard lavage with 0.5 litre (L) with extensive 8-L lavage was performed in 20 consecutive patients, following a full thickness resection of the rectum for deep endometriosis. Randomisation was done by the research nurse using sealed envelopes. Endpoints were C-reactive protein (CRP) concentration, white blood cell (WBC) count, temperature and the occurrence of complications. After lavage w...
Source: Gynecological Surgery - June 6, 2015 Category: OBGYN Source Type: research
The prevalence of occult leiomyosarcoma at surgery for presumed uterine fibroids: a meta-analysis
Abstract
There is a concern regarding the risk of occult leiomyosarcomas found at surgery for presumed benign fibroids. We sought to produce a comprehensive review of published data addressing this issue and provide high-quality prevalence estimates for clinical practice and future research. A comprehensive literature search using the PubMed/MEDLINE database and the Cochrane Library was performed. Inclusion criteria were human studies, peer-reviewed, with original data, involving cases for surgery in which fibroid-related indications were the primary reason for surgery, and histopathology was provided. Ca...
Source: Gynecological Surgery - May 18, 2015 Category: OBGYN Source Type: research
