Abstract:
STUDY OBJECTIVE:To demonstrate the feasibility of laparoscopic management of a huge myoma nascendi. DESIGN:Step-by-step video demonstration of the surgical procedure (Canadian Task Force classification III-C). SETTING:Uterine myoma is the most common benign neoplasm of the female reproductive tract, with an estimated incidence of 25% to 30% at reproductive age [1,2]. Patients generally have no symptoms; however, those with such symptoms as severe pelvic pain, heavy uterine bleeding, or infertility may be candidates for surgery. The traditional management is surgery; however, uterine artery embolization or hormonal therapy using a gonadotropin-releasing hormone agonist or a selective estrogen receptor modulator should be preferred as the medical approach. Surgical management should be performed via laparoscopy or laparotomy; however, the use of laparoscopic myomectomy is being debated for patients with huge myomas. Difficulties in the excision, removal, and repair of myometrial defects, increased operative time, and blood loss are factors keeping physicians away from laparoscopic myomectomy [1,2]. INTERVENTIONS:A 35-year-old woman was admitted to our clinic with complaints of chronic pelvic pain and heavy menstrual bleeding. Her medical history included multiple hospitalizations for blood transfusions, along with a recently measured hemoglobin level of 9.5 g/dL and a hematocrit value of 29%. She had never been married and had no children. Pelvic ultrasonography revealed a 12 × 10-cm uterine myoma located on the posterior side of the corpus uteri and protruding through to the cervical channel. This was a huge intramural submucous myoma in close proximity to the endometrial cavity and spreading through the myometrium. On vaginal examination, the myoma was found to extend into the vagina through the cervical channel. Laparoscopic myomectomy was planned because of the patient's desire for fertility preservation. Abdominopelvic exploration revealed a huge myoma filling the posterior side of the corpus uteri and extending to the isthmus uteri and cervical channel. A myomectomy was performed using standard technique as described elsewhere. A vertical incision was made using a harmonic scalpel. The myoma was fixed with a corkscrew manipulator and enucleated. During the procedure, the endometrial cavity was torn and was closed with 2-0 Vicryl separately. Total intraoperative blood loss was 250 mL, the total weight of the myoma was 245 g, and the operation lasted about 120 minutes. The patient experienced no intraoperative complications. She was discharged on postoperative day 1 and did not exhibit any problems at follow-up. The final histopathological examination confirmed the diagnosis of uterine leiomyoma. CONCLUSION:Laparoscopic management of huge myomas in difficult locations appears to be a feasible and safe surgical option, especially in experienced hands.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Peker N,Gündoğan S,Şendağ Fdoi
10.1016/j.jmig.2016.09.003subject
Has Abstractpub_date
2017-01-01 00:00:00pages
347-348issue
3eissn
1553-4650issn
1553-4669pii
S1553-4650(16)31043-3journal_volume
24pub_type
杂志文章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::To reduce bladder function impairment and avert the serious complications of anastomotic leakage after segmental rectosigmoidectomy and to minimize the persistence of endometriotic lesions associated with discoid resection, we used the double circular stapling (DCS) technique. This technique enables excision of bowel ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.07.022
更新日期:2014-01-01 00:00:00
abstract::We performed a literature review of reports comparing a levonorgestrel-releasing intrauterine device (LNG-IUD) with transcervical polyp resection (TCRP) as a treatment for heavy menstrual bleeding (HMB). Our second objective was to investigate the effectiveness of LNG-IUD and TCRP in reducing menstrual bleeding and th...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2015.06.016
更新日期:2015-11-01 00:00:00
abstract:STUDY OBJECTIVE:The aim of our study was to determine if laparoscopic radical hysterectomy (LRH) can be routinely used for the treatment of early-stage cervical cancer. DESIGN:From May 2008, LRH was planned for all primarily operable cervical cancer patients after receiving informed consent in our department. The surg...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.09.009
更新日期:2015-02-01 00:00:00
abstract:STUDY OBJECTIVE:To show different abdominal methods of tissue containment and specimen extraction techniques as an alternative to electromechanical morcellation (EMM). DESIGN:A stepwise surgical tutorial using a narrated video (Canadian Task Force classification III). SETTING:An academic tertiary care hospital. INTE...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2016.05.014
更新日期:2016-01-01 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 OBJECTIVES:To examine the effect of body mass index (BMI) on postoperative 30-day morbidity and mortality after surgery to treat endometrial cancer. DESIGN:Retrospective cohort study (Canadian Task Force classification II-2). SETTING:National Surgical Quality Improvement Program. PATIENTS:Patients with endomet...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.07.014
更新日期:2015-01-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if the use of a 5-mm umbilical incision and laparoscope would result in a higher likelihood of earlier discharge from hospital after total laparoscopic hysterectomy (TLH) compared with a 10-mm umbilical incision and laparoscope. Secondary objectives of the study were to determine if the use...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2015.09.001
更新日期:2016-01-01 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 assess the efficacy of prostaglandin F2α (PGF2α) in hysteroscopic myomectomy of submucous myomas. DESIGN:Single-blind, randomized clinical trial study. SETTING:Teaching hospital, affiliate of Iran University of Medical Sciences, Tehran, Iran. PATIENTS:Forty-four patients with symptomatic submucous...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.05.026
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:Privileging and credentialing requirements are determined by medical staff leadership at the hospital level to ensure clinicians provide safe healthcare services. No standardized guidelines exist for gynecologic surgery. The objective of this study is to examine the variability of the criteria used to g...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jmig.2016.08.001
更新日期:2016-01-01 00:00:00
abstract::At laparoscopic-assisted vaginal hysterectomy with a novel "paper roll" vaginal morcellation technique, large uteri (> or = 500 g) can be removed via the vagina with safety, speed, and ease. The technique provides protection for the bladder and rectum, and large uteri can be removed in 1 piece, allowing the pathologis...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.02.005
更新日期:2010-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the prevalence of adenomyosis and deep adenomyosis after NovaSure (Hologic Inc., Newark, DE) endometrial ablation in hysterectomy specimens after NovaSure endometrial ablation failure. DESIGN:Prospective observational study (Canadian Task Force classification II-2). SETTING:The TweeSteden...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.10.006
更新日期:2015-02-01 00:00:00
abstract:STUDY OBJECTIVE:Laparoscopic port site metastases (PSMs) have an incidence of .5% to 2%. The management of an isolated PSM (iPSM), without evidence of recurrence elsewhere, remains unclear. The aim of this study was to elucidate practices regarding iPSMs. DESIGN:A 23-item survey was created using commercially availabl...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.01.011
更新日期:2017-01-01 00:00:00
abstract::The reproductive outcome in 41 consecutive patients with cesarean-induced isthmocele and secondary infertility was evaluated prospectively. Patients included menopausal women (mean [SD; 95% CI] age, 35 [4.1; 29-42] years), with fertility duration of 3 to 8 (4.6 [28]) years with isthmocele, postmenstrual abnormal uteri...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.10.011
更新日期:2011-03-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the factors associated with poorer oncologic outcomes in patients undergoing laparoscopic radical hysterectomy (LRH) for early stage cervical cancer. DESIGN:Multicenter retrospective study. SETTING:Three gynecologic oncology referral centers. PATIENTS:Patients with International Federa...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.04.015
更新日期:2021-01-01 00:00:00
abstract:STUDY OBJECTIVE:To review pregnancy outcomes after laparoscopic myomectomy with the use of barbed suture. DESIGN:Retrospective cohort study and follow-up survey. SETTING:Single, large academic medical center. PATIENTS:Patients who underwent laparoscopic myomectomy with the use of barbed suture for myometrial closure...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.02.005
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate step-by-step the technique of hysteroscopic adhesiolysis (HA) by means of a blunt spreading technique using double-action forceps to dissect and restore the layer between the anterior and posterior uterine walls in a patient with severe intrauterine adhesions (IUAs), particularly in cases...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.10.011
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To demonstrate our application of the ghost ileostomy in the setting of laparoscopic segmental bowel resection for symptomatic bowel endometriosis nodule. DESIGN:Technical step-by-step surgical video description (educative video) SETTING: University Tertiary Hospital. Institutional Review Board ruled that ap...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.09.769
更新日期:2020-01-01 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 evaluate the clinical presentation and surgical outcome in patients with deep lateral pelvic endometriosis (dLPE). DESIGN:A retrospective multicentric study (Canadian Task Force classification II-2). SETTING:University tertiary referral centers. PATIENTS:One hundred forty-eight women with deep inf...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jmig.2018.02.015
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the incidence of uterine vascular malformations (UVMs) including uterine arteriovenous malformations (AVMs) in patients after abortion or delivery and in outpatients. DESIGN:Prospective study (Canadian Task Force classification II-3). SETTING:Fukushima Red Cross Hospital. PATIENTS:Six pat...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.12.008
更新日期:2013-05-01 00:00:00
abstract:STUDY OBJECTIVES:To estimate whether variability in the size and ratios of the lower and upper abdomen exist in women undergoing robotic gynecologic surgery and whether demographic variables are significantly associated, and to determine the association between abdominal wall dimensions and supraumbilical robotic port ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.04.008
更新日期:2010-09-01 00:00:00
abstract::Virginity in adult women, although a personal decision, is a limiting factor for gynecologists in diagnosis and treatment. This report presents 26 cases of virgin patients with various gynecologic problems: 11 with vaginal bleeding, 7 with heavy discharge and foul odor, 6 with protruding vaginal mass, and 2 with a sen...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.05.002
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Infection in natural orifice transluminal endoscopic surgery (NOTES) remains controversial. OBJECTIVE:To estimate the frequency of infection during NOTES peritoneoscopy with different routes of access and to compare with laparoscopy. DESIGN:Prospective randomized controlled study (Canadian Classification t...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.08.001
更新日期:2011-11-01 00:00:00
abstract:STUDY OBJECTIVES:To compare the intraoperative direct costs of a single-use energy device with reusable energy devices during laparoscopic hysterectomy. DESIGN:A randomized controlled trial (Canadian Task Force Classification I). SETTING:An academic hospital. PATIENTS:Forty-six women who underwent laparoscopic hyste...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2015.08.881
更新日期:2016-01-01 00:00:00
abstract:STUDY OBJECTIVE:To review the changing trends in the surgical management of ectopic pregnancy and to evaluate the effect of an ongoing training program for resident surgeons on the rate and success of laparoscopic surgery. DESIGN:Retrospective chart review (Canadian Task Force classification II-3). SETTING:University...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2006.01.007
更新日期:2006-05-01 00:00:00
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:We sought to determine whether relief of chronic pelvic pain symptoms with hormonal treatment is predictive of presence or absence of endometriosis or location of endometriosis within the pelvis. DESIGN:A retrospective, chart review (Canadian Task Force classification II-3). SETTING:A private practice...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.09.002
更新日期:2008-01-01 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