Laparoscopic hysterectomy trends in challenging cases (1995–2018)

Orhan, Adnan; Özerkan, Kemal; Kasapoğlu, Işıl; Ocakoğlu, Gökhan; Demir, Bilge Çetinkaya; Gunaydin, Tuba; Uncu, Gürkan

doi:10.1016/j.jogoh.2019.06.007

Cited by 38 publications

(29 citation statements)

References 20 publications

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“…Laparoscopy is a minimally invasive procedure that offers some multiple postoperative benefits including less surgical trauma, pain, pulmonary dysfunction, quicker recovery, and shorter hospital stay ( 11 ) . There is an increasing trend of preference in favor of laparoscopic procedures compared with laparotomy ( 12 ) . Traditionally, laparoscopic procedures are performed under GA.…”

Section: Discussionmentioning

confidence: 99%

Spinal versus general anesthesia in gynecologic laparoscopy: A prospective, randomized study

Uğur

Pirbudak

Öztürk

et al. 2020

tjod

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Amaç: İn vitro fertilizasyon (İVF) ve embriyonik manipülasyonlar yoluyla gebe kalan kadınlarda hormon kullanımı, pulmoner hipertansiyon olasılığı da dahil olmak üzere yenidoğanların sağlığıyla ilgili endişeleri artırmıştır. Bu nedenle bu çalışma, term İVF yenidoğanlarında pulmoner arter basıncını değerlendirmeyi amaçlamıştır. Gereç ve Yöntemler: Bu prospektif kesitsel çalışma Mart 2013 ile Ekim 2017 arasında gerçekleştirilmiştir ve 160 İVF yenidoğanı (grup 1) 160 doğal yolla olan yenidoğanla (grup 2) karşılaştırmaktadır. Her iki gruptaki yenidoğanlar, gebelik ve yenidoğan yaşı açısından eşleştirilmiş sezaryen ile doğan yenidoğanlardı. Yenidoğanlar üç-yedi günlük idi, 37-39 hafta ve 6 günlük tam dönem gebelik yaşına sahipti ve yenidoğanların doğum ağırlığı normal sınırlarda (2500-4000 g) idi. Sistolik pulmoner arter basıncı (SPAB), triküspit yetersizlik jetinin pik akış hızını temel alan gerçek zamanlı ekokardiyografi kullanılarak tahmin edildi. Bulgular: İki grup arasındaki ortalama SPAB açısından anlamlı bir fark gözlendi (p<0,001). Her ne kadar gestasyonel yaşın SPAB'yi düşürücü etkisi grup 1'de daha fazla ve istatistiksel olarak anlamlı olsa da, doğumdan sonra PAB'de kademeli azalma bu grupta daha yavaş gözlenmiştir. Ayrıca, her iki grupta da gebelik yaşının SPAB'yi düşürücü etkisi yenidoğan yaşına göre daha belirgindi. Ayrıca, her iki grupta da SPAB ile yenidoğan ağırlığı arasında anlamlı bir ters korelasyon gözlendi; ancak bu korelasyonun grup 1'de daha kuvvetli olduğu görüldü. Sonuç: Çalışmamız, İVF'yi yenidoğanlarda pulmoner hipertansiyon insidansında artış ile ilişkili bulmuştur. Bu nedenle, İVF yenidoğanlarında pulmoner

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Section: Discussionmentioning

confidence: 99%

Spinal versus general anesthesia in gynecologic laparoscopy: A prospective, randomized study

Uğur

Pirbudak

Öztürk

et al. 2020

tjod

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“…The topic was also debated at Ulm University Hospital. The present analysis shows that this openended discussion did not lastingly influence the trend toward minimally invasive procedures (19,20). This result is remarkable since efforts to achieve a reliable preoperative sarcoma diagnosis have not yet yielded a feasible test (13,21) and Desai et al (20), for example, report a clear decline in supracervical hysterectomies in the wake of the FDA warning.…”

Section: Discussionmentioning

confidence: 58%

Choosing a Surgical Access Point for Hysterectomy: A Paradigm Shift Over a 10-Year Span

et al. 2020

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Background: When choosing a surgical procedure for a hysterectomy, doctors and patients have various options in terms of the multiple surgical access points available. The aim of this study was to descriptively analyze developments concerning the surgical access point selected over the past 10 years at Ulm University Hospital, (south) Germany, assess the variables associated with the surgical method and explore any potential significant correlations that influence these surgical access routes. Explicitly, we wished to investigate whether the approval of ulipristal acetate and the warning issued by the Food and Drug Administration (FDA) in connection with its use changed existing trends.Material and Methods: This monocentric study retrospectively assessed data from all patients who underwent a hysterectomy due to a benign disease or endometrial cancer from January 2007 until December 2016.Results: Of the benign indications considered, myomas and descensus genitalis occurred most frequently (49.5 and 30.6%, respectively). The percentage of abdominal procedures declined from 61.4 to 13.4% between 2007 and 2016 for all hysterectomies, whilst it increased from 4.1 to 69.7% for laparoscopic hysterectomies. The rate of vaginal hysterectomies increased to 45.5% until 2013 and declined in the years afterwards. Laparoscopic assisted vaginal hysterectomies were comparatively rare.The trends in terms of surgical routes were similar for endometrial cancer. During the observation period, the share of abdominal hysterectomies fell from 100 to 11.3%, whilst the share of laparoscopic hysterectomies increased from 0 to 86.6%. The other two procedures were less frequently used.Use of the laparoscopic hysterectomy procedure also increased significantly after the FDA's 2014 warning. Ulipristal acetate may have tended to influence the process.Conclusion: Contrary to the national decrease in hysterectomy numbers, the annual number of hysterectomies at Ulm University Hospital remained stable during the observation period. Nevertheless, there was a clear shift in the preferred surgical routes for hysterectomy.

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“…Further, it has been reported that laparoscopic hysterectomy is not a limiting factor in complex cases with an increasing trend over the years [23]. Continuing advances in instrumentation, energy sources, hemostatic agents, and vaginal cuff closure techniques have expanded the use of minimally invasive hysterectomy [24].…”

Section: Discussionmentioning

confidence: 99%

Factors related to blood loss in laparoscopic hysterectomy

Andan,

Aksin,

Goklu

et al. 2021

Clin. Exp. Obstet. Gynecol.

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In this study, we aimed to retrospectively investigate the effects of patients' age, body mass index (BMI), uterine size, presence of fibroids, previous surgery, and the experience of surgeons on blood loss during total laparoscopic hysterectomy. Methods: Data of 416 patients who underwent total laparoscopic hysterectomy in our gynecology clinic were retrospectively evaluated. Several factors that may be correlated with blood loss were investigated based on the changes in their hemoglobin levels. Results: In this study, BMI (under 30: 1.25 g/dL and over 30: 1.10 g/dL, p = 0.140), age (over 50 years: 1.05 g/dL and under 50 years: 1.20 g/dL, p = 0.196), uterus size (above 500 cm 3 : 1.00 g/dL and below 500 cm 3 : 1.20 g/dL, p = 0.227), presence of fibroids (fibroids: 1.20 g/dL and without fibroids: 1.10 g/dL) mg/dL, p = 0.843), previous operation history (surgical history: 0.90 g/dL and no surgical history: 1.00 g/dL, p = 0.631) were not correlated with blood loss. Case experience (inexperienced period: 1.10 g/dL and experienced period: 1.20 g/dL, p = 0.185) of each surgeon was not correlated with blood loss. When we examined the blood loss of 11 surgeons separately, it ranged from 0.75 g/dL (0.4-1.9 g/dL) to 1.65 g/dL (0.83-2.15 g/dL). Correlation of the individual surgeon factor with blood loss was statistically significant (p = 0.041). Discussion: Age, BMI, uterine size, presence of fibroids and previous operation history were not correlated with blood loss during total laparoscopic hysterectomy. We determined the individual surgeon as the only aspect affecting blood loss.

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Laparoscopic hysterectomy trends in challenging cases (1995–2018)

Cited by 38 publications

References 20 publications

Spinal versus general anesthesia in gynecologic laparoscopy: A prospective, randomized study

Spinal versus general anesthesia in gynecologic laparoscopy: A prospective, randomized study

Choosing a Surgical Access Point for Hysterectomy: A Paradigm Shift Over a 10-Year Span

Factors related to blood loss in laparoscopic hysterectomy

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