{"title":"Handling cervical myomas.","authors":"Pravin Patel, Manish Banker, Sujal Munshi, Aditi Bhalla","doi":"10.4103/0974-1216.85277","DOIUrl":"https://doi.org/10.4103/0974-1216.85277","url":null,"abstract":"<p><p>Compared to myomas that occur in the uterine corpus, cervical myomas are closer to other organs such as the bladder, ureter, and rectum, and the approach needs to be modified, as the organs that have to be considered differ depending on the location of the myoma. Surgical difficulties associated with these cases are, poor access to the operative field, difficulty in suturing the repairs, increased blood loss, and distortion of the anatomy of the vital neighboring structures in the pelvic cavity.</p>","PeriodicalId":89586,"journal":{"name":"Journal of gynecological endoscopy and surgery","volume":"2 1","pages":"30-2"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4103/0974-1216.85277","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30522947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laparoscopic myomectomy: methods to control bleeding.","authors":"Nikita Trehan","doi":"10.4103/0974-1216.85278","DOIUrl":"https://doi.org/10.4103/0974-1216.85278","url":null,"abstract":"<p><p>Most of the surgeons find it difficult to perform myomectomy when it bleeds during the procedure as it becomes difficult to get into the correct plane of dissection. If this bleeding or blood staining of tissues is prevented it will be easier to get into the correct plane of dissection. In several studies, it is found that bilateral uterine artery ligation, at origin, does not interfere with future fertility as the end vessels and collaterals of the uterus are not interfered with. As no energy source is used to incise the myoma once Vasopressin has been used, the myomectomy scar integrity is better, as noted by various surgeons.</p>","PeriodicalId":89586,"journal":{"name":"Journal of gynecological endoscopy and surgery","volume":"2 1","pages":"33-5"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4103/0974-1216.85278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30522948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"President's Message for IAGE Journal.","authors":"Rakesh Sinha","doi":"10.4103/0974-1216.85271","DOIUrl":"https://doi.org/10.4103/0974-1216.85271","url":null,"abstract":"","PeriodicalId":89586,"journal":{"name":"Journal of gynecological endoscopy and surgery","volume":"2 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4103/0974-1216.85271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30524647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Robotic sacrocolpopexy: an observational experience at mayoclinic, USA.","authors":"Krishna Kavita Ramavath, Pp Srinivasa Murthy","doi":"10.4103/0974-1216.85285","DOIUrl":"https://doi.org/10.4103/0974-1216.85285","url":null,"abstract":"<p><p>Although there are many studies the ongoing debate on the management of posthysterectomy vault prolapse whether it should be abdominal, vaginal, or laparoscopic still continues. However there is no clear consensus. Though the incidence of vaginal vault prolapse is said to range from 0.2 to 45%, the choice of the optimal treatment depends on the surgeon's experience, suitability for surgery, age, symptoms, quality of life impairment, and prolapse grade. Abdominal sacrocopopexy (ASCP) with mesh interposition is the traditional surgical procedure for treating pelvic organ prolapse and has been shown to have one of the highest long-term success rates for vaginal vault prolapse. The laparoscopic approach offers reduced morbidity, shorter hospitalization, and decreased post operative pain. The disadvantages of the laparoscopic approach include longer operating time and need for advanced laparoscopic surgical skills including suturing. Robot-assisted laparoscopic procedure allows the performance of complex laparoscopic maneuvers with less difficulty, and thereby simplifies the complex procedure. The aim is to describe and demonstrate the use and benefit of robot-assisted laparoscopic sacrocolpopexy in the treatment of posthysterectomy vaginal vault prolapse in obese patients along with mid-urethral sling application.</p>","PeriodicalId":89586,"journal":{"name":"Journal of gynecological endoscopy and surgery","volume":"2 1","pages":"53-7"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4103/0974-1216.85285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30522952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multiple layer closure of myoma bed in laparoscopic myomectomy.","authors":"Nutan Jain","doi":"10.4103/0974-1216.85281","DOIUrl":"https://doi.org/10.4103/0974-1216.85281","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility and outcome of laparoscopic myomectomy and multiple layer closure of the myoma bed, for management of myomas, at a tertiary care hospital.</p><p><strong>Materials and methods: </strong>From September 2005 to September 2010, 417 patients, with large and moderate size myomas, were managed by laparoscopic myomectomy. Indications were subfertility, menorrhagia, and abdominal mass. Preoperative evaluation included history, clinical examination, and sonographic mapping. The myomas were enucleated and retrieved laparoscopically. Myoma beds were sutured in multiple layers by endoscopic intracorporeal suturing.</p><p><strong>Results: </strong>Three hundred and fifteen patients presented with subfertility, 45 with menorrhagia, and 57 with abdominal mass. The average maximum diameter of a myoma was 9 cm. The mean duration of surgery was 120 minutes. The mean postoperative stay was 24 hours. No intraoperative complication occurred and the hospital course was uncomplicated. In one case, a minilap incision was performed for retrieval of the myoma with suturing of the bed. Two patients had minor delayed wound healing of the morcellator port site. The patients did not report any complaints during the follow-up, except one patient who developed omental hernia at the morcellator port site. There was no rupture of the scar and very low adhesion scores in the subsequent cesarean sections or second-look scopies.</p><p><strong>Conclusion: </strong>With proper multilayer closure of the myoma bed, laparoscopic myomectomy was feasible for moderate and even large myomas and had excellent outcomes.</p>","PeriodicalId":89586,"journal":{"name":"Journal of gynecological endoscopy and surgery","volume":"2 1","pages":"43-6"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4103/0974-1216.85281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30522950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Single incision laparoscopic myomectomy.","authors":"B Ramesh, Madhuri Vidyashankar, Bv Bharathi","doi":"10.4103/0974-1216.85288","DOIUrl":"https://doi.org/10.4103/0974-1216.85288","url":null,"abstract":"<p><p>Single port laparoscopic surgery (SPLS), also called SILS is the natural extension of multi-incisional laparoscopic surgery, in the quest for reduction of traumatic insult and residual scarring to the patient. Today with the evolution of newer instruments, bidirectional self-retaining sutures, and surgical experience we are able to perform many surgeries in gynecology.</p>","PeriodicalId":89586,"journal":{"name":"Journal of gynecological endoscopy and surgery","volume":"2 1","pages":"61-3"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4103/0974-1216.85288","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30522954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The magic lies in the magician, not in the wand.","authors":"Rajesh Modi","doi":"10.4103/0974-1216.85270","DOIUrl":"https://doi.org/10.4103/0974-1216.85270","url":null,"abstract":"","PeriodicalId":89586,"journal":{"name":"Journal of gynecological endoscopy and surgery","volume":"2 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4103/0974-1216.85270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30524646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laparoscopic myomectomy with uterine artery ligation: review article and comparative analysis.","authors":"Rakesh Sinha, Meenakshi Sundaram, Chaitali Mahajan, Shweta Raje, Pratima Kadam, Gayatri Rao","doi":"10.4103/0974-1216.85272","DOIUrl":"https://doi.org/10.4103/0974-1216.85272","url":null,"abstract":"<p><p>Uterine leiomyomas are one of the most common benign smooth muscle tumors in women, with a prevalence of 20 to 40% in women over the age of 35 years. Although many women are asymptomatic, problems such as bleeding, pelvic pain, and infertility may necessitate treatment. Laparoscopic myomectomy is one of the treatment options for myomas. The major concern of myomectomy either by open method or by laparoscopy is the bleeding encountered during the procedure. Most studies have aimed at ways of reducing blood loss during myomectomy. There are various ways in which bleeding during laparoscopic myomectomy can be reduced, the most reliable of which is ligation of the uterine vessels bilaterally. In this review we propose to discuss the benefits and possible disadvantages of ligating the uterine arteries bilaterally before performing laparoscopic myomectomy.</p>","PeriodicalId":89586,"journal":{"name":"Journal of gynecological endoscopy and surgery","volume":"2 1","pages":"3-10"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4103/0974-1216.85272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30524648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rafique B Parkar, M A Hassan, David Otieno, Richard Baraza
{"title":"Laparoscopic Trachelectomy for Cervical Stump 'Carcinoma in situ'.","authors":"Rafique B Parkar, M A Hassan, David Otieno, Richard Baraza","doi":"10.4103/0974-1216.85287","DOIUrl":"https://doi.org/10.4103/0974-1216.85287","url":null,"abstract":"<p><p>A 43-year-old, who underwent a subtotal hysterectomy for postpartum hemorrhage following a normal delivery, 10 years ago, presented with a history of persistent vaginal discharge and post-coital bleeding. A pap smear reported moderate dysplasia, and a subsequent colposcopic biopsy reported severe dysplasia with crypt extension. The patient underwent a laparoscopic trachelectomy, and histology of the stump reported cervical squamous carcinoma in situ, with no microinvasion.</p>","PeriodicalId":89586,"journal":{"name":"Journal of gynecological endoscopy and surgery","volume":"2 1","pages":"58-60"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4103/0974-1216.85287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30522953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laparoscopic management of broad ligament fibroids.","authors":"Palaskar Pandit, Shradha Chandak","doi":"10.4103/0974-1216.85290","DOIUrl":"https://doi.org/10.4103/0974-1216.85290","url":null,"abstract":"<p><p>Two cases of true broad ligament fibroids and thirty cases of false broad ligament fibroids were operated. All were removed through the laparoscopic route, with very minimal blood loss and without a need for blood transfusion. We traced the course of the ureters in all cases. No complications were met with.</p>","PeriodicalId":89586,"journal":{"name":"Journal of gynecological endoscopy and surgery","volume":"2 1","pages":"64-6"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4103/0974-1216.85290","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30522955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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