Instruments & Methods Laparoscopically assisted vaginal removal of ovarian dermoid cysts

Abstract

Dermoid cysts were diagnosed by transvaginal sonography in 19 patients who subsequently underwent laparoscopy to confirm the nature and extent of the lesion and the mobility of the adnexa. Eighteen patients underwent surgery after the ovary was exteriorized through a posterior colpoceliotomy. No intraoperative complications were observed, and sonographic follow-up at 3 and 6 months after surgery showed a normal sonographic ovarian pattern. Laparoscopically assisted vaginal removal of dermoid cysts should be considered as an alternative to laparotomy and operative laparoscopy in cases when adnexal mobility is proven and vaginal extraction is feasible.

A Modified Technique to Reduce Spillage and Operative Time: Laparoscopic Ovarian Dermoid Cyst Enucleation ‘in a Bag’

“…In fact the mean operative time in our experience (64 min) is similar to that reported by Volz et al [10], who used a similar technique, and by Yuen and Rogers [20] (60 min) and Morgante et al [58] (57 min) for open surgery and by Pardi et al [42] for laparoscopy-assisted vaginal removal, but it was lower than what was reported by other authors for laparotomy [18,21,22] or laparoscopy (table 2), [8,9,12,18,19,20,21,22,26,27,29,33,34,36,37,39,40]. Our mean surgical time is also lower than that reported by Ferrari et al [38] or Wang et al [44] for the direct vaginal approach (81 and 78 min, respectively).…”

“…In order to reduce the risk of spillage during laparoscopy, some authors propose to remove dermoid cysts via culdotomy through an incision on the posterior vaginal fornix [26,35,42,43,44], but with this technique Teng et al [31] reported 6 cases of spillage from 14 cysts (43%); Reich et al [26] reported 9 cases of spillage in 25 cysts removed vaginally (36%), and in the experience of Nezhat et al [35] spillage occurred in 4 of 9 cysts (44%). In a retrospective study, Ferrari et al [38] proposed a direct vaginal approach without laparoscopic assistance for surgical treatment of ovarian dermoid cysts.…”

Correlation of the guanosine exchangeable and nonexchangeable base protons in 13C-/15N-labeled RNA with an HNC-TOCSY-CH experiment

“…In this system, the guanosine amino nitrogen assignments were obtained by observation of strong NOEs between adjacent guanosine imino and amino protons . These new techniques for resonance assignment and structure determination, when combined with previously developed techniques (see Pardi (1995) for a review), greatly simplify the assignment and structure determination of isotopically labeled RNAs.…”

Laparoscopically Assisted Vaginal Ovarian Cystectomy for Clinically Diagnosed Benign Large Ovarian Masses

“…However, the risk of penetration of the large tumors with the introduction of the Veress needle and, subsequently, the trocar has led to the recommendation for insertion of the needle and trocar under sonographic control or the use of open laparoscopy. [10][11][12][13] In our patient, we chose an open laparoscopy. The trocars were inserted under visual control, and controlled decompression was achieved by the insertion of a needle connected to a suction apparatus, secured with a purse-string suture to prevent fluid leakage.…”

“…3,12,14 A review of the English literature on laparoscopicassisted vaginal or vaginal management of ovarian tumors disclosed that the rate of cervical laceration, infection, and conversion to laparotomy were 0.6 (1=168), 6.5 (11=168), and 7.7% (13=168), respectively ( Table 2). [6][7][8][9]11,12 Our study required no open conversion and 1 patient (10.0%) suffered from postoperative infection controlled by 3-day parenteral antibiotic therapy. The complication rate was less than average (10.0 versus 13.8%; Table 2).…”