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 simple and safe way. DESIGN:Step-by-step video demonstration of the surgical technique. SETTING:Private hospital in Curitiba, Paraná, Brazil. INTERVENTIONS:The patient was 32 years old (gravidity and parity, G3A3; late progressive miscarriage), had no comorbidities, and had a radiologic diagnosis of cervical incompetence. The main steps of LAC are described in detail. A complete laparoscopic approach was performed. Under general anesthesia, the patient was placed in the 0-degree supine decubitus position with arms alongside her body. The operative setup included a 15-mm Hg pneumoperitoneum created using the closed Veress technique and 4 trocars: a 10-mm trocar at the umbilicus for a 0-degree laparoscope; a 5-mm trocar in the right iliac fossa; a 5-mm trocar in the left iliac fossa; and a 5-mm trocar in the suprapubic area. After systematic exploration of the pelvic and abdominal cavities, the procedure began. Step 1 involved identification of anatomic key landmarks and exposure of the operation field. Step 2 involved opening of the anterior peritoneum. The anterior peritoneal reflection was opened over the peritoneum uterovesicalis and then extended laterally until the uterine artery could be clearly identified on both sides. Step 3 involved dissection of the avascular space on each side of the uterus. The vesical-cervical avascular space was created, and the bladder was pushed down, away from the isthmus area. Step 4 involved preparation for a perfect stitch placement. A 5-mm Mersilene suture (Ethicon, Somerville, NJ) with a straight needle was introduced by a suprapubic trocar into the abdominal cavity before a complete identification of uterine vessels at both the sides using atraumatic graspers. Step 5 involved identification of the perfect space in the posterior aspect for Mersilene suture placement. Step 6 was to make a perfect anterior stitch. For this, the needle was grasped at the proximal portion in a 90-degree angle. In posterior position and when helped by a cranial and posterior uterine mobilization, the needle passed through the right, broad ligament in the avascular space created on the anterior leaf and medially from the uterine artery until the tip of the needle was seen on the posterior face above the uterosacral ligament. All steps were possible by synchronic uterine mobilization. Step 7 was to make a perfect posterior stitch. The procedure was then repeated contralaterally following the same anatomic and technical precepts but from posteriorly to anteriorly. Step 8 involved correct positioning and orientation of the Mersilene suture far away from the ureter and medial to the uterine arteries 2 cm over the uterosacral ligaments. Step 9 involved fixation of the Mersilene suture with an adequate blocking sequence. Step 10 involved fixation of the Mersilene suture and reperitonealization. The tape was knotted with an adequate blocking intracorporeal suturing sequence at the cervicoisthmic junction, and a Monocryl 2-0 stitch (Ethicon, Somerville, NJ) was made to fix the knot and left it horizontally. Finally, the procedure was ended with anterior reperitonealization, covering all the plica uterovesicalis and mesh, leaving it completely extraperitoneal. The surgery ended without any intraoperative complications and within 30 minutes. Patient was discharged on the first day postoperatively and became pregnant 6 months after surgery, with a C-section delivery of a healthy term newborn at 39 weeks of gestational age. CONCLUSION:LAC in nonpregnant women with a diagnosis of cervical incompetence is safe and feasible in experienced hands, adding all the intrinsic advantages of minimally invasive surgery and providing better obstetric outcomes. In this patient, the procedure was performed without any intra- or postoperative complications, and the patient had an uneventful term pregnancy in the follow-up period. We must remember that adequate standardization of surgical procedures will help reduce the learning curve.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Vigueras Smith A,Cabrera R,Zomer MT,Ribeiro R,Talledo R,Kondo Wdoi
10.1016/j.jmig.2019.10.019subject
Has Abstractpub_date
2020-01-01 00:00:00pages
1025-1026issue
5eissn
1553-4650issn
1553-4669pii
S1553-4650(19)31281-6journal_volume
27pub_type
杂志文章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: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:Laparoscopic termino-terminal ureteral anastomosis has all the advantages of a minimally invasive approach in addition to the treatment of the pathologic condition [1]. Ureteral deep endometriosis can lead to severe consequences, such as hydroureteronephrosis and renal failure [2,3]. The main objective ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.11.017
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVES:To evaluate the efficacy of performing the Essure hysteroscopic sterilization in an office-based setting. DESIGN:Prospective, longitudinal analysis (Canadian Task Force classification II-3). SETTING:University out-patient office. PATIENTS:All patients undergoing permanent sterilization in our outpat...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.11.010
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To perform a systematic review of the literature to identify best practices for nonhysteroscopic myomectomy for women with myomas who desire future fertility. The focus areas included factors associated with conception and pregnancy outcomes after myomectomy, impact of surgical route (laparotomic, laparoscopi...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2020.10.006
更新日期:2020-10-14 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::Value-based care is quality health care delivered effectively and efficiently. Data registries were created to collect accurate information on patients with enough clinical information to allow for adequate risk adjustment of postoperative outcomes. Because most gynecologic procedures are elective and preference-sensi...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.07.003
更新日期:2015-11-01 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 examine the rate of abstract publication from the Society of Gynecologic Surgeons Annual Scientific Meeting (SGSASM), 2004 to 2012. STUDY DESIGN:This is a retrospective study in which all abstracts presented at the SGSASM from 2004 to 2012 were reviewed. Information was collected on oral (O), oral p...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.05.020
更新日期:2015-09-01 00:00:00
abstract::The incidence of adnexal masses in pregnancy is estimated to be 1% to 4%. In select cases, surgical intervention is required. Recent studies have demonstrated that laparoscopy during pregnancy is safe and confers many advantages over laparotomy. Herein we present a series of nine cases collected prospectively that dem...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.02.024
更新日期:2013-09-01 00:00:00
abstract::Bilateral tubal ligation (BTL) for sterilization has been known to decrease the risk of ovarian cancer. Recent studies have suggested that bilateral salpingectomy (BS) may be an alternative to BTL or tubal occlusion for women desiring permanent sterilization, owing to a possibly greater protective effect against ovari...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2017.01.001
更新日期:2017-01-01 00:00:00
abstract::Hemangiomas are known to be common benign tumors. However, hemangiomas of female genital organs are very rare. Furthermore, a retroperitoneal hemangioma arising from ovarian vessels has never been reported. Here we report a case of a 29-year-old woman with a retroperitoneal cavernous hemangioma arising from the ovaria...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.07.017
更新日期:2009-11-01 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 stepwise techniques for the successful use of the laparoscopic single-site technique for safely performing transvaginal sacrocolpopexy for pelvic organ prolapse. DESIGN:Stepwise demonstration with narrated video footage (Canadian Task Force classification III). SETTING:Academic tertiary...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.11.018
更新日期:2020-11-26 00:00:00
abstract:STUDY OBJECTIVES:To evaluate the rate of intrauterine adhesions after hysteroscopic resection of hyperplastic and/or cancer areas and the efficacy of combined treatment. DESIGN:Observational retrospective study. SETTING:Patients affected by endometrial atypical hyperplasia of the endometrium or early stage endometria...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.06.004
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:This study aimed to compare the risks of intraoperative and postoperative urologic complications after robotic radical hysterectomy (RRH) compared with laparoscopic radical hysterectomy (LRH). DATA SOURCES:We searched Pubmed, EMBASE, and the Cochrane Library for studies published up to March 2019. Related ar...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.jmig.2019.07.008
更新日期:2020-01-01 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::Abnormal uterine bleeding and other gynecologic complications associated with a previous cesarean section scar are only recently being identified and described. Herein we report a rare case of a woman with recurring massive uterine bleeding after 2 cesarean sections. Curettage and hormone therapy were unsuccessfully u...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.10.005
更新日期:2015-02-01 00:00:00
abstract:STUDY OBJECTIVE:To compare perioperative and long-term outcomes related to laparoscopic and open abdominal surgical management of cervical cancer. DESIGN:Propensity-matched comparison of prospectively collected data (Canadian Task Force classification II-1). SETTING:University teaching hospital. PATIENTS:Sixty-five ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.03.018
更新日期:2014-09-01 00:00:00
abstract:STUDY OBJECTIVE:To estimate the concentration of natural killer (NK) cells in the peripheral blood in patients with and without endometriosis. DESIGN:Case-control study (Canadian Task Force classification II-2). SETTING:Tertiary referral hospital. PATIENTS:One hundred fifty-five patients who had undergone videolapar...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.12.021
更新日期:2012-05-01 00:00:00
abstract:STUDY OBJECTIVE:To present a series of robotic laparoendoscopic single-site surgery (LESS) and reduced-port hysterectomy cases and discuss the surgical technique required for successful use on this new platform. DESIGN:Retrospective case series. SETTING:Academic medical center. PATIENTS:All patients undergoing robot...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.08.009
更新日期:2020-08-20 00:00:00
abstract:STUDY OBJECTIVE:To assess the clinical course and surgical and fertility outcomes of patients diagnosed with tubo-ovarian abscess (TOA) after fertility treatment. DESIGN:Parallel case series over 10 consecutive years (Canadian Task Force classification II-2). SETTING:Tel Aviv Sourasky Medical Center, a tertiary unive...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.06.004
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:To present a modified technique for laparoscopic cornual resection for the surgical treatment of heterotopic istmocornual pregnancy. DESIGN:A step-by-step explanation of the surgery using video (Canadian Task Force Classification III-c). SETTING:Heterotopic pregnancy is the coexistence of pregnancy in...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2016.07.008
更新日期:2017-01-01 00:00:00
abstract::Robotic surgery is a new technology that has been progressively implemented to treat endometrial and cervical cancer. However, the use of robotic surgery for ovarian cancer is limited to a few series of cases and comparative studies with laparoscopy or laparotomy. The technical issues concerning robotic surgery, as we...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2015.10.014
更新日期:2016-03-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether pain, as part of an indication for global endometrial ablation, is an independent risk factor for failure. DESIGN:Retrospective cohort study (Canadian Task Force classification II-2). SETTING:Academic-affiliated community hospital. PATIENTS:Women undergoing global endometrial abl...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.01.020
更新日期:2018-01-01 00:00:00
abstract::Laparoscopic vessel sealing devices have revolutionized modern laparoscopy. These devices fall into 2 major categories: advanced bipolar and ultrasonic instruments. The range of tissue effects available with these technologies is more limited than with conventional monopolar electrosurgery; however, both advanced bipo...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2013.02.012
更新日期:2013-05-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to evaluate the incidence of postoperative voiding dysfunction in patients undergoing vaginal hysterectomy (VH) or total laparoscopic hysterectomy (TLH) and to identify risk factors for the development of postoperative urinary retention after uncomplicated total hysterectomy. DESIGN:Prospecti...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.06.013
更新日期:2007-11-01 00:00:00
abstract::Enhanced recovery after surgery (ERAS), or "fast-track" protocol, aims to minimize the physiologic stress of surgery and optimize the rehabilitation of patients. However, there is limited data in obstetrics and gynecology. We reviewed the published literature on ERAS programs in gynecology to evaluate the outcomes and...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.12.010
更新日期:2019-02-01 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: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