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 in which the endometrial lining is obscured on ultrasound imaging and the endometrial cavity is completely occluded on hysteroscopy. DESIGN:A step-by-step explanation of the technique using videos and pictures (educative video) (Canadian Task Force Classification III). SETTING:A university-affiliated hospital. PATIENT:A 36-year-old, gravida 3, para 1, abortus 2 woman presenting with amenorrhea for 5 months after surgical termination of a 53-day intrauterine pregnancy. She had no cyclic lower abdominal pain. Ultrasound revealed an obscure endometrial stripe and no obvious hematometra. Both the urine human chorionic gonadotropin test and the progesterone withdrawal test were negative. One month before admission, hysteroscopic adhesiolysis failed because the uterine cavity was inaccessible because of adhesions completely occluding the lower uterine cavity. Additionally, the uterine cavity could not be explored with a probe because the anatomic layer of the endometrial lining could not be easily identified by transabdominal ultrasound. INTERVENTION:HA using a blunt spreading dissection technique with double-action forceps to restore the uterine cavity followed by "ploughing" of the intrauterine scar tissue using cold scissors [1]. MEASUREMENTS AND MAIN RESULTS:An intraoperative technique with commentary highlighting tips for a successful dissection. The uterine cavity was successfully restored using the blunt spreading dissection technique. There were no complications, including false uterine wall passage, uterine perforation, or fluid overload. Postoperative hysteroscopy at 1 month revealed an almost normal uterine cavity. CONCLUSIONS:HA using a blunt spreading dissection technique to restore the uterine cavity is a simple, effective, and safe hysteroscopic skill, especially when the endometrial stripe is obscured on ultrasound imaging and exploring the uterine cavity by means of a probe has failed. Furthermore, this technique may serve as an alternative to resectoscopic techniques because it uses cold forceps and scissors, which provide better protection for the endometrium.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Huang H,Cheng C,Johnson G,Wang R,Xue M,Zhang A,Xu D,Guan Xdoi
10.1016/j.jmig.2017.10.011subject
Has Abstractpub_date
2018-01-01 00:00:00pages
583-584issue
4eissn
1553-4650issn
1553-4669pii
S1553-4650(17)31235-9journal_volume
25pub_type
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
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更新日期:2015-11-01 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...
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journal_title:Journal of minimally invasive gynecology
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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
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更新日期:2015-09-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
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更新日期:2020-10-14 00:00:00
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journal_title:Journal of minimally invasive gynecology
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更新日期:2019-02-01 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.2008.03.005
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journal_title:Journal of minimally invasive gynecology
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journal_title:Journal of minimally invasive gynecology
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.10.021
更新日期:2015-03-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.10.009
更新日期:2008-03-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
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更新日期:2014-09-01 00:00:00
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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
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journal_title:Journal of minimally invasive gynecology
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更新日期:2020-01-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
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更新日期:2012-09-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
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更新日期:2012-07-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
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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
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
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更新日期:2018-01-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
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journal_title:Journal of minimally invasive gynecology
pub_type: 临床试验,杂志文章
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究
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更新日期:2016-01-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
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更新日期:2009-09-01 00:00:00
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journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
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更新日期:2007-11-01 00:00:00
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更新日期:2008-07-01 00:00:00