Management of large cystic adnexal tumor by gasless laparoscopic-assisted surgery with wound retractor

Takeda, Akihiro; Sakai, Kotaro; Mitsui, Takashi; Nakamura, Hiromi

doi:10.1016/j.jmig.2007.04.003

Cited by 25 publications

(12 citation statements)

References 17 publications

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“…Yuen et al 14 showed that spillage rates are comparable in laparoscopy and laparotomy. The incidence of tumor spillage in published series of laparoscopically managed large ovarian masses varies between 22% and 100%, 7,12,15,16 whereas the risk of rupture during laparotomy has been reported to be in the range of 10% to 26%. 17 Several techniques have been described that aim to prevent or eliminate spillage during laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Management of Large Ovarian Cysts

et al. 2012

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The aim of this study was to describe a new technique for laparoscopic removal of large ovarian cystic masses. The authors performed a retrospective study during the period January 2008 to December 2009 in the Second Department of Obstetrics and Gynecology of Aretaieion University Hospital; 19 women with large ovarian cysts were included in the study. During the study period, 53 women underwent laparoscopic excision of ovarian cysts. Among them, 19 had very large complex ovarian cysts with a mean diameter of 8.4 cm. The mean age of the patients was 32.1 years. Ultrasound examination revealed findings suggestive of benign disease in all patients. In 8 out of 19 patients CA-125 levels were elevated, ranging from 40.5 to 194.7 IU/mL. A 5-mm suprapubic trocar was directly inserted into the cyst and fluid contents aspirated, so the decompressed cyst could fit in a 5-cm laparoscopic bag. The cyst wall was carefully detached from the healthy ovarian tissue and placed in the bag without any spillage. The remaining cyst wall was removed from the peritoneal cavity with the laparoscopic bag. The mean operative time was 45 minutes. No operative or postoperative complications were noted. There was no conversion to laparotomy. Mean hospital stay was 1 day. Pathology revealed 7 endometriomas, 3 mucinous cystadenomas, 3 serous cystadenomas, 3 serous cysts, and 3 teratomas. Direct trocar insertion within the ovarian cyst followed by aspiration of the fluid contents is a safe and feasible method for the laparoscopic management of large ovarian cysts.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Management of Large Ovarian Cysts

et al. 2012

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“…The SAND balloon facilitates the procedure by draining the contents of the gallbladder and decompressing it, which prevents bile leakage, enables easy retraction of the gallbladder without the need for grasping, and requires only limited use of forceps (Figure ). There have been only a few previous reports of the SAND balloon being used in gynecologic laparoscopic surgery . Evidence indicates that for other surgical steps in SILS cholecystectomy, including the manipulation of Hartman's pouch and dissecting the gallbladder wall, the SAND balloon does not offer specific advantages.…”

Section: Discussionmentioning

confidence: 99%

Use of the SAND balloon catheter in single‐incision laparoscopic cholecystectomy for acute cholecystitis

Ikegami

Shirabe

Yoshizumi

et al. 2013

Asian J Endoscop Surgery

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“…In addition, removal of big solid specimens is always difficult in conventional laparoscopic surgery. However, using the gasless technique, the minilaparotomy incision makes it easy by introducing and removing an extraction pouch or by using the fingers to remove the specimens, such as bigger myomas or large bony parts in the dermoid cyst (Takeda et al, 2007). In the meantime, large vessels legation can be done by extracorporeal knot-typing, which saves time and avoids severe bleeding during surgery.…”

Section: Discussionmentioning

confidence: 99%

Gasless laparoscopy for benign gynecological diseases using an abdominal wall-lifting system

Wang

Cui

Zhao

et al. 2009

J. Zhejiang Univ. Sci. B

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Abstract:Objectives: The use of gasless laparoscopy with an abdominal wall-lifting device for benign gynecological diseases was compared to conventional laparoscopy with CO 2 pneumoperitoneum. Methods: From February 2007 to July 2007, 76 women with uterine and/or adnexal benign diseases and candidates for laparoscopic surgery were recruited in this study. Thirty-two women underwent gasless laparoscopic surgery and 44 women underwent pneumoperitoneum laparoscopic surgery. Results: Diverse pathologies, including adnexal cyst, uterine myoma and ectopic pregnancy, were treated successfully with gasless laparoscopic surgery. Compared with the patients in the pneumoperitoneum group, the similar hospital stay (P=0.353) and intraoperative blood loss (P=0.157) were observed. However, the mean operative time in the gasless group was significantly longer than that in the pneumoperitoneum group (P=0.003). No severe intraoperative or postoperative complications were found in either group, except for one case of laparotomic conversion in the pneumoperitoneum group due to dense pelvic adhesions. The total hospital charges were significantly less in the gasless group than in the pneumoperitoneum group (P=0.001). In 38 cases of ovarian cyst resection, the mean operative time in the gasless group remained longer than that in the pneumoperitoneum group (P=0.017). The total hospital charges were also significantly less in the gasless group than in the pneumoperitoneum group (P<0.001). Conclusion: Our preliminary results demonstrated that the laparoscopic procedure using the gasless technique was a safe, effective method to treat benign gynecological diseases. Moreover, it was easy to master. As a minimally invasive treatment, gasless laparoscopic surgery provides a good choice to patients in the undeveloped regions in China without increasing the patients' and the government's burden significantly.

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Management of large cystic adnexal tumor by gasless laparoscopic-assisted surgery with wound retractor

Cited by 25 publications

References 17 publications

Laparoscopic Management of Large Ovarian Cysts

Laparoscopic Management of Large Ovarian Cysts

Use of the SAND balloon catheter in single‐incision laparoscopic cholecystectomy for acute cholecystitis

Gasless laparoscopy for benign gynecological diseases using an abdominal wall-lifting system

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