Abstract:
STUDY OBJECTIVE:To demonstrate a technique for the laparoscopic surgical management of cesarean section scar ectopic pregnancy. DESIGN:Step-by-step presentation of the procedure using video (Canadian Task Force classification III). SETTING:Cesarean section scar ectopic pregnancy is a rare form of ectopic pregnancy with an incidence ranging from 1:1800 to 1:2216. Over the last decade, the incidence seems to be on the rise with increasing rates of cesarean deliveries and early use of Doppler ultrasound. These pregnancies can lead to life-threatening hemorrhage, uterine rupture, and hysterectomy if not managed promptly. Local or systemic methotrexate therapy has been used successfully but can result in prolonged hospitalization, requires long-term follow-up, and in some cases treatment can fail. In the hands of a trained operator, laparoscopic resection can be performed to manage this type of pregnancy. PATIENT:Consent was obtained from the patient, and exemption was granted from the local Internal Review Board (The Womens' Hospital, Parkville). INTERVENTIONS, MEASUREMENTS AND MAIN RESULTS:In this video we describe our technique for laparoscopic management of a cesarean scar ectopic pregnancy. We present the case of a 34-year-old G4P2T1 with the finding of a live 8-week pregnancy embedded in the cesarean section scar. The patient had undergone 2 previous uncomplicated cesarean sections at term. On presentation her β-human chorionic gonadotropin (β-hCG) level was 52 405 IU/L. She was initially managed with an intragestational sac injection of potassium chloride and methotrexate, followed by 4 doses of intramuscular methotrexate. Despite these conservative measures, the level of β-hCG did not adequately fall and an ultrasound showed a persistent 4-cm mass. A decision was made to proceed with surgical treatment in the form of a laparoscopic resection of the ectopic pregnancy. The surgery was uneventful, and the patient was discharged home within 24 hours of her procedure. Her serial β-hCG levels were followed until complete resolution. CONCLUSION:Laparoscopic excision of cesarean section scar ectopic pregnancy is an effective procedure for the management of this increasingly more common condition. The use of vasopressin intraoperatively and laparoscopic suturing can prevent hemorrhage and allow for the safe removal of the ectopic pregnancy with multilayer repair of the uterine defect.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Ades A,Parghi Sdoi
10.1016/j.jmig.2016.11.006subject
Has Abstractpub_date
2017-01-01 00:00:00pages
533-535issue
4eissn
1553-4650issn
1553-4669pii
S1553-4650(16)31168-2journal_volume
24pub_type
杂志文章abstract::Radiation treatment planning for women with locally advanced cervical cancer (stages IB2-IVA) is often based on positron emission tomography (PET). PET, however, has poor sensitivity in detecting metastases in aortocaval nodes. We have initiated a study with the objective of determining whether pre-therapeutic laparos...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jmig.2013.07.007
更新日期:2014-01-01 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::The radio-guided occult lesion localization (ROLL) technique has been in use since the mid-1990s, mainly in breast surgery. Today, ROLL is used for numerous oncologic pathologies, including parathyroid lesions, melanomas, and colorectal tumors. We report a patient with an 11-mm left mesorectal solitary recurrence of a...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2016.09.012
更新日期:2017-01-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the surgical technique and short-term outcomes for 26 cases of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) sacrocolpopexy for the treatment of pelvic organ prolapse (POP). DESIGN:Retrospective case series study (Canadian Task Force classification II-2). SETTING:Ac...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.08.009
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:To study the safety, feasibility, learning curve, and surgical outcome for single-port laparoscopic full staging of endometrial cancer. DESIGN:A retrospective study (Canadian Task Force classification II-3). SETTING:A university academic hospital. PATIENTS:Women with endometrial cancer undergoing sin...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.06.017
更新日期:2017-01-01 00:00:00
abstract:STUDY OBJECTIVE:To assess all electromechanical morcellators used in gynecology to achieve an objective comparison between them and to make suggestions for improvements in future developments. DESIGN:Literature review. INTERVENTION:The PubMed, Web of Science, EMBASE, and MAUDE databases were systematically searched f...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2013.12.121
更新日期:2014-05-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if the number of myomas removed during myomectomy for symptomatic relief affects long-term fertility outcomes in reproductive-aged women. DESIGN:Retrospective cohort survey study (Canadian Task Force classification II-2). SETTING:University hospital. PATIENTS:One hundred forty-four patie...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.01.016
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:Our primary goal was to uncover preoperative and intraoperative risk factors that prevented same-day discharge (SDD) after myomectomy in a setting where SDD was the standard of care. Uncovered predictors would serve to enhance patient counseling and medical optimization before surgery. DESIGN:Single-ce...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.03.022
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate our technique for hysteroscopic resection of the complete uterine septum. DESIGN:Step-by-step description and demonstration of the procedure using pictures and video (educational video). The video was approved by our hospital's Ethical Committee. SETTING:Uterine malformations represent ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.07.013
更新日期:2020-01-01 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
abstract:STUDY OBJECTIVE:To evaluate the actual cost difference in performing Essure hysteroscopic sterilization in the office compared with ambulatory surgery using laparoscopic sterilization in the operating room. DESIGN:Cost-comparison analysis (Canadian Task Force classification III). SETTING:University hospital and affil...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.05.016
更新日期:2005-07-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the efficacy and safety of repeated endometrial resection. DESIGN:Retrospective study (Canadian Task Force classification II-3). SETTING:University teaching hospital. PATIENTS:Women with a failed primary endometrial resection. INTERVENTION:Repeated endometrial resection, roller-ball coag...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.08.003
更新日期:2008-11-01 00:00:00
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 per...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2016.03.016
更新日期:2016-09-01 00:00:00
abstract::Lower limb lymphedema and an accompanying lymphatic fistula (lymphorrhea) occur as complications after gynecologic surgery to treat cancer. Herein, we report the case of a 68-year-old woman who underwent resection and radiotherapy because of uterine cervical cancer (stage 2a) 20 years previously. Left lower limb and p...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.04.005
更新日期:2012-09-01 00:00:00
abstract::A panel of experts in the field of endometriosis expressed their opinions on management options in a 35-year-old patient desiring pregnancy with a history of previous surgery for endometrioma and bowel obstruction symptoms. Many questions that this paradigmatic patient may pose to the clinician are addressed, and vari...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.01.021
更新日期:2015-05-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate whether the presence of an ultrasonographic visible isthmocele has an impact on the chance of pregnancy in women undergoing embryo transfer. DESIGN:An age-matched retrospective study SETTING: Private assisted reproductive center PATIENTS: The study included a total of 150 patients with a pr...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.10.002
更新日期:2020-10-07 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::We performed a search of PUBMED and MEDLINE for articles concerning surgical management of early stage endometrial cancer from 1950 to 2011. From the articles collected we extracted data such as estimated blood loss, operating room time, complications, conversion to laparotomy, and length of hospital stay. Forty-seven...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2012.02.006
更新日期:2012-07-01 00:00:00
abstract:STUDY OBJECTIVE:Sacrocolpopexy (SCP) has become the standard procedure to correct uterovaginal prolapse in women, but techniques and approaches are not standardized. We report the results of the Austrian Sacrocolpopexy Registry, which aimed to collect data on surgical techniques and perioperative outcomes. DESIGN:The ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.10.020
更新日期:2020-11-01 00:00:00
abstract:STUDY OBJECTIVE:The objective of this study was to describe perioperative outcomes of minimally invasive sacrocolpopexy (MISCP) based on 4 different routes of concurrent hysterectomy: vaginal (VH), laparoscopic-assisted (LAVH), laparoscopic supracervical (LSCH), and total laparoscopic (TLH). DESIGN:This was a retrospe...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.08.010
更新日期:2020-01-01 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
abstract:OBJECTIVE:To determine whether accuracy of visual diagnosis of endometriosis at laparoscopy is determined by stage of disease. DESIGN:Prospective longitudinal cohort study (Canadian Task Force classification II-2). SETTING:Tertiary referral centers in three Australian states. PATIENTS:Of 1439 biopsy specimens, endom...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.04.017
更新日期:2013-11-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the effects of hypoxia-inducible factor (HIF) inhibitors, flotation agents, barriers, and a surfactant on pneumoperitoneum-enhanced adhesions in a laparoscopic mouse model. DESIGN:Prospective randomized trial (Canadian Task Force classification I). SETTING:Department of Obstetrics and G...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.04.002
更新日期:2007-09-01 00:00:00
abstract:STUDY OBJECTIVE:To compare outcomes after minimally invasive surgery (MIS) vs open radical hysterectomy for early stage cervical cancer incorporating 2018 Federation of Gynecology and Obstetrics (FIGO) staging. DESIGN:A retrospective analysis. SETTING:A single teaching hospital. PATIENTS:Patients after radical hyste...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.07.021
更新日期:2020-07-28 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:STUDY OBJECTIVE:To evaluate the safety and short-term outcomes of laparoscopic subtotal hysterectomy using the PK and Lap Loop systems. DESIGN:Prospective observational study (Canadian Task Force classification II-2). SETTING:Princess Royal University and Chelsfield Park Hospitals, Kent, UK. PATIENTS:One hundred wom...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.05.007
更新日期:2005-07-01 00:00:00
abstract:STUDY OBJECTIVE:To report the combined hysteroscopic and laparoscopic treatment of a complete septate uterus with unilateral cervical aplasia (class U2bC3V0/ESHRE/ESGE classification) and isolated mullerian remnants. DESIGN:Step-by-step presentation of the surgical treatment (Canadian Task Force classification 4). SE...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.09.006
更新日期:2016-01-01 00:00:00
abstract:STUDY OBJECTIVE:To compare reduction of pain after laparoscopy for ablation or excision of endometriosis. DESIGN:Prospective, randomized, double-blind study (Canadian Task Force classification I). SETTING:Endometriosis and pelvic pain clinic at a university teaching hospital. PATIENTS:Women of reproductive age with ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2014.04.002
更新日期:2014-11-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to estimate effectiveness of transdermal scopolamine to prevent postoperative nausea and vomiting after gynecologic laparoscopy. DESIGN:Patients were randomized to receive preoperative transdermal scopolamine or placebo. Main outcome measure was incidence of nausea during the first 24 hours p...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2007.08.616
更新日期:2008-01-01 00:00:00