Robotic Excision of Disseminated Peritoneal Leiomyomas

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.2024.09.061

O Dawodu , MN Allen , M Gedeon , JHJ Kim

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引用次数: 0

Abstract

Study Objective

To demonstrate a minimally invasive surgical approach to disseminated peritoneal leiomyomatosis.

Design

Case report.

Setting

Tertiary medical center.

Patients or Participants

36-year-old G0 with prior myomectomy with use of power morcellator and now disseminated peritoneal leiomyomatosis undergoing fertility sparing management.

Interventions

The patient underwent a successful robot-assisted laparoscopic myomectomy, abdominal wall mass excision, and excision of abdominal and pelvic masses. Key surgical steps illustrated include:

•
Image guided mapping of lesions
•
Port placement for multi-quadrant visualization
•
30° camera supraumbilical
•
Port hopping feature
•
Use of vessel sealer
•
Identification of vital structures
•
Resection of myomas
○
Traction-Countertraction
○
Blunt and sharp dissection
○
External downward pressure for identification of intramuscular masses
•
Repair of fascial defect
•
Abdominal survey - “run the bowel.”
•
Specimen bagging and cold knife morcellation

Measurements and Main Results

Patient was discharged home on the day of surgery with an uncomplicated post-operative course.

Conclusion

Utilization of Da Vinci Xi Robotic Surgical System features and multidisciplinary planning allow strategic surgical approach and adequate visualization of the abdomen and pelvis to resect leiomyomas in unusual locations.

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播散性腹膜子宫肌瘤的机器人切除术

患者或参与者36岁，G0级，曾使用动力碎肌器进行子宫肌瘤切除术，现患播散性腹膜子宫肌瘤，正在接受保留生育功能的治疗。干预措施患者成功接受了机器人辅助腹腔镜子宫肌瘤切除术、腹壁肿块切除术以及腹部和盆腔肿块切除术。图解的关键手术步骤包括：-图像引导下的病灶映射-用于多象限可视化的端口放置-30°摄像头脐上-端口跳转功能-血管封堵器的使用-重要结构的识别-肌瘤的切除○牵引-反牵引○钝性和锐性剥离○外部下压以识别肌内肿块-筋膜缺损的修复-腹部调查-"运行肠道。"结论利用达芬奇Xi机器人手术系统的特点和多学科规划，可以采取战略性手术方法，充分观察腹部和盆腔，切除异常位置的子宫肌瘤。

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.