Surgical Approach to Laparoscopic Trachelectomy

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology Pub Date : 2024-11-01 DOI:10.1016/j.jmig.2024.09.059

LE Larson , NR King

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引用次数: 0

Abstract

Study Objective

To demonstrate several reproducible strategies used to overcome the surgical challenges of laparoscopic trachelectomy.

Design

N/A.

Setting

The patient was placed in dorsal lithotomy position, in steep Trendelenburg to aid in the performance of pelvic laparoscopy. Insufflation was carried out to 15mmHg. A primary 10mm umbilical trocar was used for the camera through the mini lap and three additional 5mm assist ports were placed.

Patients or Participants

The patient is a 41-year-old G1P1001 with history of supracervical hysterectomy who presented with persistent pelvic/back pain and vaginal bleeding. Extensive workup for alternative causes were unrevealing and remaining cervix was suspected source of symptoms. With appropriate options counseling and shared-decision making, patient elected to undergo laparoscopic trachelectomy.

Interventions

Laparoscopic trachelectomy with bilateral ureteral stent placement.

Measurements and Main Results

Uncomplicated surgery with same-day discharge followed by uneventful post-operative recovery.

Conclusion

Laparoscopic trachelectomy poses many challenges to the surgeon. In this video, we present a step-wise approach and several reproducible strategies to overcome these obstacles encountered in laparoscopic trachelectomy.

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腹腔镜气管切除术的手术方法

研究目的展示用于克服腹腔镜气管切除术手术挑战的几种可重复策略。设计N/A.设置将患者置于背侧平卧位，采用陡峭的 Trendelenburg，以帮助实施骨盆腹腔镜手术。充气至 15 毫米汞柱。患者或参与者患者是一名 41 岁的 G1P1001，有子宫颈上位切除术史，出现持续性骨盆/背部疼痛和阴道出血。对其他病因进行了广泛检查，但均未发现异常，怀疑残留的宫颈是症状的根源。干预措施腹腔镜气管切除术，双侧输尿管支架置入术。测量和主要结果手术简单，当天出院，术后恢复顺利。在这段视频中，我们介绍了一种循序渐进的方法和几种可重复的策略，以克服腹腔镜气管切除术中遇到的这些障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of minimally invasive gynecology 医学-妇产科学

CiteScore

5.00

自引率

7.30%

发文量

272

审稿时长

37 days

期刊介绍： The Journal of Minimally Invasive Gynecology, formerly titled The Journal of the American Association of Gynecologic Laparoscopists, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this emerging field.