当前位置： SCI文献检索 > Journal of Minimally Invasive Gynecology期刊下所有文献 > Ureterolysis for Laparoscopic Hysterectomy.

Ureterolysis for Laparoscopic Hysterectomy.

Abstract：

STUDY OBJECTIVE:To demonstrate techniques of ureterolysis during complex laparoscopic hysterectomy. DESIGN:Technical video demonstrating different approaches to ureterolysis for complex benign pathology during laparoscopic hysterectomy (Canadian Task Force classification III). SETTING:Benign gynecology department at a university hospital. INTERVENTION:Performance of ureterolysis during laparoscopic hysterectomy for benign pathology. CONCLUSION:Ureteric injury has significant morbidity and is the most common reason for litigation following hysterectomy, with an estimated risk of 0.02% to 0.4%. [1,2]. Ureterolysis is infrequently practiced by benign gynecologists; however, it may be necessary during complex surgery. Benign pathology requiring hysterectomy, such as endometriosis, myomas, large uteri, and adnexal masses, are recognized risk factors for ureteric injury [3]. Most injuries occur during division of the uterine artery at the level of the internal cervical os. The average distance between the ureter and cervix is 2 cm, but it is only 0.5 cm in 3.2% of the population with a normal pelvis [4]. Preventive strategies, such as the use of a uterine manipulator, may increase this distance, although it still might not be sufficient to prevent injury in women with normal anatomic variants and complex pathology. Visualizing the ureter at the pelvic brim and side wall without retroperitoneal dissection may be inadequate because the segment of ureter between the intersection of the uterine artery and the bladder is not visible. The ureter can be safely dissected up to 15 cm without compromising its viability. In this educational video, we demonstrate various simple, quick, and reproducible techniques to perform ureterolysis for complex benign pathology. These techniques can be used by both expert and novice surgeons to perform and teach ureterolysis. Our method determines the course of the ureter throughout the pelvis and relation to the uterine artery to reduce intraoperative injury. We have performed more than 350 cases with no injuries.

journal_name

J Minim Invasive Gynecol

journal_title

Journal of minimally invasive gynecology

authors

Jan H,Ghai V

doi

10.1016/j.jmig.2018.05.023

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

401

issue

eissn

1553-4650

issn

1553-4669

pii

S1553-4650(18)30309-1

journal_volume

pub_type

杂志文章

在线工具

Ureterolysis for Laparoscopic Hysterectomy.