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 report (Canadian Task Force classification III). SETTING:Tertiary referral center in Strasbourg, France. PATIENT:Woman age 59 years. INTERVENTION:Single-port platform used in the transvaginal approach for resection of sacrocolpopexy mesh. The local institutional review board approved the video. MEASUREMENTS AND MAIN RESULTS:A 59-year-old woman suffering from insulin-dependent diabetes and a tobacco user had 2 laparoscopic sacrocolpopexies for recurrent rectocele, the first in 2007 and the second in 2012. The sequences were marked by mesh erosion and granuloma in the vagina, requiring its surgical excision in 2016. The patient was then symptomatic, with an increasingly foul-smelling vaginal discharge with recurrent mesh erosion. Magnetic resonance imaging showed an abscess formation along the length of the mesh to the promontory. The patient then underwent surgery, realized under probabilistic antibiotic therapy, consisting of complete excision of the sacrocolpopexy mesh by the transvaginal approach. After putting the single-port trocar (GelPoint; Applied Medical, Rancho Santa Margarita, CA) into the vagina and obtaining distension with the insufflator (AirSeal; Conmed, Utica, NY), classic laparoscopic instruments were introduced by the single-port trocar. The mesh was entirely resected in the retroperitoneal space. Mesh was again used because the exposed space is almost always surrounded by loose granulation tissue that facilitates dissection and also prevents injury to adjacent structures such as bladder, rectum, and peritoneum. Moreover, the opening of adjacent structures will manifest gas leaks and, consequently, loss of the pneumovagina. At the end of procedure, the vagina is not closed to permit optimal drainage with a multitubular drain in the dissection space. The surgery lasted 60 minutes. The mesh excision was completed with relative ease, and there was no blood loss. Bacteriologic examination revealed the presence of Streptococcus anginosus, Klebsiella pneumoniae, and Bacteroides fragili. The operating suites were simple with great cicatrization after 6 weeks. The principal difficulties of this surgery were obtaining a good seal by the creation of cutaneous sutures. Finally, there are less conflicts between the instruments inside the single-port trocar used in transvaginally because of a more limited dissection space. Indeed, the rate of mesh erosion reached 2.4% and, in case of infection, justifies this excision. CONCLUSION:The transvaginal use of a single-port trocar represents a good alternative, allowing easy resection of the sacrocolpopexy mesh while remaining in the retroperitoneal space.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Schaub M,Lecointre L,Faller E,Boisramé T,Baldauf JJ,Akladios CYdoi
10.1016/j.jmig.2017.09.027subject
Has Abstractpub_date
2018-01-01 00:00:00pages
391-392issue
3eissn
1553-4650issn
1553-4669pii
S1553-4650(17)31223-2journal_volume
25pub_type
杂志文章abstract::Cornual, interstitial, and angular pregnancies are terms that are often used interchangeably in both the literature and clinical setting to describe various ectopic pregnancies. The diagnosis of these pregnancies can be difficult, and fear of disrupting an intrauterine pregnancy can cause hesitation during evaluation ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.08.002
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the operative outcomes of patients undergoing either single-port or multiport laparoscopic hysterectomy (LH). METHODS:Two hundred fifty-six women scheduled for LH for symptomatic myoma and/or adenomyosis from 8 tertiary teaching hospitals were randomized to single-port or multiport groups. P...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-07-01 00:00:00
abstract:STUDY OBJECTIVE:To assess features of power morcellators (blade diameter, circular vs oscillating cutting, blade rotation speed, experience level) regarding their effect on the amount of tissue spill. In addition, the amount of tissue spill after the initial two-thirds and final one-third of the morcellated specimen wa...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
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abstract::The objective of this retrospective study was to evaluate the feasibility, safety, and efficacy of a new laparoscopic technique for the treatment of uterovaginal prolapse using a transcervical access port to minimize the laparoscopic incision. From February 2008 through August 2010, symptomatic pelvic organ prolapse i...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.06.009
更新日期:2012-11-01 00:00:00
abstract::Heterotopic pregnancy refers to the simultaneous presence of ectopic pregnancy and intrauterine pregnancy. With the advent of assisted reproductive technology, the overall incidence of heterotopic pregnancies has risen. We report a case of a 36-year-old woman with type 2 diabetes mellitus and 1-year of primary inferti...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.11.003
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the reliability of four commonly used tests to confirm the placement of the Veres needle during closed laparoscopy and their ability to determine other complications of entry. DESIGN:A prospective observational study (Canadian Task Force classification II-2). SETTING:A university-affiliat...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.01.011
更新日期:2005-03-01 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:STUDY OBJECTIVE:To describe the clinical test parotid area sign, which is used to assess fluid absorption during resectoscopic surgery and to compare the test with volumetric fluid balance method with respect to its ability to detect fluid overload. DESIGN:Historical cohort study (Canadian Task Force classification II...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2006.09.017
更新日期:2007-03-01 00:00:00
abstract:STUDY OBJECTIVE:To compare perioperative outcomes and cost of robotic-assisted and laparoscopic transperitoneal infrarenal para-aortic lymphadenectomy (TIPAL) for treatment of gynecologic malignant conditions. DESIGN:Prospective non-randomized study (Canadian Task Force classification II-2). SETTING:Tertiary center f...
journal_title:Journal of minimally invasive gynecology
pub_type: 临床试验,杂志文章
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更新日期:2014-07-01 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 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::A 29-year-old woman with placenta increta with hemorrhage underwent uterine artery embolization using 12.5% NBCA (N-butyl 2-cyanoacrylate) diluted with iodized oil (Lipiodol). Complete resolution of placenta increta without performing curettage was obtained. The uterus returned to its normal shape, with restored endom...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.03.020
更新日期:2012-07-01 00:00:00
abstract:STUDY OBJECTIVES:To study the surgical and functional outcomes of single-incision mesh surgery for treatment of advanced pelvic organ prolapse (POP). DESIGN:Case series (Canadian Task Force classification II-3). SETTING:University hospital. PATIENTS:Sixty-five patients who underwent surgery to treat symptomatic POP ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.07.002
更新日期:2015-01-01 00:00:00
abstract:STUDY OBJECTIVE:Our aim was to assess incidence and risk factors for pelvic pain after pelvic mesh implantation. DESIGN:Retrospective study (Canadian Task Force classification II-2). SETTING:Single university hospital. PATIENTS:Women who have undergone surgery with pelvic mesh implant for treatment of pelvic floor d...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2016.10.001
更新日期:2017-01-01 00:00:00
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 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:STUDY OBJECTIVE:To evaluate the effect of endometrial ablation on 6 premenstrual symptoms for up to 1 year after treatment. DESIGN:Prospective cohort of 59 women awaiting endometrial ablation (Canadian Task Force classification II-2). SETTING:University tertiary care hospital. PATIENTS:Adult women of childbearing ag...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.01.023
更新日期:2015-05-01 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
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更新日期:2021-01-18 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
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.01.011
更新日期:2011-05-01 00:00:00
abstract::This article reveals our surgical approach for treatment of a patient with severe pelvic and infiltrative bladder endometriosis with mucosal involvement using robotic-assisted laparoscopic excision and cystotomy repair. To our knowledge, this is the first case of total robotic-assisted laparoscopic partial bladder res...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.07.002
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:To illustrate the laparoscopic surgical management of a particular localization of extrauterine pregnancy misdiagnosed until 12 weeks gestational age, complicated by hemoperitoneum and abortion. DESIGN:Canadian Task Force III on the Periodic Health Examination's Levels of Evidence. SETTING:The prevalence of...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.01.023
更新日期:2017-01-01 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::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:OBJECTIVE:To demonstrate our technique for robot-assisted laparoscopic ectopic pregnancy excision and concomitant scar revision. DESIGN:We present a stepwise narrated demonstration of our primary laparoscopic technique. SETTING:Although cesarean scar pregnancy is rare, it leads to life-threatening complications and o...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.06.017
更新日期:2020-06-27 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::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::Excessive opioid use and misuse is a pervasive and growing societal problem, and decreasing the surgical contribution to this epidemic represents an opportunity to improve outcomes. Here we describe patterns of opioid prescription, consumption, and persistent use among women undergoing minimally invasive hysterectomy ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.08.024
更新日期:2019-02-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether completion rates of salpingostomy for tubal ectopic pregnancy are compromised by initial medical management with methotrexate (MTX). DESIGN:Retrospective cohort study. SETTING:Single academic hospital system. PATIENTS:Patients requiring surgery for ectopic pregnancy between 2006 ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.09.003
更新日期:2020-09-07 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