The Vasopressin Injection Technique for Laparoscopic Excision of Ovarian Endometrioma: A Technique to Reduce the Use of Coagulation

Saeki, Ai; Mutoh, T.; Ikuma, K; Tanase, Yasuhito; Inaba, Fujiyuki; Oku, Hisato; Kuno, Atsushi

doi:10.1016/j.jmig.2009.11.004

Cited by 31 publications

(16 citation statements)

References 15 publications

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“…Yet, precautions must be taken during laparoscopic procedures to minimize ovarian damage, not only the by keeping the size of the incision at a minimum, but also by gentle, careful coagulation of the bleeding points by bipolar diathermy after stripping of the capsule and by not using elecrocoagulation at the ovarian hilum to avoid vascular damage. Another option is to offer an injection of diluted vasopressin before the cystectomy to minimize ovarian damage and reduce the need for electrocoagulation [23]. The present study did not assess the effect of diluted vasopressin injection on ovarian reserve after laparoscopic cystectomy using bipolar electrocagulation; this will be the subject of further research.…”

Section: Discussionmentioning

confidence: 88%

Effect on ovarian reserve of laparoscopic bipolar electrocoagulation versus laparotomic hemostatic sutures during unilateral ovarian cystectomy

Mohamed

Nouh

El-Behery

et al. 2011

Intl J Gynecology & Obste

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Section: Discussionmentioning

confidence: 88%

Effect on ovarian reserve of laparoscopic bipolar electrocoagulation versus laparotomic hemostatic sutures during unilateral ovarian cystectomy

Mohamed

Nouh

El-Behery

et al. 2011

Intl J Gynecology & Obste

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“…Our technique of laparoscopic stripping is similar to other studies, except that vasopressin is injected on the uterus rather than on the endometrioma [6,15]. On injecting vasopressin on the uterus, we get a generalized vasoconstriction of the pelvis which helps in maintaining a clear view without much bleeding during adhesiolysis.…”

Section: Discussionmentioning

confidence: 83%

Laparoscopic ovarian reconstruction without suturing after cystectomy for endometrioma

Paul¹,

Kaur²,

Narasimhan³

et al. 2014

Gynecol Surg

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The primary aim of this study is to evaluate the technique of ovarian reconstruction without suturing after laparoscopic cystectomy of endometrioma. The secondary aim is to find the pregnancy rate following this technique. The study is a prospective observational study (Canadian Task Force classification II-3). The interventions used in the study are laparoscopic ovarian cystectomy and reconstruction without suturing. Laparoscopic ovarian cystectomy was performed in 240 patients between May 2007 and April 2012 of which 182 consecutive patients who met the selection criteria were enrolled in the study. Intraoperatively, the cyst wall is completely enucleated. Ovarian tissue is kept apposed together with a bowel grasper for 5 min to reconstruct the ovary. No sutures are used for approximation of ovarian edges. The median (range) operating time for cystectomy and reconstruction was 22 min (15-75), and estimated blood loss was 50 ml (30-200). The ovarian reconstruction was good in 84.6 % of the cases, average in 10 % and poor in 5.4 % of the patients. Postoperative scan on day 1 showed pelvic collection (blood) in five cases (20-50 ml). 9.89 % had intraovarian haematoma of 2-3 cm which resolved spontaneously. All patients were followed at 1 month and pregnancy rate was calculated after a minimum follow up of 12 months. Pregnancy rate was 50.7 % (33 patients) in our study. Approximation of ovarian surface for ovarian reconstruction was associated with shorter operating times, good morphological ovarian reconstruction and comparable pregnancy outcome. This technique requires further well-designed randomized controlled trials.

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“…Surgical techniques that have been described in the literature include laparoscopic drainage and ablation (with various different energy sources), laparoscopic cystectomy (using the stripping technique), combination techniques, the vasopressin technique (aiming for relatively bloodless hydrodissection with diluted vasopressin) and aggressive treatment in the form of oophorectomy (see Table 1) [20,25,[35][36][37][38]40,42,43,[73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90][91][92]. In centres in which minimal access surgical expertise is not available, open surgery still has a role [92].…”

Section: Surgical Techniquesmentioning

confidence: 99%

Review of the management of ovarian endometriosis

Psaroudakis

Hirsch

Davis

2014

Current Opinion in Obstetrics &Amp; Gynecology

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Consensus from Europe and the USA is for a conservative approach to the treatment of ovarian endometriosis, with early recourse to assisted reproductive technology for subfertility. Surgery is currently only being advised for severe pain or difficult access to growing follicles and only after careful counselling regarding the potential adverse effect on ovarian reserve. Research has still not identified the optimal technique for treating ovarian endometriosis. Laparoscopic ovarian cystectomy not only offers the lowest risk of recurrence and the highest chance of spontaneous pregnancy rate, but also risks significant injury to ovarian function. Medical treatment offers temporary symptom relief but does not improve the fertility outcomes, and the role of ultrasound-guided drainage remains to be established.

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The Vasopressin Injection Technique for Laparoscopic Excision of Ovarian Endometrioma: A Technique to Reduce the Use of Coagulation

Cited by 31 publications

References 15 publications

Effect on ovarian reserve of laparoscopic bipolar electrocoagulation versus laparotomic hemostatic sutures during unilateral ovarian cystectomy

Effect on ovarian reserve of laparoscopic bipolar electrocoagulation versus laparotomic hemostatic sutures during unilateral ovarian cystectomy

Laparoscopic ovarian reconstruction without suturing after cystectomy for endometrioma

Review of the management of ovarian endometriosis

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