Surgical Approach for Enlarged Uteri: Further Tailoring of vNOTES Hysterectomy

Buzzaccarini, Giovanni; Stabile, Guglielmo; Török, Péter; Petousis, Stamatios; Mikuš, Mislav; Corte, Luigi Della; Barra, Fabio; Laganà, Antonio Simone

doi:10.1080/08941939.2021.1967528

Cited by 15 publications

(12 citation statements)

References 10 publications

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“…Finally, attention should be given to the appropriate administration of new techniques. Although there is worldwide attention paid to minimally invasive surgery, such as vaginal natural orifice transluminal endoscopic surgery, with the aim to reduce post-operatory pain, blood losses, and aesthetic impairment, some approaches should be not considered in peculiar cases where the hymen integrity is necessary and undeniable [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Hymen conservative techniques for vaginal surgery – a practical approach

Sleiman¹,

Ayed²,

Christoforou³

et al. 2022

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Vaginal approach remains one of the safest and easiest surgical procedures to treat many gynaecological pathologies such as cervico-vaginal fibroids or vaginal septum.These classical procedures are, however, hindered by the disruption of the integrity of the hymen, an issue that remains controversial if not unfavourable in certain conservative geographical areas such as the Middle East.Herein, we describe 3 alternative surgical laparoscopic techniques to deal with the issue of hymen conservation. In the first 2 cases we suggest a laparoscopic approach through an anterior or a posterior colpotomy to treat large cervico-vaginal fibroids. In the third case, we propose a laparoscopic technique for the resection of a vaginal septum in a young girl with obstructed hemivagina and ipsilateral renal agenesis syndrome.

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Section: Discussionmentioning

confidence: 99%

Hymen conservative techniques for vaginal surgery – a practical approach

Sleiman¹,

Ayed²,

Christoforou³

et al. 2022

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“…The ENG implant is among the most effective reversible contraceptives available, with efficacy as good or better than the sterilization procedures, but without the risk of invasive surgery [ 1 , 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Alternative Insertion Site of Nexplanon: Description of a Case Report and Systematic Review of the Literature

Stabile

Foti

Mordeglia

et al. 2022

JCM

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The etonogestrel (ENG) implant is among the most effective reversible contraceptives. It can be a good option for patients with different chronic diseases due to no clinically significant effects on lipid metabolism or liver function. Some limitations in the use of this type of device are represented by social and psychiatric disorders, where the easy accessibility of the device becomes a negative feature. In these patients several cases of self-removal or damage to the device have been reported. We report the successful insertion of the Nexplanon® device into the scapular region in a young woman with a chronic psychiatric disorder. To verify the presence in the literature of other possible implantation sites, we performed a systematic review of the literature on Pubmed, Google scholar and Scopus from 2000 to 2021 using different combinations of the following terms: (Nexplanon), (contraceptive implant), (insertion). Two manuscripts with three cases were detected. Nexplanon® was implanted in the upper back. In all cases, there were no complications during the insertions and the follow up demonstrated no side effects with contraceptive efficacy. Our report and review is a further confirmation that the scapular region can become a valid insertion site, maintaining good efficacy and safety of the subcutaneous device.

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“…Treatment is challenging and different protocols have been proposed, which consider both medical and surgical approaches. Minimally invasive approaches are extensively preferred since their importance in reducing blood losses, surgery time and post-operatory pain [4,5]. In particular, the CSP resection through a transvaginal approach is a promising treatment with a low complication rate [6].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic management of a 13 weeks viable ectopic cesarean section Scar pregnancy: a case report

Sleiman¹,

Feghali²,

Daccache³

et al. 2022

Ital J Gynaecol Obstet

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Background. Cesarean scar ectopic pregnancy is a rare type of life-threatening pregnancy whereby the embryo implants on a uterine scar, due to a previous cesarean section. It accounts for about 4.2% of total ectopic pregnancies. It is very rare that an ectopic scar pregnancy arrives undetected up to 13 weeks, but this is the case of some patients, not regularly scanned during the early pregnancy. The objective of our case report is to present a novel conservative laparoscopic approach in such cases. Case presentation. A 28-year-old G3P2A0 patient, presented to our primary care for heavy vaginal bleeding. The ultrasound performed confirmed a viable 13week embryo ectopic scar pregnancy. In this regard, the case was considered eligible for a conservative laparoscopic intervention treatment which was divided in the following steps: extensive dissection of the bladder; identification of the ectopic pregnancy at the level of the lower segment; extraction of the product of conception; suturing of the lower segment defect. Conclusions. The success of this technique may help amplifying its usage in other similar scenarios. In particular, the failure of medical treatment may be the first indication in trespassing the laparoscopic surgery approach. Further investigations about minimally invasive technologies seems undeferrable.

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Surgical Approach for Enlarged Uteri: Further Tailoring of vNOTES Hysterectomy

Cited by 15 publications

References 10 publications

Hymen conservative techniques for vaginal surgery – a practical approach

Hymen conservative techniques for vaginal surgery – a practical approach

Alternative Insertion Site of Nexplanon: Description of a Case Report and Systematic Review of the Literature

Laparoscopic management of a 13 weeks viable ectopic cesarean section Scar pregnancy: a case report

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