scholarly journals Laparoscopic dissection of the intramural ureter to repair a complete transection of the distal ureter: Initial experience with a new minimally invasive technique that preserves the anatomy of the urinary tract

2014 ◽  
Vol 8 (5-6) ◽  
pp. 366 ◽  
Author(s):  
Alvaro Juarez-Soto ◽  
Jose Miguel Arroyo-Maestre ◽  
Manuel Soto-Delgado ◽  
Pastora Beardo-Villar ◽  
Miguel Angel Arrabal-Polo ◽  
...  
Keyword(s):  
Laparoscopic Hysterectomy ◽  
Muscle Layer ◽  
Ureteral Injury ◽  
Complete Resection ◽  
Invasive Technique ◽  
Distal Stump ◽  
Distal Ureter ◽  
Complete Transection ◽  
Repair Procedure ◽  
Unilateral Injury

We report 2 patients with ureteral injury after a simple total laparoscopic hysterectomy for uterine myoma with a complete resection of the distal ureter. One patient had unilateral injury and the other 2 patients had bilateral injury. The surgical laparoscopic repair procedure was carried out 3 to 5 days after the injury. Surgery involved intramural dissection of the distal ureteral stump to expose at least 1 cm of the ureter, percutaneous ureteral stent placement, elimination of tension between the proximal ureter and the dissected distal stump, end-to-end anastomosis, and reinsertion of the distal ureter into the bladder muscle layer, which was previously dissected for the anastomosis.

scholarly journals Technique description: Incisionless ultrasound-assisted biceps tenotomy in dogs

2021 ◽  
Vol 10 (4) ◽  
pp. 457-464
Author(s):  
David Lane ◽  
Teresa Schiller
Keyword(s):  
Ultrasound Imaging ◽  
Invasive Technique ◽  
Hypodermic Needle ◽  
Surgical Incision ◽  
Percutaneous Approach ◽  
Complete Transection ◽  
Biceps Tenotomy ◽  
Iatrogenic Damage ◽  
Scalpel Blade ◽  
Open Arthrotomy

Background: Bicipital tendinitis and/or tendinopathy is a common cause of forelimb lameness in dogs, particularly in larger and more active patients. Although conservative treatment aimed at resolving discomfort and preserving the tendon remains the primary therapeutic goal, in certain cases it is necessary to surgically transect the tendon to eliminate pain and lameness. Transection of the tendon can be performed by open arthrotomy, arthroscopically, or percutaneously using a scalpel blade. This paper examines the utility of a modified percutaneous approach using ahypodermic needle in place of a scalpel blade, under ultrasound-guided assistance.Aim: To develop and describe a surgical technique for performing a percutaneous biceps tenotomy using a hypodermic needle under ultrasound guidance Method: The technique was piloted using the shoulders of 12 cadaver dogs initially and once developed, then applied to another 12 cadavers. The final procedure was performed on a total of 22 shoulders. Assessments were recorded on time to complete the procedure, completeness of bicipital tendon transection, and presence of any iatrogenic damage to associated joint structures. Results: Procedure time averaged fewer than 2 minutes. Complete transection was achieved in 20 out of 22 of the shoulders, with evidence of incomplete transection discernable by ultrasound imaging in the remaining two shoulders. One cadaver shoulder experienced iatrogenic damage secondary to incorrect hypodermic needle angulation. Conclusion: Percutaneous biceps tenotomy using a hypodermic needle is an efficient and straightforward procedure. The lack of a surgical incision makes it the least invasive technique devised so far. Ultrasound imaging allows thepractitioner to assess the completeness of the transection increasing precision.

scholarly journals Leiomyosarcoma after Total Laparoscopic Hysterectomy with Power Morcellation

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Tsukasa Takahashi ◽  
Tomohisa Ugajin ◽  
Noriaki Imai ◽  
Atsushi Hayasaka ◽  
Nobuo Yaegashi ◽  
...  
Keyword(s):  
Pelvic Mass ◽  
Laparoscopic Hysterectomy ◽  
Additional Treatment ◽  
Total Laparoscopic Hysterectomy ◽  
Invasive Technique ◽  
Pathologic Evaluation ◽  
Power Morcellation ◽  
Pathological Evaluation ◽  
Submucosal Fibroids ◽  
Occult Malignancy

Introduction. Power morcellation is an effective and minimally invasive technique used to remove specimen tissues or the uterus in total laparoscopic hysterectomy (TLH). However, it has the risk of intraperitoneal dissemination of tissue and can cause a parasitic myoma. We report a case of leiomyosarcoma that occurred 4 years after TLH with power morcellation for fibroids. Case. A 52-year-old woman was referred to our hospital with a pelvic mass. She was diagnosed to have submucosal fibroids and had undergone TLH with power morcellation 4 years previously. The uterus weighed 398 g at that time. At present, a parasitic myoma was suspected, owing to the diagnosis of fibroids on the initial pathological evaluation. She underwent laparotomy, and the tumor was removed. Although the pathological evaluation confirmed the tumor to be a leiomyosarcoma, a review of the initial tissue did not show the presence of any malignancy. Since there was no metastasis, she was followed-up without additional treatment. Conclusion. Even if the initial pathologic evaluation suggests a benign mass, parasitic myoma and even sarcoma can occur after TLH with power morcellation. Considering the risk of dissemination and occult malignancy, the use of power morcellation should be avoided if there are alternative options to remove the tumor.

scholarly journals COMPARATIVE ANALYSIS OF NON-DESCENT VAGINAL HYSTERECTOMY VERSUSTOTALABDOMINAL HYSTERECTOMY IN BENIGN UTERINE DISORDERS AT DMCH, LAHERIASARAI, BIHAR

2020 ◽  
pp. 1-2
Author(s):  
Suchandra Suchandra ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Postoperative Complications ◽  
Vaginal Hysterectomy ◽  
Intraoperative Complications ◽  
Operating Time ◽  
Early Mobilization ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Invasive Technique ◽  
Group A ◽  
Group B

Background: Hysterectomy is the most common operation performed by gynecologist, next to caesarean section. Currently, there are three main types of hysterectomy operations in practice for benign diseases-Abdominal hysterectomy (AH), vaginal hysterectomy (VH) and Laparoscopic hysterectomy (LH). Vaginal route for non-descentuterus is an acceptable method of hysterectomy. The objective of present study was to compare the operating time, intraoperative and postoperative complications between VH and TAH in non-descent uterus. Methods: The study was conducted in the Department of Obstetrics Gynaecology for a period of 18months at Darbhanga Medical College & Hospital, Laheriasarai, Bihar. Results: Over the study period 100 patients were taken, 50 patients underwent non-descent vaginal hysterectomy andlabelled as group A and 50 patients were under went total abdominal hysterectomy and labelled as group B. It wasseen that intraoperative complications and postoperative complications were less in group A patients and operating time is also less with group A patients when compared with group B patients. Conclusions: From the present study, it was concluded that NDVH is associated with less blood loss during surgery, quicker recovery, and early mobilization, less operative and less postoperative morbidity when compared to TAH. NDVH is a less invasive technique with shorter hospital stay and faster convalescence.

Ureteral catheter placement for prevention of ureteral injury during laparoscopic hysterectomy

2007 ◽  
Vol 0 (0) ◽  
pp. 071101174848005-??? ◽  
Author(s):  
Yudai Tanaka ◽  
Hironori Asada ◽  
Naoaki Kuji ◽  
Yasunori Yoshimura
Keyword(s):  
Laparoscopic Hysterectomy ◽  
Ureteral Injury ◽  
Catheter Placement ◽  
Ureteral Catheter

scholarly journals A Case of Delayed Diagnosis of Bilateral Ureteral and Bladder Injury after Laparoscopic Hysterectomy: An Unusual Complication

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Maximilien C. Goris-Gbenou ◽  
Nicolas Arfi ◽  
Abdel Mitach ◽  
Sheer Rashed ◽  
Jean-Gabriel Lopez
Keyword(s):  
Unusual Case ◽  
Delayed Diagnosis ◽  
Laparoscopic Hysterectomy ◽  
Ureteral Injury ◽  
Bladder Injury ◽  
Unusual Complication ◽  
Gynaecological Surgery ◽  
Uterine Adenomyosis

The incidence of ureteral and bladder lesions after laparoscopic hysterectomy is the most encountered urinary complication in gynaecological surgery. We report the unusual case of 42-year-old woman who had a delayed diagnosis of bilateral ureteral injury associated with bladder lesion and loose of vaginal suture after undergoing laparoscopic hysterectomy for uterine adenomyosis.

scholarly journals Case Report: Early Recognition and Repair of Distal Iatrogenic Ureteral Injury During Laparoscopic Rectal Surgery

2021 ◽  
Vol 2 (2) ◽  
pp. 73-76
Author(s):  
Abdul Mughni ◽  
Ahmad Fathi Fuadi ◽  
Nanda Daniswara
Keyword(s):  
Rectal Cancer ◽  
Colorectal Surgery ◽  
Early Recognition ◽  
Rectal Surgery ◽  
Laparoscopic Approach ◽  
Ureteral Injury ◽  
Uneventful Recovery ◽  
Rectal Cancer Surgery ◽  
Distal Ureter ◽  
Iatrogenic Ureteral Injury

Background: Ureteral injury is an uncommon complication of the colorectal procedure. The colorectal procedure is the second most common cause of ureteral injury. The laparoscopic approach for colorectal surgery has contributed to the increase of ureteral injury. Delayed diagnosis of the iatrogenic ureteral injury is associated with higher morbidity. However, the early diagnosis of ureteral injury during the operation is difficult. We presented an early recognition and laparoscopic repair of iatrogenic ureteral injury during laparoscopic rectal cancer surgery cases and the strategy for recognizing and managing that injury for the surgeon.Case Presentation: A Male, 34 years old, had an iatrogenic ureteral injury during laparoscopic low anterior resection for rectal cancer. The left distal ureter was transected by an energy device. The diagnosis of ureteral injury was prompt. The repair of the ureter was done endo-laparoscopically. The patient had an uneventful recovery and was discharged on day 6 after surgery.Conclusion: The iatrogenic ureteral injury, although uncommon, is a serious complication of laparoscopic colorectal surgery. Direct visual identification of the distal ureter is mandatory in every rectal surgery. The iatrogenic ureteral injury is not an indication for open conversion when there is an adequate resource to do the endo-laparoscopic ureteral repair.

Left Ventricular Apical Papillary Fibroelastoma Resection via Mediastinoscope through the Aortic Valve

2012 ◽  
Vol 7 (6) ◽  
pp. 452-453 ◽  
Author(s):  
Hadi Daood Toeg ◽  
Robert James Cusimano
Keyword(s):  
Emergency Department ◽  
Aortic Valve ◽  
Left Ventricular ◽  
Complete Resection ◽  
Papillary Fibroelastoma ◽  
Invasive Technique ◽  
Biopsy Forceps ◽  
Mobile Mass ◽  
Ischemic Attack

This case report describes a novel minimally invasive technique for complete resection of a cardiac papillary fibroelastoma by directly visualizing the mass via an intraoperative mediastinoscope placed through the aortic valve. A 68-year-old man presented to the emergency department with two episodes of transient ischemic attack. Echocardiography demonstrated a pedunculated, mobile mass in the left ventricular apex. Cardiac surgery was consulted, and complete resection of the fibroelastoma was carried out by inserting a mediastinoscope through the aortic valve and into the left ventricle, whereby the mass was directly visualized and excised with biopsy forceps. There were no postoperative complications, and at 1-year follow-up, the patient had no further evidence of embolic events.

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