scholarly journals BIPOLAR VAGINAL HYSTERECTOMY IN THE FUTURE AND PRESENT

2018 ◽  
Vol 5 (2) ◽  
pp. 93-96
Author(s):  
A. I Slobodyanyuk ◽  
Anton A. Ishchenko ◽  
A. I Ishchenko ◽  
B. A Slobodyanyuk
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Operation Time ◽  
Pain Syndrome ◽  
Bipolar Coagulation ◽  
Prospective Comparison ◽  
The Future

Vaginal hysterectomy seems to be the optimal access, but this method does not take a worthy place in operative gynecology. In this study, a prospective comparison of 2 different techniques of vaginal hysterectomy was performed in 125 patients with the use of vicryl ligatures and 215 patients using bipolar coagulation devices (Gyrus and Emed) in different clinics. In the analysis of immediate and remote results, in the group with electrosurgery, blood loss, operation time and pain syndrome at 4 and 48 hours were found to be statistically significantly less. Also, we did not discern any differences in the number of postoperative complications, which allows us to make conclusions regarding the safety and effectiveness of the use of modern bipolar coagulation devices by experienced surgeons.

scholarly journals Technique of the laparoscopic pelvic exenteration

2018 ◽  
Vol 46 (6) ◽  
pp. 631-639
Author(s):  
E. A. Galliamov ◽  
R. G. Biktimirov ◽  
V. P. Sergeev ◽  
L. N. Aminova ◽  
A. E. Sanzharov ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
World Literature ◽  
Pelvic Exenteration ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Laparoscopic Technique ◽  
Negative Resection Margin ◽  
Invasive Approach

Background: Laparoscopic surgery has proved itself to be a “golden standard” for treatment of most abdominal and retroperitoneal cancers. Such a serious procedure as pelvic exenteration continues to be a complex surgical intervention usually performed through a  conventional laparotomic access. However, studies on minimally invasive approach for this intervention have becoming increasingly published in the world literature.Aim: To describe the laparoscopic pelvic exenteration technique of pelvic exenteration, as well as to assess short- and long-term results of these interventions.Materials and methods: From 2011 to 2018, 21 procedures of laparoscopic pelvic exenteration have been performed in 6  surgical centers (Moscow, Russia). Six (6) patients had previously confirmed cervical cancer, 7 patients had bladder cancer, 4 patients had rectal cancer, 1 patient had vaginal cancer, 2 patients had relapsing vaginal cancers after previous uterine extirpation, and 1 patient had an ovarian neoplasm.Results: The laparoscopic pelvic exenteration volumes were as follows: 9  total, 7 anterior and 5 posterior procedures. In 19 out of 21 cases, negative resection margin (R0) was possible. Median duration of the procedure was 254 minutes, median blood loss was 515 ml, and median postoperative hospital stay was 13 days. Postoperative complications were registered in 6 (28.6%) patients. The 3-year overall survival was 85.71%.Сonclusion: The choice of laparoscopic access can reduce blood loss, decrease the rates of early postoperative complications, contributes to a more comfortable postoperative period with early activation and less severe pain syndrome, and leads to a reduction in the duration of hospital stay. These results of the laparoscopic technique are comparable with those of laparoscopic and open pelvic exenteration published by other authors.

Laparoscopically assisted vaginal hysterectomy versus abdominal hysterectomy in stage I endometrial cancer

2002 ◽  
Vol 12 (1) ◽  
pp. 57-61 ◽  
Author(s):  
K. M Fram
Keyword(s):  
Endometrial Cancer ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Intraoperative Complications ◽  
Abdominal Hysterectomy ◽  
Pelvic Lymphadenectomy ◽  
Stage I ◽  
Laparoscopic Treatment ◽  
Laparoscopically Assisted Vaginal Hysterectomy

Abstract.Fram KM. Laparoscopically assisted vaginal hysterectomy versus abdominal hysterectomy in stage I endometrial cancer.The purpose of this study was to evaluate and compare laparoscopic treatment for stage I endometrial cancer with the traditional transabdominal approach. From July 1996 to July 1998, 61 patients with clinical stage I endometrial cancer were treated at the Gynaecology Oncology Unit at the Royal North Shore of Sydney, Australia. Twenty-nine patients were treated with laparoscopic assisted vaginal hysterectomy (LAVH) and bilateral salpingo-oophrectomy (BSO) ± laparoscopic pelvic lymphadenectomy (LPLA), while 32 patients were treated with the traditional laparotomy and underwent total abdominal hysterectomy (TAH) and BSO ± pelvic lymphadenectomy (PLA). The main outcomes studied were operative time, blood loss, blood transfusion, intraoperative complications, postoperative complications, duration of hospital stay, and number of lymph nodes obtained. In conclusion, laparoscopic treatment of endometrial cancer is safe in the hands of experienced operators with minimal intraoperative and postoperative complications. This procedure is associated with significantly less blood loss and shorter hospitalization; however, it is associated with significantly longer operating time. Proper selection of patients for the laparoscopic procedure is the vital step in achieving the major goals of this approach.

scholarly journals The Ten-Step Vaginal Hysterectomy – A Newer and Better Approach

2012 ◽  
Vol 30 (2) ◽  
pp. 71-77 ◽  
Author(s):  
I Bina ◽  
D Akhter
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Traditional Method ◽  
Operation Time ◽  
Abdominal Hysterectomy ◽  
Vaginal Wall ◽  
Safe Procedure ◽  
Uterine Arteries ◽  
Starting Point ◽  
Uterine Ligaments

Aims and Objectives: This study was undertaken to compare with the traditional Heaney‘s method of vaginal hysterectomy and the newer Ten-Step Vaginal Hysterectomy and to emphasize that this is a safe procedure with lesser blood loss, shorter operation time and shorter requirements of analgesia. Study Design: 110 Patients with non descent, first, second and third degree prolapsed uterus from 45 to 72 years of age were subjected to this study in Khalishpur Clinic. Those women were randomly selected. Among them 54 women had the traditional Heany‘s Methods of Vaginal Hysterectomy and 56 women had the Ten-Step Vaginal Hysterectomy (TSVH). The blood loss was measured by hemoglobin assessment before and 3 days after operation. Material and Methods: In Ten-Step Vaginal Hysterectomy the vaginal wall was incised by drop-like incision starting under the urethra, continuing laterally and down, encircling the cervix from behind and returning back to the starting point from the other side, then separation was done laterally to the side to the uterus. Bladder is detached from the uterus, and the posterior peritoneum is opened. The sacro-uterine ligaments and the paracervical ligaments are clamped together, cut and ligated in both sides. Next the uterine arteries are clamped, cut and ligated. Uterus is pulled down and two fingers are introduced behind the fundus to lift anterior peritoneum and opened under supervision. The round and ovarian ligaments and blood vessels are clamped together and ligated in both side. The peritoneum is left open, then reconstruction of the pelvic floor is done and the vaginal wall is closed continuously. Results: It was found that in comparison of traditional methods with the ten steps vaginal hysterectomy, there are lesser blood loss (400ml vs 80ml; P<0.05) with lower complications, shorter operation time (52.5min vs 30.3min; P<0.05), lesser pain and lesser requirements of analgesia (5.8 vs 3.9 days; P<0.05) and shorter period of convalescence. Hospital stay remains same for both groups. Conclusion: The Ten-Step Vaginal Hysterectomy is a better operation than traditional method of vaginal hysterectomy, Abdominal Hysterectomy and LAVH. At the same time this method is logical and easy to learn, to perform and to teach.   DOI: http://dx.doi.org/10.3329/jbcps.v30i2.11407   J Bangladesh Coll Phys Surg 2012; 30: 71-77  

scholarly journals Application of near-infrared fluorescent cholangiography using indocyanine green in laparoscopic cholecystectomy

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097922
Author(s):  
Chusi Wang ◽  
Wenguang Peng ◽  
Jiarui Yang ◽  
Yuxuan Li ◽  
Jiawei Yang ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Near Infrared ◽  
Hepatic Duct ◽  
Operation Time ◽  
Common Hepatic Duct ◽  
Intraoperative Blood Loss ◽  
Real Time Identification

Objective Near-infrared fluorescence cholangiography (NIRF-C) can help to identify the bile duct during laparoscopic cholecystectomy. This retrospective study was performed to investigate the effect of NIRF-C in laparoscopic cholecystectomy. Methods Consecutive patients who underwent NIRF-C-assisted laparoscopic cholecystectomy (n = 34) or conventional laparoscopic cholecystectomy (n = 36) were enrolled in this study. Identification of biliary structures, the operation time, intraoperative blood loss, and postoperative complications were analyzed. Results Laparoscopic cholecystectomy was completed in all patients without conversion to laparotomy. The median operation time and intraoperative blood loss were not significantly different between the two groups. No intraoperative injuries or postoperative complications occurred in either group. In the NIRF-C group, the visualization rate of the cystic duct, common bile duct, and common hepatic duct prior to dissection was 91%, 79%, and 53%, respectively. The success rate of cholangiography was 100% in the NIRF-C group. NIRF-C was more effective for visualizing biliary structures in patients with a BMI of <25 than >25 kg/m2. Conclusions NIRF-C is a safe and effective technique that enables real-time identification of the biliary anatomy during laparoscopic cholecystectomy. NIRF-C helps to improve the efficiency of dissection.

scholarly journals Interval versus external fixation for the treatment of pelvic fractures: a comparative study

2017 ◽  
Author(s):  
Xianping Ma ◽  
Xudong Zheng ◽  
Wei Zhao ◽  
Zifeng Lu ◽  
Lei Xu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
External Fixation ◽  
Operation Time ◽  
Pelvic Fractures ◽  
Efficacy And Safety ◽  
Postoperative Rehabilitation ◽  
Clinical Indicators ◽  
Postoperative Fever

Purpose: This retrospective study evaluated the efficacy and safety of internal fixation (IF) in the treatment of pelvic fractures (PF). Methods: A total of 263 unstable PF patients were treated from February 2009 to April 2015. Patients were divided into two groups according to type of fixation used to treat their PF: 136 cases received IF surgery (IF group); and, 127 cases received external fixation (EF) surgery (EF group). Postoperative follow-ups were conducted to record the clinical data, perioperative clinical indicators, Matta scores for fracture displacements, Majeed scores for hip functions and postoperative complications. Results: Operation time, blood loss, the total length of the wound, postoperative fever rate, hospitalization time and complication rate for the IF group were significantly decreased in comparison with the EF group, while the ratings of pain, working and sitting ability and Matta and Majeed scores of the IF group were significantly higher than those of the EF group. Conclusion: IF was found to be associated with shorter operation times, less blood loss and better postoperative rehabilitation in comparison with EF, suggesting that it is an effective therapy for the treatment of unstable PF and will lead to restoration of normal pelvis functions.

scholarly journals Laparoscopic assisted vaginal hysterectomy: an experience at a Fortis Escorts hospital

2020 ◽  
Vol 9 (9) ◽  
pp. 3749
Author(s):  
Neelu Rajput ◽  
Sahab Singh Yadav ◽  
Pratibha Narwade
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Intraoperative Complications ◽  
Pelvic Surgery ◽  
Bladder Injury ◽  
Duration Of Hospital Stay ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Laparoscopic Assisted

Background: The objective of this study was to evaluate the laparoscopic assisted vaginal hysterectomy (LAVH) in terms of demographic data of patients, indications, uterine size, intraoperative and postoperative complications, amount of blood loss, operative time and duration of hospital stay.Methods: A retrospective study was conducted on 160 cases, who underwent laparoscopic assisted vaginal hysterectomy in the period between October 2018 to November 2019 at the Fortis Escorts Hospital, Faridabad, Haryana, India.Results: Majority of patients (58.75%) belongs to age group between 40-50 year. Only 30.62% cases had a history of one previous abdomino-pelvic surgery. Majority of cases (52.5%) in the study group had uterine size between 6-12 weeks. Most common indication of hysterectomy in this study was fibroid uterus which account for 49.37% of cases followed by dysfunctional uterine bleeding (16.87%) cases. Mean time of surgery in this study was 114.4±0.59 min and average blood loss was 135.62±47.63 ml. The mean weight of uterus was 243.75±82.94 gm. 5% cases had major intraoperative complications while minor postoperative complications were seen in 16.87% cases. Bladder injury was seen in 1.25%. Major haemorrhage occur in 1.25%. In this study conversion to laparotomy rate was 1.25%. Only one case of ureteric injury and one case of bowel injury was noted. Among minor complications fever (6.25%) and urinary tract infection (5.62%) were mainly seen. Mean duration of hospital stay was 2.82±1.17 days.Conclusions: LAVH enables the surgeon to convert most of the abdominal hysterectomies into vaginal ones and hence decreases postoperative pain, decreases complications, lesser duration of hospital stay and rapid return to normal activity.

scholarly journals Direct Anterior Versus Anterolateral and Posterior Approaches to Total Hip Replacement: Comparative Accuracy of Acetabular Implant Placement and Early Clinical Outcomes

2020 ◽  
Author(s):  
Ying-Lin Chen ◽  
Chi-Horng Horng ◽  
Shang-Lin Hsieh ◽  
Chin-Jung Hsu ◽  
Chien-Chun Chang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Operation Time ◽  
Surgical Approaches ◽  
Anterolateral Approach ◽  
Acetabular Cup ◽  
Total Hip ◽  
Significant Difference ◽  
Cup Position ◽  
Acetabular Cup Position

Abstract BackgroundDifferent surgical approaches used in total hip arthroplasty (THA) include a direct anterior approach (DAA), anterolateral approach (AL), and posterolateral approach (PL). However, the acetabular cup position varies according to surgical view, surgical table, and patient position for each approach. This study is aimed to compare acetabular cup position in THA under different approaches, including surgical time, blood loss, and postoperative complications.MethodsBetween Jan 2017 and Dec 2018, 231 patients who underwent THA (64 DAA, 96 AL, and 71 PL THAs) were analyzed retrospectively. Intraoperative blood loss, operation time, preoperative and postoperative WOMAC score, cup anteversion, inclination angle, and postoperative complications were analyzed.ResultsDAA showed longer operation time and more blood loss, but shorter hospital stays. The cup was found in the safe zone for 97% of DAA patients, 74% of AL patients, and 56% of PL patients. PL showed the highest complication rate (9.9%), followed by DAA (3.1%) and AL (1%). There was no statistically significant difference in preoperative and postoperative WOMAC scores. ConclusionTHA by DAA using a special table is a more reliable procedure to achieve safe cup position. Although DAA showed fewer outliers in cup position, it resulted in longer operation time and greater blood loss compared to other groups.Trial registration: Retrospective study

Laparoscopically assisted versus open surgery for endometrial cancer—a meta-analysis of randomized controlled trials

2008 ◽  
Vol 18 (6) ◽  
pp. 1315-1325 ◽  
Author(s):  
F. Lin ◽  
Q. J. Zhang ◽  
F. Y. Zheng ◽  
H. Q. Zhao ◽  
Q. Q. Zeng ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Open Surgery ◽  
Operation Time ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled

There is no clear consensus on the advantages of laparoscopically assisted surgery (LAS) versus open surgery (OS) for endometrial cancer. The present study compared LAS versus OS for patients with endometrial cancer with regard to operative parameters and outcomes. A search of the PubMed, EMBASE, the China Biological Medicine Datadase (CBMdisc), Ovid, and the Cochrane Library identified four studies that met the inclusion criteria for data extraction. Estimates of effectiveness were performed using fixed- and random effects models. The effect was calculated as an odds ratio (OR) or weighted mean difference (WMD) with 95% confidence intervals (CIs). Level of significance was set at P< 0.05. Outcomes of 331 patients were studied. When randomized controlled trials were analyzed, OR for LAS was 0.34 (95% CI: 0.13, 0.89; P= 0.03) for postoperative complications and 0.14 (95% CI: 0.05, 0.39; P= 0.0002) for incidence of transfusion; and WMD for LAS was 263.58 mL (95% CI: 467.71, 59.45 mL; P= 0.01) for blood loss, 38.09 min (95% CI: 10.50, 65.68 min; P= 0.007) for operation time, and 3.35 days (95% CI: 3.84, 2.86 days; P< 0.00001) for hospital stay. There was no difference in patients in terms of recurrence and survival. The present study has shown that LAS was associated with fewer postoperative complications, lower incidence of transfusion, less blood loss, longer operation time, and shorter hospital stay. What's more, no significant difference was found in terms of recurrence and survival. When performed by suitably specialized surgeons in selected patients, it appears to be a better choice than OS.

scholarly journals Our Contrivances to Diminish Complications After Pylorus-Preserving Pancreaticoduodenectomy

2015 ◽  
Vol 100 (5) ◽  
pp. 882-890 ◽  
Author(s):  
Tatsuo Shimura ◽  
Hideki Suzuki ◽  
Kenichiro Araki ◽  
Tsutomu Kobayashi ◽  
Rei Yashima ◽  
...  
Keyword(s):  
Food Intake ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
The Novel ◽  
Nasogastric Tubes ◽  
Hospital Stays ◽  
Group B ◽  
Time Required

The objective of this study is to diminish postoperative complications after pylorus-preserving pancreaticoduodenectomy. Pylorus-preserving pancreaticoduodenectomy is still associated with major complications, especially leakage at pancreatojejunostomy and delayed gastric emptying. Traditional pylorus-preserving pancreaticoduodenectomy was performed in group A, while the novel procedure, an antecolic vertical duodenojejunostomy and internal pancreatic drainage with omental wrapping, was performed in group B (n = 40 each). We compared the following characteristics between the 2 groups: operation time, blood loss, time required before removal of nasogastric tube and resumption of food intake, length of hospital stay, and postoperative complications. The novel procedure required less time and was associated with less blood loss (both P &lt; 0.0001). In the comparison of the 2 groups, group B showed less time for removal of nasogastric tubes and resumption of food intake, shorter hospital stays, and fewer postoperative complications (all P &lt; 0.0001). The novel procedure appears to be a safe and effective alternative to traditional pancreaticoduodenectomy techniques.

scholarly journals Comparative Characteristics of Hemostasis During Vaginal Hysterectomy

2019 ◽  
Vol 26 (6) ◽  
pp. 61-69
Author(s):  
Andrei N. Plekhanov ◽  
Vitalii F. Bezhenar ◽  
Tat’yana A. Epifanova ◽  
Fedor V. Bezhenar
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Cost Effective ◽  
Control Group ◽  
Uterine Disease ◽  
Intraoperative Blood Loss ◽  
Bipolar Coagulation ◽  
Suture Ligation

Aim. To compare the results of surgical treatment using bipolar hemostasis and traditional ligation of ligaments and blood vessels in vaginal hysterectomy.Material and methods. Fifty patients with benign uterine disease underwent vaginal hysterectomy using electrosurgery (n = 29) or conventional suture ligation (n = 21 controls).Results. Postoperative pain (especially on the fi rst day) was decreased in the electrosurgery group (5.50 ± 1.43 VAS points) as compared to the control group (7.64 ± 0.58 points), p < 0.001. Intraoperative blood loss was signifi cantly lower in electrosurgery group (82.86 ± 22.58 ml) than in the control group (226.36 ± 129.12 ml), p < 0.001. Operating time was signifi cantly shorter in the main group than in the controls (65.36 ± 20.9 min vs. 86.59 ± 40.19 min, p < 0.05). On average, 2.75 ± 1.11 suture packages were used with bipolar coagulation, 6.00 ± 1.93 in the controls (p < 0.001). Hospital stay was similar for both groups. Adverse event rates did not differ signifi cantly.Conclusions. Bipolar coagulation with the TissueSeal Plus proved to be more effi cient or identical to traditional suture ligation. Intraoperative blood loss, postoperative pain and the duration of the operation were less, while the complications were identical for both groups. In addition, bipolar coagulation was easier to use and cost effective. These fi ndings prove the feasibility and effectiveness of the use of electrosurgical techniques to perform hysterectomy and its further study

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