Abstract:
STUDY OBJECTIVES:To describe a technique to manually morcellate large uteri within a polyurethane endoscopic bag at the time of laparoscopic hysterectomy, and report perioperative outcomes from our 5 years of experience. STUDY DESIGN:Retrospective review of all consecutive hysterectomies with uterine weight >500 g performed between January 2010 and December 2014 in which the uterus was manually morcellated within an endoscopic bag by either an abdominal or vaginal approach (Canadian Task Force Classification Level III). SETTING:Tertiary care academic medical center. PATIENTS:A total of 104 women with a uterine weight >500 g who underwent laparoscopic hysterectomy using a manual morcellation technique. INTERVENTION:Manual morcellation was done extracorporeally, within a partially exteriorized specimen bag, using a scalpel under direct visualization by the operating surgeon. MEASUREMENTS AND MAIN RESULTS:A total of 104 laparoscopic hysterectomies were performed in women with a uterus weighing >500 g using a manual morcellation technique for specimen extraction. The median patient age was 48.1 years (range, 34-69 years), and the median body mass index was 31.0 kg/m(2) (range, 19.1-56.7 kg/m(2)). The median blood loss and specimen weight were 200 mL (range, 20-1200 mL) and 741.5 g (range, 500-1930 g), respectively. Morcellation was performed through an abdominal approach in 58.7% of the patients and through a vaginal approach in 41.3%. The median duration of morcellation was 14.8 minutes (range, 4.5-21.6 minutes) for the abdominal route and 11.7 minutes (range, 5.2-16.8 minutes) for the vaginal route. Occult malignancy was identified in 2 patients. There were no complications related to the morcellation technique or gross bag rupture. CONCLUSION:Manual morcellation within an endoscopic bag allows for the extraction of large uteri without the use of a power morcellator. In our 5 years of experience, we have not experienced any incidence of gross spillage, visually noted bag rupture, or complications associated with our morcellation technique.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Serur E,Zambrano N,Brown K,Clemetson E,Lakhi Ndoi
10.1016/j.jmig.2016.03.016subject
Has Abstractpub_date
2016-09-01 00:00:00pages
903-8issue
6eissn
1553-4650issn
1553-4669pii
S1553-4650(16)00151-5journal_volume
23pub_type
杂志文章abstract:STUDY OBJECTIVE:To demonstrate the surgical technique of laparoscopic cerclage (LAC) in nonpregnant women with a clinical diagnosis of cervical incompetence. In this video, the authors describe the complete procedure in 10 steps to standardize and facilitate the comprehension and performance of the procedure in a simpl...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.10.019
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:To compare obstetric and surgical outcomes of transabdominal cerclage (TAC) via laparotomy (TAC-LAP) versus robotic-assisted (TAC-RA) approaches. DESIGN:Retrospective cohort study. SETTING:An academic medical center. PATIENTS:Sixty-nine women with acquired or congenital cervical insufficiency. INTER...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.08.014
更新日期:2020-01-01 00:00:00
abstract::Abnormal uterine bleeding and other gynecologic complications associated with a previous cesarean section scar are only recently being identified and described. Herein we report a rare case of a woman with recurring massive uterine bleeding after 2 cesarean sections. Curettage and hormone therapy were unsuccessfully u...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.10.005
更新日期:2015-02-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the safety and efficacy of cold loop hysteroscopic myomectomy in a large series of cases. DESIGN:Retrospective study (Canadian Task Force Classification III). SETTING:Arbor Vitae Center for Endoscopic Gynecology, Rome, Italy. PATIENTS:A total of 1215 patients with 1 or more G1-G2 submucous ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.03.004
更新日期:2015-07-01 00:00:00
abstract::Conservative surgical management of uterine prolapse with uterine conservation has become an alternative treatment in women who wish to maintain their uterus. Vaginal and abdominal approaches for uterine suspension have been described and reported. Certain concomitant pathologic conditions of the uterus such as uterin...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2013.04.025
更新日期:2013-11-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the accuracy of historic averages for estimating operating room (OR) time for hysterectomy among women with small and large uteri. DESIGN:A retrospective cohort study. SETTING:Data from women who underwent abdominal, vaginal, or laparoscopic hysterectomy between 2015 and 2017 at the Univer...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.01.003
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the cost-effectiveness of ultrasound (US)-guided aspiration and ethanol sclerotherapy versus laparoscopic surgery for benign-appearing ovarian endometrioma. DESIGN:Prospective, cohort pilot study. SETTING:Multiple centers, Spain. PATIENTS:Forty patients with suspected ovarian endometrioma ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jmig.2019.08.036
更新日期:2020-01-01 00:00:00
abstract::Annual surgeon case volume has been linked to patient outcome in a variety of surgical fields, although limited data focus on gynecologic surgery performed by general gynecologists. Herein we review the literature addressing the associations between intraoperative injury, postoperative morbidity, and resource use amon...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2013.03.005
更新日期:2013-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate risk of leakage and tissue dissemination associated with various contained tissue extraction (CTE) techniques. DESIGN:In vitro study (Canadian Task Force classification: II-1). SETTING:Academic hospital simulation laboratory. INTERVENTION:Beef tongue specimens weighing 400 to 500 g were s...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.06.004
更新日期:2014-09-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to estimate the impact of sentinel nodes in gynecologic oncology on fellowship training and discuss potential solutions. DESIGN:Retrospective multi-institution cohort (Canadian Task Force classification II-2). SETTING:Three tertiary cancer referral cancer centers. PATIENTS:Patients with end...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.08.006
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:To perform a cost-minimization analysis comparing robotic-assisted, laparoscopic, and abdominal sacrocolpopexy. DESIGN:Cost-minimization analysis using a micro-costing approach (Canadian Task Force classification III). MEASUREMENTS AND MAIN RESULTS:A decision model was developed to compare the costs (...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.03.011
更新日期:2010-07-01 00:00:00
abstract:STUDY OBJECTIVE:To identify the lengthiest step of total laparoscopic hysterectomy (TLH) in a teaching hospital and to determine which clinical factors affect the duration of this step. SETTING:The University of Louisville Hospital. DESIGN:Single institution retrospective case series. METHODS AND MAIN RESULTS:This i...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.04.020
更新日期:2015-09-01 00:00:00
abstract::Laparoendoscopic single-site surgery (LESS) and natural orifice translumenal endoscopic surgery are now being used in gynecologic oncologic procedures. We used our expertise with LESS to perform nerve-sparing laparoscopic radical hysterectomy. A 45-year-old woman with stage IA2 cervical cancer was referred to us. The ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.04.019
更新日期:2013-11-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the perioperative outcomes of various modes of myomectomy (abdominal [AM], laparoscopic [LM], or robotic [RM]) in cases of extreme myoma burden. DESIGN:Retrospective cohort study (Canadian Task Force classification II-2). SETTING:A tertiary academic center in Boston, Massachusetts. PATIEN...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.10.022
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:To estimate pulmonary complications and diaphragm recurrence after resection of diaphragm metastases by minimally invasive surgery (MIS) for epithelial ovarian cancer (EOC). DESIGN:Retrospective analysis (Canadian Task Force classification III). SETTING:Mayo Clinic in Scottsdale, Arizona, from January...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.12.003
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:To determine patient and hospital characteristics that were associated with undergoing laparoscopic hysterectomy compared with abdominal hysterectomy. DESIGN:Canadian Task Force Classification II-3. METHODS:In this retrospective cohort study, we analyzed the 2010 Healthcare Cost and Utilization Projec...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.08.709
更新日期:2014-03-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate stepwise techniques for the successful use of the laparoscopic single-site technique for safely performing transvaginal sacrocolpopexy for pelvic organ prolapse. DESIGN:Stepwise demonstration with narrated video footage (Canadian Task Force classification III). SETTING:Academic tertiary...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.11.018
更新日期:2020-11-26 00:00:00
abstract:STUDY OBJECTIVE:Although all ectopic pregnancies are associated with risk of hemorrhage, cornual pregnancies are feared for catastrophic hemorrhage and uncontrollable bleeding. The maternal mortality rate can be as high as 2.5%, which is 7 times higher than the mortality rate for ectopic pregnancies in general. Differe...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.04.005
更新日期:2017-01-01 00:00:00
abstract::Vasopressin has been used in gynecologic surgery since the 1950s. Since its initial introduction, multiple applications of vasopressin have been explored. The expansion of vasopressin usage in gynecologic surgery is being fueled in part by the increase in minimally invasive surgical techniques, in which alternative me...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2012.03.022
更新日期:2012-07-01 00:00:00
abstract::Bleeding in adolescence is a common but, potentially, difficult condition to manage. Adolescents present with unique issues related to their age, involvement of family members, different differential diagnosis when compared to an older populations, and challenges associated with their evaluation and treatment. ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.08.014
更新日期:2008-11-01 00:00:00
abstract:STUDY OBJECTIVE:Laparoscopy using a single port improves morbidity while keeping the same level of requirement. This technique has been evaluated in gynecology for salpingectomy, ovarian surgery, and hysterectomy. Here, the authors illustrate a new use of a single port using the transvaginal approach. DESIGN:Case repo...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.09.027
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the feasibility of office hysteroscopy in patients with pregnancy-related problems such as retained trophoblastic tissue, persistent molar tissue, pregnancy with in situ intrauterine device (IUD), isthmocele, embryoscopy, and osseous metaplasia. DESIGN:Retrospective cohort chart review of u...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.11.004
更新日期:2014-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine which patient characteristics are associated with an increased risk of postablation pelvic pain. DESIGN:Canadian Task Force classification II-2. METHODS:Data were collected from a retrospective cohort of patients who underwent endometrial ablation between January 2006 and September 2010 a...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.04.006
更新日期:2013-09-01 00:00:00
abstract:STUDY OBJECTIVE:The objective of our study is to provide a contemporary description of hysterectomy practice and temporal trends in Canada. DESIGN:A national whole population retrospective analysis of data from the Canadian Institute for Health Information SETTING: Canada PATIENTS: All women who underwent hysterectomy...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2021.01.010
更新日期:2021-01-18 00:00:00
abstract::Although the use of vaginal mesh kits in treatment of pelvic organ prolapse (POP) has decreased the number of surgical failures, mesh exposure can occur. When conservative management fails, removing the exposed material is associated with the risk of recurrence of POP and could be challenging. We report a successful o...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.10.007
更新日期:2013-03-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate visual pattern parameters obtained with hysteroscopy for the prediction of endometrial cancer, to evaluate observer variation of these parameters, and to present a scoring system of the parameters for the prediction of malignancy compared with subjective evaluation. DESIGN:A prospective con...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.06.018
更新日期:2015-11-01 00:00:00
abstract::Splenic rupture is a rare and severe complication of laparoscopic surgery. We report a case of delayed splenic rupture as a severe complication of laparoscopy, occurring 5 days after surgery performed on a 52-year-old woman with history of abdominal surgery and with acute pelvic infection. Subcapsular hematoma, result...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.08.615
更新日期:2008-01-01 00:00:00
abstract::Uterocutaneous fistula is a rare complication that may follow cesarean section. Herein is described a rare case of uterocutaneous fistula. The patient, a 28-year-old woman with a history of American Society for Reproductive Medicine stage IV endometriosis (Douglas pouch obliteration), underwent a cesarean section at 2...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.10.010
更新日期:2012-03-01 00:00:00
abstract:STUDY OBJECTIVE:To compare 2-year follow-up intestinal function and quality of life (QoL) between women with temporary protective ileostomy (PI) and recanalization and women without PI after colorectal segmental resection for deep infiltrating endometriosis (DIE). DESIGN:Prospective observational exploratory study. S...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.10.017
更新日期:2020-01-01 00:00:00
abstract::The literature was searched for endometriosis and hysterectomy on PubMed and the individual search engines of the Journal of Minimally Invasive Surgery, Fertility and Sterility, BJOG, Obstetrics and Gynecology, the American Journal of Obstetrics and Gynecology, and Human Reproduction. Eighty references of interest wer...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2006.06.022
更新日期:2006-11-01 00:00:00