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Susana MAIA

Hospital de Faro EPE
Faro, Portugal
MD
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Fully laparoscopic segmental rectosigmoid resection with Natural Orifice Specimen Extraction (NOSE) for bowel endometriosis
We report the case of a 45-year-old woman, G2P2, who presents with rectal bleeding, constipation and subocclusive syndrome caused by rectosigmoid endometriosis. The laparoscopic exploration revealed a sigmoid stuck by a few adhesions to the lateral abdominal wall underneath the left ovary and obliteration of the left uterosacral ligament and rectovaginal septum. A segmental bowel resection was performed with all necessary steps for mechanical bowel anastomosis carried out laparoscopically. The transvaginal specimen extraction obviated the need to create an abdominal incision. There were no complications and the patient presented a clinical remission following surgery. This surgical technique has the advantage of a shorter division of the mesentery, which enables a better vascularization of the bowel.
Surgical intervention
7 years ago
2370 views
10 likes
0 comments
08:03
Fully laparoscopic segmental rectosigmoid resection with Natural Orifice Specimen Extraction (NOSE) for bowel endometriosis
We report the case of a 45-year-old woman, G2P2, who presents with rectal bleeding, constipation and subocclusive syndrome caused by rectosigmoid endometriosis. The laparoscopic exploration revealed a sigmoid stuck by a few adhesions to the lateral abdominal wall underneath the left ovary and obliteration of the left uterosacral ligament and rectovaginal septum. A segmental bowel resection was performed with all necessary steps for mechanical bowel anastomosis carried out laparoscopically. The transvaginal specimen extraction obviated the need to create an abdominal incision. There were no complications and the patient presented a clinical remission following surgery. This surgical technique has the advantage of a shorter division of the mesentery, which enables a better vascularization of the bowel.
Laparoscopic partial cystectomy for deep endometriosis
Patients with bladder endometriosis may present with variable painful symptoms, hematuria, repeated urinary infection and/or infertility. The main treatment is a complete resection of the lesion. We report the case of a 30-year-old patient with no previous pregnancies presenting with pelvic endometriosis recurrence located at the level of the bladder dome. Her medical history shows a cystoscopic coagulation of an endometriotic nodule of the bladder. Preoperative MRI showed a 3cm single nodule protruding of the bladder. The procedure started by the dissection of the vesicouterine space followed by partial cystectomy using a monopolar hook. A running suture in two layers was carried out to close the cystotomy, and its integrity and bilateral ureteral patency was confirmed. Six weeks later at postoperative follow-up the patient was pain-free and without any urinary symptoms.
This video was awarded first place at the AAGL 5th International Congress on Minimally Invasive Gynecology held in conjunction with the Turkish Society of Gynecological Endoscopy (TSGE) 4th Annual Scientific Meeting.
Surgical intervention
8 years ago
2132 views
14 likes
0 comments
07:37
Laparoscopic partial cystectomy for deep endometriosis
Patients with bladder endometriosis may present with variable painful symptoms, hematuria, repeated urinary infection and/or infertility. The main treatment is a complete resection of the lesion. We report the case of a 30-year-old patient with no previous pregnancies presenting with pelvic endometriosis recurrence located at the level of the bladder dome. Her medical history shows a cystoscopic coagulation of an endometriotic nodule of the bladder. Preoperative MRI showed a 3cm single nodule protruding of the bladder. The procedure started by the dissection of the vesicouterine space followed by partial cystectomy using a monopolar hook. A running suture in two layers was carried out to close the cystotomy, and its integrity and bilateral ureteral patency was confirmed. Six weeks later at postoperative follow-up the patient was pain-free and without any urinary symptoms.
This video was awarded first place at the AAGL 5th International Congress on Minimally Invasive Gynecology held in conjunction with the Turkish Society of Gynecological Endoscopy (TSGE) 4th Annual Scientific Meeting.
Laparoscopic sacrocolpopexy with subtotal hysterectomy: the six points technique
Standardization means: implementing guidelines or measurements in order to obtain solutions to a disorganized system. Laparoscopic sacrocolpopexy is a long and complete surgical procedure that requires good knowledge of the anatomy and of the surgical technique, as well as advanced suturing skills. Laparoscopic sacrocolpopexy is also the gold standard procedure for POP repair, and its standardization is justified by its difficulty.
This video demonstrates the standard technique for laparoscopic sacrocolpopexy with sub-total hysterectomy. It is called “the six-point technique” due to the six stitches used to fix the meshes.
Surgical intervention
8 years ago
8301 views
101 likes
0 comments
28:50
Laparoscopic sacrocolpopexy with subtotal hysterectomy: the six points technique
Standardization means: implementing guidelines or measurements in order to obtain solutions to a disorganized system. Laparoscopic sacrocolpopexy is a long and complete surgical procedure that requires good knowledge of the anatomy and of the surgical technique, as well as advanced suturing skills. Laparoscopic sacrocolpopexy is also the gold standard procedure for POP repair, and its standardization is justified by its difficulty.
This video demonstrates the standard technique for laparoscopic sacrocolpopexy with sub-total hysterectomy. It is called “the six-point technique” due to the six stitches used to fix the meshes.