We use cookies to offer you an optimal experience on our website. By browsing our website, you accept the use of cookies.

Vasilios TANOS

St George’s Medical School Nicosia University
Nicosia, Cyprus
MD, PhD
219 likes
6.8K views
0 comments
Filter by
Specialty
View more
Lastest Publication
View more
Sort by:
Prevention and treatment of intrauterine adhesions
The severe form of intrauterine adhesions (IUA) is probably the most difficult pathology to be treated by hysteroscopic surgery. The use of small diameter resectoscopes facilitates faster operations and less endometrial trauma, and is expected to be more efficient for the treatment of IUA. The concomitant use of ultrasound helps the surgeon to identify the ostia and prevents him from perforating the myometrium. The main effort is to identify the endometrial and sub-endometrial cleavage plane without injuring the myometrium. Longer periods of amenorrhea, older aged patients, and repeated surgery attempts to clear adhesions reduce chances of achieving pregnancy. Postoperative Hyalobarrier® anti-adhesive agents reduce the risk of adhesion reformation but do not increase pregnancy rates.
Lecture
4 years ago
1203 views
39 likes
0 comments
12:40
Prevention and treatment of intrauterine adhesions
The severe form of intrauterine adhesions (IUA) is probably the most difficult pathology to be treated by hysteroscopic surgery. The use of small diameter resectoscopes facilitates faster operations and less endometrial trauma, and is expected to be more efficient for the treatment of IUA. The concomitant use of ultrasound helps the surgeon to identify the ostia and prevents him from perforating the myometrium. The main effort is to identify the endometrial and sub-endometrial cleavage plane without injuring the myometrium. Longer periods of amenorrhea, older aged patients, and repeated surgery attempts to clear adhesions reduce chances of achieving pregnancy. Postoperative Hyalobarrier® anti-adhesive agents reduce the risk of adhesion reformation but do not increase pregnancy rates.
Complications in operative hysteroscopy
Most hysteroscopic surgery complications can be prevented. Education and good training are definitely the most important factors for both novice and experienced surgeons to reduce complications risks. The most frequent complications in hysteroscopic surgery are uterine wall perforation (during dilatation, or during surgery) and uterine or cervical bleeding. Fluid overload can be reduced with the use of a bipolar resectoscope, normal saline being the distending medium. Air embolism is a life-threatening condition and all surgeons should be aware and ready for the adequate treatment. Complications related to anesthesia and especially to patients with concomitant pathologies can also be minimized using office hysteroscopic surgery procedures.
Lecture
4 years ago
1595 views
63 likes
0 comments
17:38
Complications in operative hysteroscopy
Most hysteroscopic surgery complications can be prevented. Education and good training are definitely the most important factors for both novice and experienced surgeons to reduce complications risks. The most frequent complications in hysteroscopic surgery are uterine wall perforation (during dilatation, or during surgery) and uterine or cervical bleeding. Fluid overload can be reduced with the use of a bipolar resectoscope, normal saline being the distending medium. Air embolism is a life-threatening condition and all surgeons should be aware and ready for the adequate treatment. Complications related to anesthesia and especially to patients with concomitant pathologies can also be minimized using office hysteroscopic surgery procedures.
Hysteroscopic treatment option of hydrosalpinx to improve pregnancy rate
Hydrosalpinges adversely affect fertility and IVF outcomes. The toxic environment affects the endometrium and embryo implantation. Prospective randomized multicentric trials of salpingectomy prior to IVF clearly demonstrate a 2-fold increase in IVF success rates and should be recommended to all women with hydrosalpinges planning IVF. However, salpingectomy impairs regional vascular network, compromising ovarian function and induction of ovulation. In cases with severe pelvic adhesions, this risk and other operative complications increase during salpingectomy or tubal ligation. Micro-insert proximal end occlusion by hysteroscopy is another option to occlude and treat salpingectomy in an office set-up. Seven studies published on the topic have demonstrated generally positive results and success rates of pregnancies comprised between 36% and 64%. Proximal tubal occlusion using micro-inserts seem to be effective, fast, “low risk” in the management of severe forms of hydrosalpinges.
Lecture
5 years ago
1004 views
32 likes
0 comments
13:28
Hysteroscopic treatment option of hydrosalpinx to improve pregnancy rate
Hydrosalpinges adversely affect fertility and IVF outcomes. The toxic environment affects the endometrium and embryo implantation. Prospective randomized multicentric trials of salpingectomy prior to IVF clearly demonstrate a 2-fold increase in IVF success rates and should be recommended to all women with hydrosalpinges planning IVF. However, salpingectomy impairs regional vascular network, compromising ovarian function and induction of ovulation. In cases with severe pelvic adhesions, this risk and other operative complications increase during salpingectomy or tubal ligation. Micro-insert proximal end occlusion by hysteroscopy is another option to occlude and treat salpingectomy in an office set-up. Seven studies published on the topic have demonstrated generally positive results and success rates of pregnancies comprised between 36% and 64%. Proximal tubal occlusion using micro-inserts seem to be effective, fast, “low risk” in the management of severe forms of hydrosalpinges.
Hysteroscopic polypectomy
Chronic endometrial inflammation, endometrial erosion and vascular dilatation are usually prominent characteristics in cases with polyp(s). Abnormal bleeding is a frequent symptom due to vascular fragility and surface erosion. Tubocornual polyps interfere with oocyte/embryo transport and implantation. Trials have shown the effectiveness of hysteroscopic polypectomy in enhancing fertility. Using appropriate instruments and techniques, further to a suitable training, hysteroscopic polypectomy can be performed in the office setting without limitations of size, location, histological structure, and number of polyps. The surgical removal of big polyps by shavers and morcellators can reduce learning curve and increase patient safety.
Lecture
5 years ago
1689 views
44 likes
0 comments
12:51
Hysteroscopic polypectomy
Chronic endometrial inflammation, endometrial erosion and vascular dilatation are usually prominent characteristics in cases with polyp(s). Abnormal bleeding is a frequent symptom due to vascular fragility and surface erosion. Tubocornual polyps interfere with oocyte/embryo transport and implantation. Trials have shown the effectiveness of hysteroscopic polypectomy in enhancing fertility. Using appropriate instruments and techniques, further to a suitable training, hysteroscopic polypectomy can be performed in the office setting without limitations of size, location, histological structure, and number of polyps. The surgical removal of big polyps by shavers and morcellators can reduce learning curve and increase patient safety.