Japanese Journal of Gynecologic and Obstetric Endoscopy最新文献_第6页

Regular accredited laparoscopic surgeon interventions improve gynecologist disincentives and attitudes in a local hospital: a questionnaire-based study. 定期认可的腹腔镜外科医生干预措施改善了当地医院妇科医生的积极性和态度:一项基于问卷的研究。

Japanese Journal of Gynecologic and Obstetric Endoscopy Pub Date : 1900-01-01 DOI: 10.5180/JSGOE.34.2_171

K. Kurosawa, S. Horisawa, Hodaka Takeuchi, Yumi Washimi, Hondo Toru

{"title":"Regular accredited laparoscopic surgeon interventions improve gynecologist disincentives and attitudes in a local hospital: a questionnaire-based study.","authors":"K. Kurosawa, S. Horisawa, Hodaka Takeuchi, Yumi Washimi, Hondo Toru","doi":"10.5180/JSGOE.34.2_171","DOIUrl":"https://doi.org/10.5180/JSGOE.34.2_171","url":null,"abstract":"Objective: Minimally invasive surgery, such as laparoscopy, is used in many hospitals across Japan. However, this technique in not used to its full capacity, especially in local hospitals, such as those of the Nagano prefecture. Laparoscopic surgery was introduced in our hospital in 2008. Predominantly, laparoscopic operations for benign ovarian tumors were performed until 2015. Since January 2016, a lead surgeon from another hospital has been regularly educating gynecologists at our hospital about laparoscopic surgery. We have also begun performing total laparoscopic hysterectomies (TLHs) and laparoscopic myomectomies (LMs), and the frequency of laparoscopic surgeries at our hospital has increased remarkably, from about 8 to 52 cases per year. We aspire to learn how to change the motivation of gynecologists and nurses through changing incentives before 2015 and after implementation of lead surgeon education in 2016. Design: We prepared questionnaires about changes in laparoscopic surgery incentives for gynecologists and nurses before 2015 and after 2016. Setting: This report analyzed the results of the questionnaire surveys from 5 gynecologists and 75 nurses. We compared the desire for laparoscopic surgery, preparation for the operation, and impression on the attitude of the doctors before 2015 and after 2016. Primary Outcomes: Although we suspected that nurses may be frustrated by the long operation times, our analysis showed that nurses had a relatively good impression of the gynecologists. No serious problems were identified. Results: Regular performance of laparoscopic surgeries with a lead surgeon allows good collaboration between co-","PeriodicalId":325241,"journal":{"name":"Japanese Journal of Gynecologic and Obstetric Endoscopy","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127208605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Complete remission of hyperprolactinemia after laparoscopic myomectomy -A case report- 腹腔镜子宫肌瘤切除术后高泌乳素血症完全缓解1例报告

Japanese Journal of Gynecologic and Obstetric Endoscopy Pub Date : 1900-01-01 DOI: 10.5180/JSGOE.27.441

I. Yamanaka, K. Uchiyama, Taishi Akimoto, Miho Oeda, Hiroyuki Osogami, M. Yamanaka, H. Henmi, M. Inoue, T. Endo

{"title":"Complete remission of hyperprolactinemia after laparoscopic myomectomy -A case report-","authors":"I. Yamanaka, K. Uchiyama, Taishi Akimoto, Miho Oeda, Hiroyuki Osogami, M. Yamanaka, H. Henmi, M. Inoue, T. Endo","doi":"10.5180/JSGOE.27.441","DOIUrl":"https://doi.org/10.5180/JSGOE.27.441","url":null,"abstract":"Prolactin(PRL) affects more physiological process than all other pituitary hormones combined. Normal myometrium and uterine fibroids secrete PRL, but the function of myometial PRL is unknown. We report a case of complete remission of hyperprolactinemia after laparoscopic myomectomy. The patient was 37 years-of-age, gravid 0, para 0. She was referred to our hospital elsewhere because of a diagnosis with hyperprolactinemia and uterine myoma. At the age of 35, she had been diagnosed with secondary amenorrhea and hyperprolactinemia. Brain MRI and CT scans failed to detect any morphological abnormality. She had been taking cabergoline followed by terguride for nearly two years, but her hyperprolactinemia failed to respond to the deopamine agonists despite a gradual increase of their dosages. However, the hyperprolactinemia unexpectedly regressed completely after the patient underwent laparoscopic myomectomy. The rapid normalization of this patient's high-dose dopamine agonist resistant hyperprolactinemia after myomectomy clearly demonstrates that these conditions were due to her uterine myoma.","PeriodicalId":325241,"journal":{"name":"Japanese Journal of Gynecologic and Obstetric Endoscopy","volume":"150 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127271355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical study of laparoscopic coagulation with ultrasonic vibrating scalpel for ovarian endometrioma 超声振动刀腹腔镜凝固治疗卵巢子宫内膜瘤的临床研究

Japanese Journal of Gynecologic and Obstetric Endoscopy Pub Date : 1900-01-01 DOI: 10.5180/JSGOE.21.336

晴生村川, 耕平田中, 尚美松田, 将佐々木, 修一飯田, 雅洲鈴木

{"title":"Clinical study of laparoscopic coagulation with ultrasonic vibrating scalpel for ovarian endometrioma","authors":"晴生村川, 耕平田中, 尚美松田, 将佐々木, 修一飯田, 雅洲鈴木","doi":"10.5180/JSGOE.21.336","DOIUrl":"https://doi.org/10.5180/JSGOE.21.336","url":null,"abstract":"対象は、平成14年4月から平成15年4月の期間に、当院で腹腔鏡下子宮内膜症性卵巣嚢胞凝固術を施行した13症例19嚢胞とした。症例背景を表1 に示した。平均年齢は31.8歳、平均BMI(Body mass index)は21.4であった。13例中9例は不妊を主訴に受診した症例であった。子宮内膜症性卵巣嚢胞の診断は経膣超音波装置、MRI、腫瘍マーカーを用いて行った。さらに平成17年4月までの期間、全例2年間にわたり再発の有無を経膣超音波装置にて追跡評価を行った。子宮内膜症性卵巣表1症例の背景嚢胞再発の定義は、経膣超音波装置で直径30mm 以上の境界鮮明なheterogeneous領域を認めた場合とした。手術は、全身麻酔下で患者体位は砕石位とした。キルシュナー皮下鋼線を下腹部正中線を垂直にまたぐ形で臍下および恥骨上の2箇所の皮下組織に通し、腹壁を吊り上げた。骨盤内に病変部を確認した後、超音波凝固切開装置(Harmonic Scalpel, ETHICON Endo-Surgery社)鋏型ブレードにて嚢胞に小切開を加えた。茶褐色の嚢胞液を確認した後、嚢胞液の腹腔内漏出予防を目的に出来る限り速やかに嚢胞液を吸引・内腔の洗浄を行った。嚢胞を鋏型ブレードにて広く切開した後にボール型ブレード(ボール・コアギュレーター)を用いて嚢胞内腔の凝固を行った。ジェネレーター出力はレベル3から5の間で設定して凝固を行った。図1に示すように、凝固方法は単層に広く凝固(内腔組織が白色に変化)した後、再び広く凝固(内腔組織が焦げ茶色に変化:図1、 ★印部位) を行う重層凝固法とした。凝固終了後は吸収糸 (3-0モノクリル)を用いて嚢胞切開部位の体内縫合を行った。図1ボール型ブレード(ボール・コアギュレーター)を用いたチョコレート嚢胞重層凝固術","PeriodicalId":325241,"journal":{"name":"Japanese Journal of Gynecologic and Obstetric Endoscopy","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127285541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of external iliac artery injury during total laparoscopic radical hysterectomy managed laparoscopically 腹腔镜下全腹腔镜子宫根治术中髂外动脉损伤1例

Japanese Journal of Gynecologic and Obstetric Endoscopy Pub Date : 1900-01-01 DOI: 10.5180/JSGOE.32.271

S. Takakura, T. Asakura, Hirohiko Tanaka, Noboru Akiyama, T. Tokuyama, Y. Minami, M. Nakano, Yoshinari Kobayashi, Miho Izawa, H. Taniguchi, T. Motohashi, E. Kondo, T. Ikeda

{"title":"A case of external iliac artery injury during total laparoscopic radical hysterectomy managed laparoscopically","authors":"S. Takakura, T. Asakura, Hirohiko Tanaka, Noboru Akiyama, T. Tokuyama, Y. Minami, M. Nakano, Yoshinari Kobayashi, Miho Izawa, H. Taniguchi, T. Motohashi, E. Kondo, T. Ikeda","doi":"10.5180/JSGOE.32.271","DOIUrl":"https://doi.org/10.5180/JSGOE.32.271","url":null,"abstract":"Here we report on a case of an external iliac artery injury that occurred during total laparoscopic radical hysterectomy that was managed laparoscopically. The patient was a 41-year-old woman, gravida 6 para 1, who underwent a total laparoscopic radical hysterectomy for the treatment of clinical stage IB1 cervical adenocarcinoma. The right external iliac artery was lacerated during the monopolar dissection of a broad ligament, which induced severe bleeding. The bleeding was stopped by grasping of the lacerated site with an atraumatic grasper. An endovascular clip was placed both proximal and distal to the lacerated site, which was repaired with an uninterrupted intracorporeal suture. The endovascular clips were then removed and hemostasis was confirmed. The right external iliac artery was occluded for a total of 28 minutes. The laparoscopic surgery did not require a laparotomy. The patient has since been followed up for 14 months without recurrence or complications in the right lower","PeriodicalId":325241,"journal":{"name":"Japanese Journal of Gynecologic and Obstetric Endoscopy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127482338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

A case of bilateral ovarian fibroma that increased 14 years after laparoscopic ovarian tumor resection 双侧卵巢纤维瘤在腹腔镜卵巢肿瘤切除术后增加14年1例

Japanese Journal of Gynecologic and Obstetric Endoscopy Pub Date : 1900-01-01 DOI: 10.5180/jsgoe.36.1_144

N. Suda, Y. Yamazaki, Michiyo Ushijima, Haruka Nunomura, Hiroki Waki, Y. Yamakawa

{"title":"A case of bilateral ovarian fibroma that increased 14 years after laparoscopic ovarian tumor resection","authors":"N. Suda, Y. Yamazaki, Michiyo Ushijima, Haruka Nunomura, Hiroki Waki, Y. Yamakawa","doi":"10.5180/jsgoe.36.1_144","DOIUrl":"https://doi.org/10.5180/jsgoe.36.1_144","url":null,"abstract":"Ovarian fibromas, the most common benign solid ovarian tumors, often occur unilaterally in postmenopausal women treated with laparoscopic salpingo-oophorectomy. Here, we report a rare case of unusual bilateral ovarian fibroma torsion in a young woman. A 38-year-old nulliparous woman presenting with an acute abdomen had a history of laparoscopic right partial ovarian resection for bilateral ovarian fibroma and cystectomy for a left ovarian chocolate cyst at 24 years of age. Magnetic resonance imaging showed bilateral solid adnexal masses with microcysts similar to the tumor seen 14 years prior, with the largest measuring 10 cm. We diagnosed torsion of re-enlarged ovarian tumors and performed emergency laparoscopic bilateral salpingo-oophorectomy rather than conservative surgery because it was difficult to macroscopically identify normal ovaries. For a young woman with bilateral fibroma, partial tumor excision may be selected to preserve ovarian function and fertility. In such cases, careful follow-up with informed consent is critical because the tumor may re-grow and subsequently twist.","PeriodicalId":325241,"journal":{"name":"Japanese Journal of Gynecologic and Obstetric Endoscopy","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124972320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correlation between tumor marker expression and tumor diameter in mature cystic teratoma of the ovary 卵巢成熟囊性畸胎瘤肿瘤标志物表达与肿瘤直径的关系

Japanese Journal of Gynecologic and Obstetric Endoscopy Pub Date : 1900-01-01 DOI: 10.5180/jsgoe.34.1_80

Koichiro Hirashiki, Mizue Itoi, Yoshimasa Kawarai, Hiroaki Kimura

{"title":"Correlation between tumor marker expression and tumor diameter in mature cystic teratoma of the ovary","authors":"Koichiro Hirashiki, Mizue Itoi, Yoshimasa Kawarai, Hiroaki Kimura","doi":"10.5180/jsgoe.34.1_80","DOIUrl":"https://doi.org/10.5180/jsgoe.34.1_80","url":null,"abstract":"Objective: We investigated the correlation between tumor diameter and the expression of tumor markers in ovarian mature cystic teratoma (MCT). Methods: Thirty-two patients with MCT who were surgically treated at our hospital between January 2013 and March 2015 were included in this study. We investigated the correlation between tumor diameter and tumor marker expression (squamous cell carcinoma antigen [SCC], carcinoembryonic antigen [CEA], carbohydrate antigen [CA]125, and CA19-9). Results: The median tumor diameter was 7.8 cm (range 5.0-16.0 cm). The median values of SCC, CEA, CA125, and CA19-9 were 1.25 ng/mL (range 0.6-3.5 ng/mL), 1.4 ng/mL (range 0.5-10.9 ng/mL), 16 U/mL (range 5.0-86.1 U/mL), and 34.6 U/mL (range 2.0-949.4 U/mL), respectively. The levels of SCC and CEA showed significant positive correlations with tumor diameter (respective correlation coefficients = 0.499 and 0.460), while the levels of CA19-9 and CA125 showed no significant correlation with the tumor diameter. We also encountered an example of malignant transformation of MCT during the study period. The tumor diameter in this case was 18.8 cm, and the preoperative level of SCC was 25 ng/mL, which is remarkably high, even considering the tumor diameter. Conclusion: In this study, the levels of SCC and CEA showed significant positive correlations with tumor diameter. High preoperative SCC and CEA levels may suggest that the tumor diameter should be considered when planning laparoscopic surgery. On the other hand, in cases in which the tumor markers are remarkably high, preoperative evaluation for the possibility of malignancy may be necessary.","PeriodicalId":325241,"journal":{"name":"Japanese Journal of Gynecologic and Obstetric Endoscopy","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125114227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Monitoring of Water Intoxication in Transcervical Resection 经宫颈切除术中水中毒的监测

Japanese Journal of Gynecologic and Obstetric Endoscopy Pub Date : 1900-01-01 DOI: 10.5180/JSGOE.21.384

明子高島, 究大高, 彰臼井, 矢野ともね, 俊彦木下, 元博伊藤

引用次数: 0

A retrospective study of laparoscopic hysterectomy: 312 cases 腹腔镜子宫切除术312例回顾性分析

Japanese Journal of Gynecologic and Obstetric Endoscopy Pub Date : 1900-01-01 DOI: 10.5180/JSGOE.28.645

M. Seta, Y. Koyasu, M. Nishio, M. Yamada, M. Tokunaga, K. Yamamoto, T. Sekikawa, H. Uto, Naoko Suga

引用次数: 0

The usefulness of transcutaneous carbon dioxide measurement in patients undergoing gynecological laparoscopic surgery 经皮二氧化碳测量在妇科腹腔镜手术患者中的应用

Japanese Journal of Gynecologic and Obstetric Endoscopy Pub Date : 1900-01-01 DOI: 10.5180/JSGOE.17.2_70

章郎水嶋, 泰河内, 邦久三浦, 堅島しのぶ, 神山洋一郎, 昭也中村, 真理地主, 裕之武内

{"title":"The usefulness of transcutaneous carbon dioxide measurement in patients undergoing gynecological laparoscopic surgery","authors":"章郎水嶋, 泰河内, 邦久三浦, 堅島しのぶ, 神山洋一郎, 昭也中村, 真理地主, 裕之武内","doi":"10.5180/JSGOE.17.2_70","DOIUrl":"https://doi.org/10.5180/JSGOE.17.2_70","url":null,"abstract":"対象は順天堂大学浦安病院で気腹式腹腔鏡下卵巣嚢種摘出術を行った全身状態の良好な12例 (ASAリスク1~2)とした。麻酔前投薬として、プロチゾラム0.25~0.5mgを入室90分前に経口投与した。麻酔はプロポフォール2mg/kgで導入し、亜酸化窒素(50%)-酸素-セボフルラン吸入で維持した。麻酔導入後、ベクロニウム 0.1mg/kgを用いて気管挿管し、調節呼吸とした。ベクロニウムは手術の長さに応じて適宜追加し、術後に拮抗した。手術は開脚位で、クローズド法でアプローチして炭酸ガスを注入し、腹腔内圧を 10mmHgに調整した。ポートの位置は膀輪下部にスコープ用の10mm、両側下腹部の下腹壁動静脈の外側にそれぞれ5mm、術者側の左上腹部に 10mmの計4本のトロカールを刺入した2)。気腹中は約15度のトレンデレンブルグ位で手術を施行した。術中輸液には5%ブドウ糖加酢酸リンゲル液(5ml/kg/hr)を用いた。鎮痛にはブトルファノールを適宜静注(計0.01~0.02mg/kg)し、トロカール刺入部位には0.25%ブビバカインを1 カ所当たり5ml局注した。手術室入室後、 PtcCO2センサ(コーケンメディカル社、サーフェイスモニタ9900MKII(8))を前胸部に貼付し、 42°C に設定し連続的に記録した。動脈採血を気腹前(麻酔導入後)・気腹中・気腹後(気管チューブ抜去後、術後回復室自発呼吸時)に適宜行い、 PaCO2を測定した。気管挿管中はカプノメータによりPetCO2も測定し、3方法の炭酸ガス分圧値を比較した。統計にはStatview� を用い回帰分析を行い、P<0.01を有意とした。","PeriodicalId":325241,"journal":{"name":"Japanese Journal of Gynecologic and Obstetric Endoscopy","volume":"258263 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123285292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hysteroscopic surgery training model using a pumpkin 宫腔镜手术训练模型使用南瓜

Japanese Journal of Gynecologic and Obstetric Endoscopy Pub Date : 1900-01-01 DOI: 10.5180/JSGOE.24.287

K. Tajima, S. Ikeno, Ikuko Uchinami, Shin Fukuda, M. Orisaka, H. Shimada, F. Kotsuji

引用次数: 0