Journal of minimally invasive gynecology
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J Minim Invasive Gynecol · Mar 2013
Comparative StudyEffect of uterine preservation on outcome of laparoscopic uterosacral suspension.
To compare the objective outcome of laparoscopic uterosacral hysteropexy with that of hysterectomy combined with laparoscopic uterosacral colpopexy. ⋯ Hysterectomy with laparoscopic uterosacral colpopexy produced better objective success rates than did laparoscopic uterosacral hysteropexy; however, repeat operation rates were not significantly different.
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J Minim Invasive Gynecol · Mar 2013
Transversus abdominis plane block associated with locoregional anesthesia with a laparotenser for gynecologic surgery in an awake state.
The laparotenser instrument is used to perform isobaric laparoscopy to avoid adverse effects in the pneumoperitoneum. To decrease hospitalization time and increase the rate of same-day discharge, we investigated the safety of isobaric laparoscopy using the Laparotenser, a new subcutaneous abdominal wall-lifting system, with transversus abdominis plane (TAP) block combined with locoregional anesthesia (subarachnoid, peridural, spino-peridural) for patients undergoing minor and major gynecologic surgeries. ⋯ We performed ultrasound-guided TAP block with ropivacaine 0.25% 20 mL to cover the supraumbilical region in association with locoregional anesthesia (lumbar subarachnoid-peridural-spinoperidural) and bupivacaine 0.5% (10 mg/3 mL) to cover the lower pelvic region. Successful outcome was reported in 81.3% (13/16) of the patients.
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J Minim Invasive Gynecol · Jan 2013
Case ReportsEarly detection and minimally invasive management of intramural pregnancy.
Intramural pregnancy is a rare form of ectopic pregnancy, wherein the fetus is implanted within the myometrium, separate from the endometrial cavity. In the early reported cases, a diagnosis was only possible after an operation for uterine rupture; however, recent developments in ultrasonography and magnetic resonance imaging assist in early diagnosis. ⋯ Here, we report the first case of successfully combining hysteroscopy and laparoscopy in the early diagnosis and management of intramural pregnancy. Our experience reveals that the minimally invasive procedure is safe and effective in select cases where advanced endoscopic expertise is available.