Surgical Technique of a Laparoscopic Pericervical Tourniquet Placement during Laparoscopic Myomectomy

2021 ◽  
Vol 28 (11) ◽  
pp. S144
Author(s):  
D.A. Acosta ◽  
P. Urbina ◽  
C.Q. Marfori

The objective: to optimize the treatment of children with the combined course of chronic gastroduodenitis (CGD) and primary arterial hypertension (PH) against the backdrop of hypomagnesemia by including the combined preparation of magnesium and vitamin В6 in the treatment regimen. Materials and methods. We examined 20 children aged 10 to 17 years with a combined course of CGD and PH and a serum magnesium content of ≤0.8 mmol/L. Children received non-drug treatment, treatment of CGD in accordance with the clinical protocol. PH treatment included an ACE inhibitor (enalapril) in an individual dose. Additionally preparation of magnesium and vitamin В6 was assigned. Results. Against the background of combined treatment, after 1 month, complaints of abdominal pain, nausea, headache and a feeling of heaviness in the stomach were decreased most intense in patients. After 3 months, complaints of fatigue significantly decreased and normalized tests of self-assessment of the functional state and subjective assessment of the quality of night sleep. According to the ABPM data, the average daily SBP and SBP load (p<0.001) decreased most distinctly, and the SBP dipping increased (p=0.04). According to endoscopy results, the number of children with erythematous CHD after 3 months decreased from 40% to 10% (χ2=4.8; p=0.03), and erosive CHD was not diagnosed in any child (χ2=8.48; p=0.004 compared with the data before treatment). Conclusions. Children with a combined course of CGD and PН need complex therapy using a combination of magnesium and vitamin В6. This approach contributes to the normalization of serum magnesium levels, the rapid reduction of complaints, the improvement of blood pressure, the quality of night sleep and the endoscopic picture of the gastric mucosa and duodenum. Key words: chronic gastroduodenitis, primary arterial hypertension, children, treatment, magnesium preparations.

2020 ◽  
pp. 75-85
Author(s):  
I.Z. Gladchuk ◽  
◽  
G.V. Shitova ◽  
N.A. Zarzhitska ◽  
◽  
...  

Uterine fibroids are the most common benign tumors of the female genital tract and are associated with numerous clinical problems. Laparoscopic myomectomy is an absolute altermative to standard open surgical technique with comparable long-term results. Due to the wide use and improvement of operational techniques with laparoscopic access, the pressing issue is possibility of its use in women, who have leiomyomas of the uterus and reрroductive intentions. The attitude to the quality of endoscopic suturing of the uterus after the enucliation of the knot and capability of suture during the next pregnancy is controversial. The technical aspects of suture of uterine incisions and also experience and skill of a surgeon during myomectomy deserves special attention. Uterine ruptures during the pregnancy and delivery are connected with violation of suture techniques – one-row uterine suture is compared with layering, and it’s extremely important for the full recreation of uterine-wall integrity after the removal of leiomyoma; wide use of electrocoagulation, which can lead to burns of myometrium with the further worsening of tissue regeneration.Given the need for an individual approach to each patient with uterine fibroids and reproductive intentions, surgical technique, access, choice of energy and suture are determined by each surgeon depending on the size, localization of uterine fibroids and clinical course to obtain the most effective postoperative result. The article is dedicated to peculiarities of the laparoscopic myomectomy in women of reproductive age. Laparoscopic myomectomy, when performed by an experienced surgeon, can be considered a safe technique with good results in terms of pregnancy outcome. Key words: uterine fibroids, fibroid, myomectomy, laparoscopy, surgical technique.


2012 ◽  
Vol 61 (4) ◽  
pp. 23-32 ◽  
Author(s):  
Vitaliy Fedorovich Bezhenar ◽  
Anna Alekseevna Tsypurdeeva ◽  
Andrey Kirillovich Dolinskiy ◽  
Nikolay Igorevich Polenov ◽  
Evgeniy Nikolaevich Bailuk ◽  
...  

The aim of this research was to analyze the results of the experience of 85 laparoscopic myomectomy, performed by standardized surgical technique in the Department of Operative Gynecology of Ott Institute of Obstetrics and Gynecology. Developed and describes the main stages of the operation. Analysis of intra- and postoperative complications, duration of hospitalization demonstrated effectiveness and safety of this surgical technique. The most important task of this technique — the formation of a wealthy uterine scar


1997 ◽  
Vol 12 (9) ◽  
pp. 1927-1930 ◽  
Author(s):  
P. Seinera ◽  
R. Arisio ◽  
A. Decko ◽  
C. Farina ◽  
F. Crana

2009 ◽  
Vol 137 (11-12) ◽  
pp. 641-646
Author(s):  
Srdjan Sedlar ◽  
Zoran Jokic ◽  
Aleksandra Dimitrijevic ◽  
Aleksandar Zivanovic

Introduction. The advantages of laparoscopic removal of a myoma over classical surgical technique are shorter hospital stay, rapid recovery and less pain after surgery, as well as a lower frequency of ileus and thromboembolic complications. The surgical technique of laparoscopic removal of myoma involves four basic stages: incision on the wall of the uterus, separation of the myoma from the healthy uterine tissue, to stop bleeding and removal of the myoma from the abdomen. Apart from these four basic stages, it is also necessary to establish a new integrity of the uterine wall, especially in women planning pregnancy. Objective. The aim of the paper is to present the procedures used in the treatment of uterine wall defect during the laparoscopic removal of the myoma. Methods. We analyzed 96 patients who were indicated for laparoscopic myomectomy. All patients were divided into four groups according to the type of the technique of haemostasis and treatment of the defect on the uterine wall: electrocoagulation, electrocoagulation with application of argon plasma, a single suture and extended suture. Results. In order to stop bleeding, we most often used electrocoagulation by monopolar electricity, i.e. in 39.6% of the patients. To stop bleeding and treat the defect of the uterine wall, we used a single suture in 21.9% and in 11.4% patients we used the extended suture. The manner of uterine wall treatment did not have a statistically significant influence on the results of haematological parameters (p>0.05), consumption of carbon dioxide (p>0.05) and the duration of surgical procedure (p>0.05). The increased use of antibiotics (p<0.05) in the group of patients in whom we treated the defect by sutures on the uterus, the length of postsurgical hospitalization and absence from work (p<0.01) was statistically significant. Conclusion. To achieve a better reconstruction of the uterus, it is recommended to use sutures with laparoscopic removal of myoma.


2006 ◽  
Vol 175 (4S) ◽  
pp. 544-544
Author(s):  
Mireia Musquera ◽  
Anna Agud ◽  
Lluis Peri ◽  
Maria Jose Ribal ◽  
Federico Oppenheimer ◽  
...  

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