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Arnaud WATTIEZ

MD
Hôpitaux Universitaires de Strasbourg
Strasbourg, Франция
185 vidéos
918.6K просмотров
147 комментариев
20.5K лайков
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Laparoscopic salpingotomy for tubal ectopic pregnancy
About 1 to 2% of all pregnancies are ectopic. Most ectopic pregnancies are located in the uterine tube, and surgery is often used as a treatment modality. Traditionally, salpingectomy has been the standard procedure, but salpingotomy provides a conservative option in women who wish to preserve future fertility, especially if the contralateral tube is absent or damaged. Many women do not have access to IVF for financial, geographical, or religious reasons. Having an intrauterine pregnancy after salpingotomy can reach up to 70%. In this video, we demonstrate this procedure in simple steps. The case was that of a 35-year-old lady, P0+1 with a previous right tubal pregnancy, which was treated with a partial salpingectomy through a mini-laparotomy 2 years before. She was admitted to the emergency department as she presented with a 6-week amenorrhea with left iliac fossa pain. Pelvic ultrasound showed left tubal ectopic pregnancy (4 by 3cm in size), with free fluid suggestive of hemoperitoneum. She opted for a conservative laparoscopic surgery as she was keen to have a spontaneous fertility.
Хирургические операции
10 месяцев назад
7927 просмотров
62 лайка
7 комментариев
07:34
Laparoscopic salpingotomy for tubal ectopic pregnancy
About 1 to 2% of all pregnancies are ectopic. Most ectopic pregnancies are located in the uterine tube, and surgery is often used as a treatment modality. Traditionally, salpingectomy has been the standard procedure, but salpingotomy provides a conservative option in women who wish to preserve future fertility, especially if the contralateral tube is absent or damaged. Many women do not have access to IVF for financial, geographical, or religious reasons. Having an intrauterine pregnancy after salpingotomy can reach up to 70%. In this video, we demonstrate this procedure in simple steps. The case was that of a 35-year-old lady, P0+1 with a previous right tubal pregnancy, which was treated with a partial salpingectomy through a mini-laparotomy 2 years before. She was admitted to the emergency department as she presented with a 6-week amenorrhea with left iliac fossa pain. Pelvic ultrasound showed left tubal ectopic pregnancy (4 by 3cm in size), with free fluid suggestive of hemoperitoneum. She opted for a conservative laparoscopic surgery as she was keen to have a spontaneous fertility.
Laparoscopic resection of endometriotic fibrotic nodule extending from the posterior lateral aspect of the uterus to the left pelvic sidewall, encasing the internal iliac vessels and adherent to the mid-sigmoid colon
Deep endometriosis is one of the most complex and risky surgeries. Its laparoscopic management requires a systematic approach, a good anatomical knowledge, and a high level of surgical competency.
This is the case of a 37-year-old lady presenting with a complex deep pelvic endometriosis. She had a long history of severe dysmenorrhea, colicky abdominal pain, back pain, and constipation. Imaging studies (MR) showed a large fibrotic endometriotic nodule extending from the posterior lateral aspect of the uterus to the left pelvic sidewall, encasing the internal iliac vessels, nerves, and adherent to a 4cm segment of the mid-sigmoid colon.
This patient has a complicated past history of left ureter ligation during a caesarean section (in 2011), which resulted in a left-sided nephrectomy in 2012. She got a pneumothorax complication, lung drainage, right-side thoracotomy in 2013, and finally a total pleurectomy in 2014.
Хирургические операции
3 года назад
5662 просмотра
315 лайков
2 комментария
42:42
Laparoscopic resection of endometriotic fibrotic nodule extending from the posterior lateral aspect of the uterus to the left pelvic sidewall, encasing the internal iliac vessels and adherent to the mid-sigmoid colon
Deep endometriosis is one of the most complex and risky surgeries. Its laparoscopic management requires a systematic approach, a good anatomical knowledge, and a high level of surgical competency.
This is the case of a 37-year-old lady presenting with a complex deep pelvic endometriosis. She had a long history of severe dysmenorrhea, colicky abdominal pain, back pain, and constipation. Imaging studies (MR) showed a large fibrotic endometriotic nodule extending from the posterior lateral aspect of the uterus to the left pelvic sidewall, encasing the internal iliac vessels, nerves, and adherent to a 4cm segment of the mid-sigmoid colon.
This patient has a complicated past history of left ureter ligation during a caesarean section (in 2011), which resulted in a left-sided nephrectomy in 2012. She got a pneumothorax complication, lung drainage, right-side thoracotomy in 2013, and finally a total pleurectomy in 2014.
Severe complex endometriosis with ascites: laparoscopic management
Frozen pelvis due to endometriosis is one of the most complex and risky situations which surgeons sometimes face. Its laparoscopic management requires a systematic approach, a good anatomical knowledge and a high level of surgical competency. This is a frozen pelvis case secondary to a complicated severe endometriosis in a young nulliparous lady. She had hemorrhagic abdominal ascites secondary to endometriosis, with a sub-occlusive syndrome. Her disease was further complicated with upper abdominal and pelvic fibrosis with a large umbilical endometriotic nodule as well as splenic, omental and sigmoid endometriosis. This video demonstrates the strategy of the laparoscopic management of this condition.
Хирургические операции
4 года назад
4248 просмотров
162 лайка
0 комментариев
31:22
Severe complex endometriosis with ascites: laparoscopic management
Frozen pelvis due to endometriosis is one of the most complex and risky situations which surgeons sometimes face. Its laparoscopic management requires a systematic approach, a good anatomical knowledge and a high level of surgical competency. This is a frozen pelvis case secondary to a complicated severe endometriosis in a young nulliparous lady. She had hemorrhagic abdominal ascites secondary to endometriosis, with a sub-occlusive syndrome. Her disease was further complicated with upper abdominal and pelvic fibrosis with a large umbilical endometriotic nodule as well as splenic, omental and sigmoid endometriosis. This video demonstrates the strategy of the laparoscopic management of this condition.
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
9476 просмотров
313 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.