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Joana FARIA

Maternidade Dr. Alfredo da Costa
Lisbon, Португалия
MD
2.5K лайка
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Strategy for laparoscopic total hysterectomy and bilateral salpingectomy in case of large uterus
This video demonstrates the case of a 46-year-old patient presented with menorrhagia and anemia.
Clinical examination revealed a large mass almost reaching the level of the umbilicus.
The uterus appeared much bigger than usual on MRI, with a large myoma coming out of the pelvis.
It was decided to perform total laparoscopic hysterectomy combined with bilateral salpingectomy.
This video demonstrates the appropriate strategy to safely perform total laparoscopic hysterectomy in case of large uterus, showing the appropriate surgical steps and providing safety tips. The specimen weighed more than 1kg.
Хирургические операции
4 года назад
9143 просмотра
310 лайков
0 комментариев
25:01
Strategy for laparoscopic total hysterectomy and bilateral salpingectomy in case of large uterus
This video demonstrates the case of a 46-year-old patient presented with menorrhagia and anemia.
Clinical examination revealed a large mass almost reaching the level of the umbilicus.
The uterus appeared much bigger than usual on MRI, with a large myoma coming out of the pelvis.
It was decided to perform total laparoscopic hysterectomy combined with bilateral salpingectomy.
This video demonstrates the appropriate strategy to safely perform total laparoscopic hysterectomy in case of large uterus, showing the appropriate surgical steps and providing safety tips. The specimen weighed more than 1kg.
Anterior and posterior laparoscopic mesh removal due to pelvic pain, subtotal hysterectomy, mesh replacement, and Burch procedure
This is the case of a 69-year-old woman presenting with pelvic pain after laparoscopic sacrocolpopexy. The patient has a history of one vaginal birth, laparoscopic sacrocolpopexy with uterine preservation combined with a transobturator tape (TOT) sling procedure performed in 2013.
The following symptoms appeared after surgery: invalidating pelvic pain, especially in an upright position, severe terminal constipation, worsening of a previously mild stress urinary incontinence.
On clinical examination, a high rectocele (grade 2/3), a cystocele, and elective pain at the level of the TOT sling were observed. MRI revealed a perineal inflammation between the anterior aspect of the vagina and the urethra, at the level of the lower third of the urethra. A fibrotic area can be noted at the level of the rectovaginal space.
Her TOT sling was partially resected in January 2014.
Cystoscopy ruled out the presence of mesh erosion. Hysteroscopy was normal.
Endometrial biopsy demonstrated an atrophic endometrium.
In this surgery, the anterior and posterior meshes are removed. A subtotal hysterectomy combined with the replacement of meshes were performed, followed by a Burch procedure.
Хирургические операции
4 года назад
1873 просмотра
65 лайков
0 комментариев
33:56
Anterior and posterior laparoscopic mesh removal due to pelvic pain, subtotal hysterectomy, mesh replacement, and Burch procedure
This is the case of a 69-year-old woman presenting with pelvic pain after laparoscopic sacrocolpopexy. The patient has a history of one vaginal birth, laparoscopic sacrocolpopexy with uterine preservation combined with a transobturator tape (TOT) sling procedure performed in 2013.
The following symptoms appeared after surgery: invalidating pelvic pain, especially in an upright position, severe terminal constipation, worsening of a previously mild stress urinary incontinence.
On clinical examination, a high rectocele (grade 2/3), a cystocele, and elective pain at the level of the TOT sling were observed. MRI revealed a perineal inflammation between the anterior aspect of the vagina and the urethra, at the level of the lower third of the urethra. A fibrotic area can be noted at the level of the rectovaginal space.
Her TOT sling was partially resected in January 2014.
Cystoscopy ruled out the presence of mesh erosion. Hysteroscopy was normal.
Endometrial biopsy demonstrated an atrophic endometrium.
In this surgery, the anterior and posterior meshes are removed. A subtotal hysterectomy combined with the replacement of meshes were performed, followed by a Burch procedure.
Avoiding entry complications
More then 50% of major laparoscopic complications occur during the initial entry into the abdominal wall. In this lecture, the most frequent entry techniques are reviewed (Veress needle, open and direct entry techniques) and compared in terms of entry risks. New devices for the entry process have recently emerged. Nevertheless, the risk of entry complications has remained the same since the last 25 years. The entry mode is also discussed in particular cases such as previous midline laparotomy, morbid obesity, and slimness. Above all, we should use the entry technique which makes us feel more comfortable since there is no evidence that any single technique or specialized instruments to enter the abdomen helps to reduce the occurrence of vascular and organ injuries.
Лекции
4 года назад
8878 просмотров
550 лайков
0 комментариев
19:07
Avoiding entry complications
More then 50% of major laparoscopic complications occur during the initial entry into the abdominal wall. In this lecture, the most frequent entry techniques are reviewed (Veress needle, open and direct entry techniques) and compared in terms of entry risks. New devices for the entry process have recently emerged. Nevertheless, the risk of entry complications has remained the same since the last 25 years. The entry mode is also discussed in particular cases such as previous midline laparotomy, morbid obesity, and slimness. Above all, we should use the entry technique which makes us feel more comfortable since there is no evidence that any single technique or specialized instruments to enter the abdomen helps to reduce the occurrence of vascular and organ injuries.