Evaluation of laparoscopic management of gynecologic emergencies by residents

Minig, Lucas; Velazco, Andrea; Lamm, Marina; Vélez, Jorge Íván Bonilla; Venturini, N; Testa, Roberto

doi:10.1016/j.ijgo.2010.05.006

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…Early diagnosis, informed by advanced imaging and collaborative expertise, enables tailored surgical interventions that address symptomatic relief and long-term health outcomes. This case reinforces the imperative of integrating clinical vigilance with a holistic care model to optimize the quality of life for patients navigating complex gynecological conditions [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 55%

Multidisciplinary Management of Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) Syndrome in an Adolescent With Complex Congenital Anomalies: A Case Report

Kerimkulova,

Oliveira Souza Lima,

Elamin

et al. 2024

Cureus

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Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome presents with complex diagnostic and therapeutic challenges and is characterized by uterine didelphys, obstructed hemivagina, and ipsilateral renal anomaly. A 14-year-old female with a history of anorectal malformation and urogenital sinus anomaly presented with menstrual blood in her urine, abdominal pain, and distension. Investigations revealed a bicornuate uterus, vesicovaginal fistula, and right ovarian cyst, leading to the diagnosis of OHVIRA syndrome. A multidisciplinary approach resulted in salpingo-oophorectomy and subtotal hysterectomy. This case highlights the diagnostic challenges and emphasizes the role of advanced imaging and a multidisciplinary team in managing such complex conditions. It stresses the importance of patient-centered surgical planning tailored to the individual's anatomy and reproductive goals. Early recognition and a tailored, multidisciplinary approach are crucial in managing OHVIRA syndrome and improving outcomes for patients with rare congenital anomalies.

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Section: Discussionmentioning

confidence: 55%

Multidisciplinary Management of Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) Syndrome in an Adolescent With Complex Congenital Anomalies: A Case Report

Kerimkulova,

Oliveira Souza Lima,

Elamin

et al. 2024

Cureus

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“…Almost all the patients in the present study had a surgery duration of less than 2 hours (91.7%). This is the usual expected duration for most surgeries to manage EP in teaching hospital that has trainees in obstetrics and gynaecology (20,21). In non-teaching hospitals the average time is signi cantly less but the outcomes for surgery are similar (5,21).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Surgical Techniques and Outcomes for Surgically Managed Ectopic Pregnancies. A 10-Year Synopsis at a tertiary referral center in Nairobi, Kenya

Mutiso

2024

Preprint

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Background: Ectopic Pregnancies(EP) are a pregnancy related complication that can have significant morbidity. Due to this fact and the fact that most present after rupture, surgical management forms the cornerstone of management of most EP. We set out to conduct an audit ,for a 10-year period, on laparoscopically managed EP at a tertiary referral center with focus on surgical techniques used, outcomes and correlations of complications to outcomes. Methods: This study was designed as a Retrospective Clinical Audit based at the Aga Khan University Hospital (AKUH). Study population was all women admitted to AKUH with a diagnosis of ectopic pregnancy that was surgically managed between the period of January 1st 2011 to December 31st 2020. Analysis of data was done against a pre-set checklist. Descriptive statistics for continuous variables was calculated and tabulated in graphs and tables. SPSS version 22 was used for analysis of data. Results: A total of 324 patients were recruited in the analysis of surgical treatment of EP. 86.1% had a total salpingectomy done; 5.2% had a partial salpingectomy done; 2.2% had a salpingostomy done; 4% had a fimbrial milking done; 1.9% had resection of the EP and 0.6% had and oophorectomy done. 64.8% of the surgeries used bipolar and scissors; 21.2% used endoloop while 5.6%(n = 18) used a combination of instruments. Most (92.4%; n = 302) of the patient did not require conversion to an open procedure. The rate of conversion decreased with advancing years. Almost all the surgeries were less than 2 hours (91.7%,n = 297) with only 1(0.3%) going past 3 hours. Most of the surgeries did not have complications (96.3%, n = 334). Duration of stay after surgery varied from 1–13 days. Most of the patients stayed for 2 days (90.8%, n = 296); 5.8%(n = 19) had a stay of 3 days and 3.4%(n = 11) had a stay of more than 4 days. Only 50 (15.2% of 347) patients in the present study had a documented subsequent pregnancy. 42 patients had an intrauterine pregnancy: 84%,n = 42 and 16%,n = 8 had a repeat ectopic pregnancy. Conclusion: In conclusion, the present study shows that total salpingectomy is the most common surgical treatment option for patients with EP with bipolar and scissors technique being used frequently. Low conversion to open surgery rates are observed with a decline being seen as the centers’ experience grows over the years. Surgery duration and hospital stay are within the expected norms for laparoscopically managed EP when compared to more experienced centers. Moreover, the low complication rate in the present study can be attributed to the advancing experience with EP over the years coupled with the low conversion rate to open surgery hence accrued benefits from a laparoscopic approach. Lastly, most of the patients with a recurred EP had had total salpingectomy pointing towards an inherent tubal disorder causing the recurrence.

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“…18 This conversion rate is comparable with the rate of 4.6% in a study conducted at an organized laparoscopic training centre. 19 We employ sharp dissection and stitching as opposed to coagulation techniques for tissue dissection in the presence of adhesion. This follows the recommendation 2 for a safe surgical practice to reduce the incidence of bowel injury.…”

Section: Discussionmentioning

confidence: 99%

Impact of Previous Abdominal Surgery on Laparoscopic Cystectomy/Oophorectomy Results: A Comparative Clinical Study

Ramli

2012

imjm

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Introduction: In the past, patients with previous abdominal surgery were discouraged from laparoscopic surgery because of perceived increased risk of bowel injury caused by needle and trocar insertion. However, data on the feasibility and safety of surgery of this nature is increasing. We aim to evaluate the surgical outcome of laparoscopic ovarian cystectomy/oophorectomy in previous abdominal surgery. Methods: This is a cross-sectional study with descriptive analysis of retrospective data collection from the electronic medical records of women with laparoscopic ovarian cystectomy/ oophorectomy from January 2000 until Dec 2008. Results from patients with previous abdominal surgery were compared with those of women without prior abdominal surgery. Results: Three hundred and seventeen (317) laparoscopic cystectomies/ oophorectomies were performed during the study period. 71 patients (22.5%) had previous history of abdominal surgery. Adhesions were found in 72% of patients versus 40% (p=0.001) who had previous abdominal surgery but the conversion to open surgery rate was similar (3%, p < 0.05). There was no significant difference in blood loss (134.1 ml ±18.6 vs 119.0 ml ± 9.5), operating time (107 min ± 42.0 versus 102.6 min ± 42.6) and postoperative hospital stay (1.92 days ± 1.0 vs 1.91 days ± 0.7 ). The incidence of peri-operative and post-operative complication showed no significant difference in those who had undergone previous abdominal surgery than those without prior abdominal surgery (p=0.7). The overall complication rate in this series was 0.32 %. Conclusion: Laparoscopic cystectomy/ oophorectomy in the previous abdominal surgery is safe with no increase in morbidity.

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Evaluation of laparoscopic management of gynecologic emergencies by residents

Abstract: Laparoscopic management of gynecologic emergencies by senior residents and a chief resident within an organized resident training program is feasible. These results reinforce the relevance of a well-structured residency endoscopic training program.

Cited by 5 publications

References 22 publications

Multidisciplinary Management of Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) Syndrome in an Adolescent With Complex Congenital Anomalies: A Case Report

Multidisciplinary Management of Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) Syndrome in an Adolescent With Complex Congenital Anomalies: A Case Report

Laparoscopic Surgical Techniques and Outcomes for Surgically Managed Ectopic Pregnancies. A 10-Year Synopsis at a tertiary referral center in Nairobi, Kenya

Impact of Previous Abdominal Surgery on Laparoscopic Cystectomy/Oophorectomy Results: A Comparative Clinical Study

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