Experience with laparoscopic hysterectomy

2021 ◽  
Vol 50 (3) ◽  
pp. 34-39
Author(s):  
O. V. Aziev ◽  
A. E. Bugerenko ◽  
E. O. Sazonova
Keyword(s):  
Surgical Intervention ◽  
Laparoscopic Hysterectomy ◽  
Optimal Technique

The experience of using laparoscopic hysterectomy for the period of 5 years is represented. 594 laparoscopic hysterectomies were performed since 1996 up to 2000. Indications and contraindications to this kind of operation were defined, optimal technique of the surgical intervention was offered. The analysis of complications was carried out, ways of prophylaxis having been elaborated.

scholarly journals Laparoscopic total hysterectomy still not routinely chosen Operative description and available instruments

2019 ◽  
Vol 12 (3) ◽  
pp. 301-307
Author(s):  
Alexandra Popa ◽  
◽  
◽  
Catalin Copaescu ◽  
Valerica Horhoianu ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Broad Ligament ◽  
Laparoscopic Approach ◽  
Laparoscopic Hysterectomy ◽  
Vaginal Wall ◽  
Surgical Instruments ◽  
Minimal Invasiveness ◽  
Advantages And Disadvantages ◽  
Surgical Positioning ◽  
Increasing Trend

Hysterectomy is the most common gynecological surgical intervention; therefore, there are many technical variations in different healthcare systems around the world. We aimed to review, step by step, the technique of laparoscopic hysterectomy as well as to present the available variety of surgical instruments impartially so that the operative team can decide in an informed manner the model and characteristics of the equipment used. The surgical technique is presented based on the experience of the authors, focusing mainly on intraoperative recommendation and suggestions. Advantages and disadvantages of the available instruments are also extensively detailed. Surgical positioning, as well as inserting the uterine manipulator are essential steps. The open technique is used to create pneumoperitoneum. The utero-ovarian ligament or the infundibulopelvic ligament is identified, coagulated and cut. The round ligament is incised, entering the space between the two layers of the broad ligament and advancing caudally in this space, which, if correctly identified, should be avascular. The uterine vessels located on the posterior sheet of the broad ligament are dissected and coagulated. The vaginal wall is sectioned with the help of the manipulator’s cap, making it easier to expose the insertion line of the vagina on the cervix. The uterus is removed through the vagina or through a trans-parietal incision. Thereafter, the vagina is sutured using separate Vicryl sutures. Between 2011 and 2016, laparoscopic hysterectomy had an increasing trend all over Europe. With a reported percentage of 3%, Romania ranks last in hysterectomies performed laparoscopically. The laparoscopic approach offers the advantages of minimal invasiveness: less pain, faster recovery and early social reintegration; therefore, this trend of improvement should become more accepted.

Thrombolysis in Arterial Occlusion

1999 ◽  
Vol 82 (S 01) ◽  
pp. 109-111 ◽  
Author(s):  
Raymond Verhaeghe
Keyword(s):  
Clinical Practice ◽  
Thrombolytic Therapy ◽  
Hemorrhagic Stroke ◽  
Surgical Intervention ◽  
Bypass Graft ◽  
Surgical Techniques ◽  
Arterial Occlusion ◽  
Second Step ◽  
Severe Bleeding ◽  
Initial Management

SummaryIntra-arterial thrombolytic therapy has replaced systemic intravenous infusion of thrombolytic agents as a treatment modality for arterial occlusion in the limbs. Several catheter-guided techniques and various infusion methods and schemes have been developed. At present there is no scientific proof of definite superiority of any agent in terms of efficacy or safety but clinical practice favours the use of urokinase or alteplase. Studies which compared thrombolysis to surgical intervention suggest that thrombolytic therapy is an appropriate initial management in patients with acute occlusion of a native leg artery or a bypass graft. Underlying causative lesions are treated in a second step by endovascular or open surgical techniques. Severe bleeding is the most feared complication: the risk of hemorrhagic stroke is 1-2%.

Surgical treatment of alveolar echinococcosis: a single centre experience and systematic review of the literature

2019 ◽  
Vol 98 (4) ◽  
pp. 167-173
Keyword(s):  
Case Report ◽  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Lymphatic System ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Safety Margin ◽  
Surgical Removal ◽  
Single Centre Experience ◽  
Therapeutic Procedures

Introduction: Alveolar echinococcosis (AE) is a zoonosis caused by Echinococcus multilocularis. AE is primarily localised in the liver. Echinococcus multilocularis imitates tumour-like behaviour. It can metastasise through blood or lymphatic system to distant organs. Echinococcosis often remains asymptomatic due to its long incubation period and indistinct symptoms. Clinical symptoms are determined by the parasite’s location. Diagnosis of echinococcosis is based on medical history, clinical symptoms, laboratory tests, serology results, imaging methods and final histology findings. Surgical removal of the cyst with a safety margin, followed by chemotherapy is the therapeutic method of choice. Case report: We present a case report of alveolar echinococcosis in a thirty-year-old female patient in whom we surgically removed multiple liver foci of alveolar echinococcosis. The disease recurred after two years and required another surgical intervention. Conclusions: Alveolar echinococcosis is a disease with a high potential for a complete cure provided that it is diagnosed early and that the recommended therapeutic procedures are strictly adhered to.

Outcomes of endoscopic surgical intervention for acromegaly - the Wessex experience

2018 ◽  
Author(s):  
Louise Curtis ◽  
N Mathad ◽  
Aabir Chakraborty ◽  
Sarah Brewster ◽  
Kate Millar ◽  
...  
Keyword(s):  
Surgical Intervention

Acute Aortic Intramural Hematoma Presenting with Painless Recurrent Syncope

2012 ◽  
Vol 15 (5) ◽  
pp. 286
Author(s):  
Jan Droste ◽  
Heidar Zafarani Zadeh ◽  
Mohammed Arif ◽  
Ian Craig ◽  
A K Thakur
Keyword(s):  
Aortic Wall ◽  
Surgical Intervention ◽  
Intramural Hematoma ◽  
Pericardial Tamponade ◽  
Transthoracic Echocardiogram ◽  
Type A Aortic Dissection ◽  
Severe Hypotension ◽  
Patient’S History ◽  
Aortic Intramural Hematoma ◽  
Venous Pulse

<p>A patient presented with recurrent syncope due to transient severe hypotension. The patient's history, physical examination, and initial baseline investigation did not suggest a cardiovascular cause. After fluid resuscitation, a raised jugular venous pulse was noted. Bedside transthoracic echocardiogram showed a pericardial effusion and a proximally dilated aorta. Computed tomography of the thorax confirmed these findings and also demonstrated an intramural hematoma of the proximal aortic wall.</p><p>The patient was transferred to a cardiothoracic center, where he was at first treated medically. He then developed sudden cardiogenic shock due to pericardial tamponade and was successfully operated on.</p><p>It is important to recognize an acute intramural hematoma of the proximal aortic wall as a cardiothoracic emergency. This condition can present atypically, but nevertheless warrants urgent surgical intervention, equal to type A aortic dissection. Echocardiography can help in making the diagnosis.</p>

Microporous Polysaccharide Hemosphere Absorbable Hemostat (AristaAH®) in Re-Operative Cardiac Surgical Procedures

2012 ◽  
Vol 9 (2) ◽  
pp. 96-98
Author(s):  
Brian A Bruckner ◽  
Matthias Loebe
Keyword(s):  
Patient Outcomes ◽  
Surgical Procedures ◽  
Systematic Approach ◽  
Surgical Intervention ◽  
Transfusion Requirement ◽  
Cardiac Surgical Procedures ◽  
Platelet Inhibitors ◽  
Hemostatic Agents ◽  
Surgical Field ◽  
Improve Patient

Patients undergoing re-operative cardiac surgical procedures present a great challenge with regard to obtaining hemostasis in the surgical field. Adhesions are ever-present and these patients are often on oral anti-coagulants and platelet inhibitors. As part of a well-planned surgical intervention, a systematic approach to hemostasis should be employed to decrease blood transfusion requirement and improve patient outcomes. Topical hemostatic agents can be a great help to the surgeon in achieving surgical field hemostasis and are increasingly being employed. Our approach, to these difficult patients, includes the systematic and planned use of AristaAH, which is a novel hemostatic agent whose use has proven safe and efficacious in our patient population.

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