scholarly journals Laparoscopic Management of Interstitial Ectopic Pregnancies

2014 ◽  
Vol 6 (3) ◽  
pp. 163-166
Author(s):  
Shyam V Desai ◽  
Gaurav S Desai ◽  
Jessi Levi
Keyword(s):  
Ectopic Pregnancy ◽  
Operative Time ◽  
Laparoscopic Management ◽  
Ectopic Gestation ◽  
Estimated Blood Loss ◽  
Laparoscopic Excision ◽  
Interstitial Ectopic Pregnancy ◽  
Ectopic Pregnancies

ABSTRACT This illustration describes the successful laparoscopic management of interstitial ectopic pregnancy. Three women underwent laparoscopic excision for interstitial ectopic gestation. Mean operative time was 49.4 ± 8.4 minutes (41- 69 mins). Estimated blood loss was 50 ± 4 ml. There were no intraoperative or postoperative complications. Duration of hospital stay was 24 ± 3 hours. All patients are doing well on follow-up. The authors demonstrate the role of laparoscopic excision and conclude that this technique, when performed by experienced surgeons, allows for improved dexterity and is a safe and effective method in the management of interstitial ectopic pregnancy. How to cite this article Desai GS, Levi J, Desai SV. Laparoscopic Management of Interstitial Ectopic Pregnancies. J South Asian Feder Obst Gynae 2014;6(3):163-166.

scholarly journals Role of methotrexate in ectopic pregnancy

2020 ◽  
Vol 10 (1) ◽  
pp. 84
Author(s):  
Munjal J. Pandya ◽  
Neha V. Ninama ◽  
Chirag V. Thummar ◽  
Meet K. Patel
Keyword(s):  
Ectopic Pregnancy ◽  
Success Rate ◽  
Surgical Intervention ◽  
Cost Effective ◽  
First Trimester ◽  
Medical College ◽  
Beta Human Chorionic Gonadotropin ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is an acute emergency in obstetric if not timely diagnosed and timely treated. Ectopic pregnancy is leading cause of death in first trimester. Ectopic pregnancy can be managed surgically or medically. Medical management with Methotrexate administration avoids anesthesia in surgery, is cost effective and also offers success rate comparable to surgical management. Aim and objectives were to study the role of methotrexate in ectopic pregnancyMethods: This will be a retrospective observational study conducted in Obstetrics and Gynecology department of AMC MET medical college. Study group constitutes of 30 females with ectopic pregnancy. Preliminary blood investigations, ultrasonography and beta-human chorionic gonadotropin (b-hcg) level will be tested. Patients will be treated with single dose of methotrexate 50 mg/M2. Follow up b-hcg level will be done after 48 hours. Response and tolerance to methotrexate will be monitored.Results: The success rate of methotrexate therapy in our study was 83.33% (n=25) and 16.66% (n=5) required surgical intervention with tubal ruptured and abdominal pain.Conclusions: Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. It has the advantage of tubal conservation and saves patients from surgical intervention.

scholarly journals Medical management of ectopic pregnancy in a low resource setting: the role of methotrexate

2021 ◽  
Vol 10 (3) ◽  
pp. 879
Author(s):  
Simon Birame Ndour ◽  
Mamour Gueye ◽  
Abdoul Aziz Diouf ◽  
Moussa Diallo
Keyword(s):  
Developing Countries ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Medical Management ◽  
University Hospital ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Ectopic Pregnancies

Background: Medical treatment using methotrexate. However, its indications and the protocol of administration are still under discussion. Even if follow-up problems are often raised in developing countries, medical treatment of ectopic pregnancy remains a reasonable option that we practice and share our experience here.Methods: We performed a retrospective cohort study of patients managed for an unruptured ectopic pregnancy in two university hospital facilities in Dakar: the Centre Hospitalier National de Pikine and the Centre de Santé de Philipe Maguilen Senghor. The data of this study are spread over a period of 10 years, from 2010 and 2019. We planned to evaluate maternal age, parity, gestational age, diagnosis circumstances, medical management, monitoring, and outcome. A single dose protocol was used. Data extracted from the registries were transferred to Microsoft Excel 2019, Mac version and then moved to SPSS (Statistical Package for Social Sciences, 26.Results: Over ten years, we had registered 18 patients who had received medical treatment out of a total of 263 ectopic pregnancies treated in the two facilities, i.e., a frequency of 6.8%. The average age was 28.8 years. The average initial HCG level was 10,460 mIU/ml. Treatment succeeded in more than 6 out of 10 patients (61.1%). However, we noted 5 cases of failure that had secondarily benefited from salpingectomy by laparotomy.Conclusions: Methotrexate is now part of the therapeutic arsenal in the management of unruptured tubal ectopic pregnancies. However, in developing countries, particularly in Senegal, there is a reluctance to use this therapeutic method, which, however, when a personalized follow-up is carried out, is achievable with a success rate comparable to other therapeutic methods.

Laparoscopic Management of Interstitial Ectopic Pregnancy: A Novel Technique

2016 ◽  
Vol 23 (7) ◽  
pp. S14
Author(s):  
RM Sawant ◽  
NR Warty ◽  
KP Parikh ◽  
TR Warty ◽  
SP Puntambekar
Keyword(s):  
Ectopic Pregnancy ◽  
Laparoscopic Management ◽  
Novel Technique ◽  
Interstitial Ectopic Pregnancy

scholarly journals Retroperitoneal hand-assisted laparoscopic nephrectomy and partial nephrectomy

2013 ◽  
Vol 3 (1) ◽  
pp. 3 ◽  
Author(s):  
Nosratollah Nezakatzgoo ◽  
Janet Colli ◽  
Matthew Mutter ◽  
Sheg Aranmolate ◽  
Robert Wake
Keyword(s):  
Partial Nephrectomy ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Oral Intake ◽  
Pathological Examination ◽  
Tumor Diameter ◽  
Renal Masses ◽  
Estimated Blood Loss ◽  
Average Operative Time

The purpose of the present paper is to describe our technique and experience with retroperitoneal hand-assisted laparoscopic (HAL) nephrectomies as an alternative to the transperitoneal approach. Eight retroperitoneal HAL nephrectomies and one partial nephrectomy were performed. Several excisional techniques were employed incorporating the Harmonic scalpel or Ligasure device. Hemostatic agents were used to cover the renal defect. Surgical bolsters were sutured to the renal capsule with pleget reinforcements to aid in hemostasis. The average operative time was 210 min and estimated blood loss 110 mL. Mean change in hematocrit was 3 units and creatinine was 1 point. No patient required a transfusion. There were no major complications, with a mean follow-up of fourteen months. On average, patients resumed oral intake in 2 days, and were discharged in 3 days. Pathological examination revealed that two lesions were benign and seven malignant. Tumor diameter averaged 3 cm. There were no positive surgical margins. In conclusion, we have demonstrated the feasibility of retroperitoneal laparoscopic hand-assisted nephrectomy and partial nephrectomy surgery for solid renal masses.

Radiofrequency bipolar coagulation for radical hysterectomy: Technique, feasibility and complications

2003 ◽  
Vol 13 (2) ◽  
pp. 187-191
Author(s):  
A. Ercoli ◽  
A. Fagotti ◽  
M. Malzoni ◽  
G. Ferrandina ◽  
T. Susini ◽  
...  
Keyword(s):  
Blood Loss ◽  
Radical Hysterectomy ◽  
Operative Time ◽  
Bipolar Coagulation ◽  
Maximal Diameter ◽  
Estimated Blood Loss ◽  
Safe Technique ◽  
Radiofrequency Coagulation ◽  
Vessel Dissection

This study describes the surgical technique and intra- and postoperative complications associated with the use of a radiofrequency bipolar coagulator in a series of 18 Piver type III-IV radical hysterectomies performed in cervical cancer patients. Preliminary vessel-by-vessel dissection of the lateral parametria was possible in 17 out of 18 (94%) cases, and a direct application of a radiofrequency bipolar coagulation instrument was performed to coagulate the posterior and anterior parametrial tissues in all cases. We were able to easily coagulate isolated vessels up to 5 mm of maximal diameter. In no case were clamps or hemoclips necessary to complete hemostasis. We did not observe any parametrial vessel damage or heat-related injury of the surrounding normal tissue. The median size of the parametria removed was 44 mm (range 31–58) and nodes were detected in 15 cases (83%). Median operative time and estimated blood loss for the whole procedure including systematic pelvic and aortic lymphadenectomy was 250 min (range 200–410) and 550 ml (range 400–2500), respectively. Median follow-up time was 9 months (range 5–13). No complications specifically related to the use of radiofrequency coagulation were found. In conclusion the radio-frequency coagulation with this instrument appears to be a safe technique that is particularly useful in reducing blood loss and operative time without affecting radicality in patients undergoing radical hysterectomy.

Laparoscopic Management of Interstitial Ectopic Pregnancy Coexistent with a Fibroid: A Cause or a Chance?

2020 ◽  
Vol 36 (6) ◽  
pp. 375-378
Author(s):  
Akshita Panwar ◽  
Alka Kriplani ◽  
Kusum Lata ◽  
Isha Kriplani ◽  
Seema Sharma ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Laparoscopic Management ◽  
Interstitial Ectopic Pregnancy

scholarly journals Submuscular plates versus flexible nails in preadolescent diaphyseal femur fractures

2018 ◽  
Vol 12 (5) ◽  
pp. 488-492 ◽  
Author(s):  
L.-K. Chen ◽  
B. T. Sullivan ◽  
P. D. Sponseller
Keyword(s):  
Operative Time ◽  
Length Of Hospital Stay ◽  
Surgical Site Infections ◽  
Patient Characteristics ◽  
Level Of Evidence ◽  
Femur Fractures ◽  
Estimated Blood Loss ◽  
Postoperative Length ◽  
Flexible Nails

Purpose To compare patient characteristics, operative time, estimated blood loss (EBL), postoperative length of hospital stay (LOS) and complications after insertion and removal of submuscular plates (SMPs) versus flexible nails (FNs) for paediatric diaphyseal femur fractures. Methods We reviewed records of 58 children (mean age, 7.7 years SD 2.0) with diaphyseal femur fractures who underwent treatment with SMPs (n = 30) or FNs (n = 28) from 2005 to 2017 (mean follow-up, 22 months SD 28). Patients with pathological fractures or musculoskeletal comorbidities were excluded. Alpha = 0.05. Results Insertion of FNs was associated with shorter operative time (ß = –24 mins) and less EBL (ß = –38 mL) (both, p < 0.001) compared with insertion of SMPs, after adjusting for fracture type and time from beginning of study period. Removal of FNs was also associated with shorter operative time (ß = –15 min) compared with removal of SMPs (p < 0.001). EBL during removal was similar between groups (p = 0.080). The FN group had a shorter LOS after insertion (ß = –0.2 d) compared with the SMP group (p = 0.032). Four patients treated with SMPs and three treated with FNs developed surgical site infections. Two patients treated with SMPs and seven treated with FNs experienced implant irritation that resolved with removal. No other complications occurred. Conclusion Compared with SMPs, FNs were associated with shorter operative time (for insertion and removal), less EBL (for insertion) and shorter post-insertion LOS in patients with diaphyseal femur fractures. Level of Evidence: III

scholarly journals Treatment of irreducible atlantoaxial dislocation using one-stage retropharyngeal release and posterior reduction

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987046 ◽  
Author(s):  
Xianfeng Ren ◽  
Feng Gao ◽  
Siyuan Li ◽  
Jiankun Yang ◽  
Yongming Xi
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Japanese Orthopaedic Association ◽  
Operation Time ◽  
Atlantoaxial Dislocation ◽  
Efficacy And Safety ◽  
Estimated Blood Loss ◽  
Irreducible Atlantoaxial Dislocation ◽  
The Mean

Introduction: Irreducible atlantoaxial dislocation (IAAD) has been challenging for spine surgeons. Various methods have been used to treat IAAD, but no consensus has been reached. This study aimed to retrospectively analyze the efficacy of anterior submandibular retropharyngeal release and posterior reduction and fixation for IAAD. Methods: From March 2007 to May 2015, 13 patients diagnosed with IAAD underwent anterior submandibular retropharyngeal release and sequential posterior reduction and fixation. The operation time, blood loss, postoperative complications, and Japanese Orthopaedic Association (JOA) scores were retrospectively recorded. Results: The surgeries were accomplished successfully. The mean operative time was about 3.8 h. The mean estimated blood loss was about 130 mL. The patients experienced postoperative pharyngeal pain. Only one patient had a vague voice and increased oral discharge postoperatively. At the final follow-up, JOA scores had significantly increased ( p < 0.05), and all the patients had solid bony fusion. Conclusion: The present study reinforces the efficacy and safety of anterior submandibular retropharyngeal release and posterior reduction and fixation for IAAD. It can achieve satisfactory clinical outcomes and is safe for experienced spine surgeons.

Conservative surgical management of ectopic pregnancy and its role in preservation of future fertility

2021 ◽  
Vol 12 (6) ◽  
pp. 64-68
Author(s):  
Indranil Dutta ◽  
Dilip Kumar Dutta ◽  
Rumpa Banerjee Dutta
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Management ◽  
West Bengal ◽  
Induced Abortion ◽  
Segmental Resection ◽  
Ectopic Gestation ◽  
Future Fertility ◽  
History Of ◽  
Related Mortality

Background: Maternal Mortality is one of the most important issues in our country. Ectopic Gestation is one of the few reasons which contribute to it. The first successful surgical management of a tubal ruptured ectopic pregnancy occurred in 1883. In those times mortality was approximately 60%. Since then lot of development in management of ectopic pregnancy has taken place which has resulted in reduction of related mortality. But still it remains as one of the important topics as now due to more infections (i.e PID) and resulting ectopic gestations and further operative salphingectomies, there is a reduced chance of patient to conceive naturally afterwards. Hence role of conservative surgeries comes to the front. Aims and Objectives: Role of Conservative Surgical Management of Ectopic pregnancy and its relation to future fertility. Materials and Methods: This Study was undertaken at GICE Clinic, Cure Hospital, Kalyani, West Bengal India from January, 2008 to January 2019. During this period 64 patients were diagnosed and operated for Ectopic pregnancy. Results: Forty (62.5%) cases were in between 20-30 years of age. Forty-four (68.7%) cases had no issue. Forty-eight (75.0%) cases were from low socio-economic group. Sixty patients (93.7%) had the history of amenorrhea. It was also observed that history of induced abortion was in 20 (31.2%) cases, PID in 12 (18.7%) cases, appendectomy – 6 (9.4%) cases and history of previous IUCD insertion - 4 (6.3%) were found to be common amongst ectopic gestation cases. Twenty-four (37.5%) cases underwent linear salpingostomy, 8 (12.5%) cases had segmental resection with end to end anastomosis whereas 16 (25.0%) cases had salpingectomy and 16 (25.0%) cases had salpingo-opherectomy with tubectomy [opposite tube] were advocated. In 4(6.3%) cases of linear salpingostomy and 4 (6.3%) cases of segmental resection, the cases had to be re-operated again for unstable haemodynamic condition within 24 hours and were subsequently advocated to salpingectomy. Conclusion: Linear Salpingostomy was found to be a better option for women who desire to become future mother, than that of segmental resection and salpingectomy on affected tube (although pregnancy was reported as opposite tube)

Sign in / Sign up

Export Citation Format

Share Document