- Email: [email protected]
2440 Efficacy of Hand Assisted Laparoscopic Adenomyomectomy with Manipulation of Uterine Artery Comparing with Classical Laparoscopic and Laparotomic Adenomyomectomy
Abstracts / Journal of Minimally Invasive Gynecology 26 (2019) S98−S231
S121
imaging showed multiple submucosal fibroids. This patient had a hysteroscopic myomectomy two years prior for abnormal bleeding. She was taken for a laparotomy/myomectomy and intraoperatively, the fibroids were found to be subendothelial; nearly 40 fibroids were resected. Case 2: A 37 year old female presented with primary infertility. This patient had a previous hysteroscopic myomectomy but was still unable to conceive. Imaging studies reported multiple submucosal and intramural fibroids. Intraoperatively the entire endometrial cavity was lined with 2cm subendothelial fibroids; over 30 fibroids were removed. Case 3: A 37 year old female presented with abnormal uterine bleeding. The patient had imaging that demonstrated multiple submucosal fibroids. The bleeding was not well managed with medical therapy. Intraoperatively she was found to have multiple 1cm subendothelial fibroids. She was managed with Lupron and multiple hysteroscopic procedures for resection for these fibroids. Conclusion: Intracavitary subendothelial leiomyomas have not been widely described in the literature. The diagnosis can be challenging as transvaginal ultrasound, sonohysterogram and MRI are unable to distinguish subendothelial from submucosal leiomyomas. These patients also had hysteroscopic procedures prior to development of intracavitary leiomyomatosis. In all our cases, the diagnosis was made intraoperatively, and resulted in the removal of a large number of leiomyomas.
operative complications, operating time, length of hospital stay or hospital re-admission.
Virtual Poster Session 1: Laparoscopy (10:20 AM — 10:30 AM) 10:20 AM: STATION Q 1665 Trends in Extraction Techniques in Minimally Invasive Myomectomies: A Retrospective Study Evans C,1,* Becker D,2 Templeman C3. 1Ob/Gyn, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA; 2Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA; 3Obstetrics and Gynecology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA *Corresponding author. Study Objective: Our study aims to evaluate how the FDA’s 2014 recommendation against the use of power morcellation for tissue extraction in minimally invasive myomectomies changed surgical approach at our hospital system. Our study investigated rates of laparoscopic versus abdominal myomectomies, and for laparoscopy, trends in mode of tissue extraction and resultant perioperative outcomes. Design: Retrospective cohort study. Setting: Southern California Kaiser Foundation Hospitals. Patients or Participants: Women undergoing a laparoscopic or robotassisted laparoscopic myomectomy involving tissue morcellation from 2008 to 2018. Interventions: One of 3 morcellation techniques: electronic power morcellation (PM), manual morcellation via minilaparotomy (ML), or contained power morcellation in a bag (CM). Measurements and Main Results: A total of 3259 myomectomies were performed at our hospital system from 2008 to 2018. Rate of abdominal versus minimally invasive myomectomies, estimated blood loss, length of operation and hospital stay, major post-operative complications, and hospital re-admission were compared in the six years before and the four years after the FDA warning. A total of 151 laparoscopic cases were performed during the study period. The cohort was 38% Hispanic, 32% Black, 15% White, and 12% Asian. Mean age was 37 (SD 7.31). Mean BMI was 28 (SD 7.16). Prior to the FDA announcement, tissue extraction methods were 75% PM, 5% ML, and 9% CM. After the announcement, 0% PM, 34% ML, and 57% CM (Pearson chi = 93.28). There was no difference in complications in aggregate or individually between tissue extraction method. Conclusion: Minimally invasive myomectomies make up a small portion of total myomectomies performed. For these cases, however, the FDA notice did, nonetheless, change surgical practice in regards to tissue extraction methods. There were no significant differences found among the tissue extraction techniques with regard to estimated blood loss, major post-
Virtual Poster Session 1: Laparoscopy (10:20 AM — 10:30 AM) 10:20 AM: STATION R 1828 Surgical Management of a Fused NonCommunicating Rudimentary Uterine Horn with Significant Myometrial Connection Kaiserman J,* Allen LM. Hospital for Sick Children, Toronto, ON, Canada *Corresponding author. Video Objective: In this video we present the surgical management of a fused non communicating, rudimentary uterine horn with significant myometrial invasion. The objectives of this video are to review the diagnostic imaging features that are suggestive of surgical complexity with non communicating fused rudimentary horn resections. And review the steps involved in their resection. Setting: A 12 year old previously healthy female presenting with 8 months of progressively worsening, severe dysmenorrhea. Onset 5 months post menarche. Her pain was not alleviated with ibuprofen, naproxen or acetaminophen. Initial Abdominal & Pelvic US: possible uterine fibroid, unremarkable kidneys. A Repeat US suggestive of a unicornuate uterus with an obstructed left rudimentary horn. She was started on menstrual suppression with a continuous combined oral contraceptive. A MRI was done confirming the presence of a left fused, non communication rudimentary horn, with significant myometrial invasion. Interventions: A laparoscopic left uterine horn resection was performed. The surgery was divided into four steps. These include to perform a anatomical survey to confirm the patients anatomy, lateral isolation of hemi-uterus, division of the myometrial connection and finally, myometrial reconstruction. Conclusion: In summary, the surgical steps in the management of a fused non communicating rudimentary uterine horn with significant myometrial connection include: To perform a anatomical survey to confirm the patients anatomy, lateral isolation of hemi-uterus, division of the myometrial connection and finally, myometrial reconstruction. A non-communicating functional fused rudimentary horn with significant myometrial invasion can present as a surgical challenge to gynecologists. It is important to do a preoperative MRI in adolescents or with complex anomalies to assess the complexity of anticipated surgery. Post operative imaging with a MRI can assess for any residual endometrium from the resected horn. Virtual Poster Session 1: Laparoscopy (10:20 AM — 10:30 AM) 10:20 AM: STATION S 2440 Efficacy of Hand Assisted Laparoscopic Adenomyomectomy with Manipulation of Uterine Artery Comparing with Classical Laparoscopic and Laparotomic Adenomyomectomy Go EB,1,* Kim HE,1 Kim JS,1 Lee SJ,1 Ahn JW,1 Lee SH,1 Cho HJ,2 Roh HJ1. 1Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea, Republic of (South); 2Department of Obstetrics and Gynecology, University of Inje College of Medicine, Haeundae Paik Hospital, Busan, Korea, Republic of (South) *Corresponding author. Study Objective: To assess the safety and benefit of Hand-assisted laparoscopic (HALS) adenomyomectomy compared with laparoscopic and laparotomic adenomyomectomy. Design: Single-center, nonrandomized, comparative study. Setting: University hospital, tertiary referral center.
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Abstracts / Journal of Minimally Invasive Gynecology 26 (2019) S98−S231
Patients or Participants: 20 patients underwent HALS adenomyomectomy with bilateral uterine artery ligation (BUAL) or transient occlusion of uterine artery (TOUA). HALS group was compared with laparoscopic adenomyomectomy (n=82) and laparotomic adenomyomectomy (n=170) with or without BUAL/ TOUA between January 2016 and January 2019. Interventions: HALS adenomyomectomy was performed via laparoscopic and/or extracorporeal approach through suprapubic incision (about 5cm). Other groups underwent laparoscopic adenomyomectomy or laparotomic adenomyomectomy alone. Measurements and Main Results: HALS and laparotomic groups were comparable with average estimated blood loss (217.5§136.0 vs, 193.6§ 193.0 mL, p=0.858), weight of removed mass (89.0 §75.2 vs 108.2§ 91.9 g, p=0.699), postoperative hospital day (HD) (4.6§1.1 vs 4.7§ 0.8 days, p=0.922). Laparoscopic group was lower in all of them (EBL 119.5§79.6 ml, mass weight 39.3§25.9 g, HD 3.6§0.8 days). The three groups did not differ significantly in transfusion rates, hemoglobin change, febrile morbidity, and perioperative complications. Additional procedures were more frequently performed in HALS (0.33§0.48) than other groups such as myomectomy, pelvic adhesiolyis, adnexa & pelvic endometriosis excision (vs. laparosopy 0.16§0.36, p=0.024; vs. laparotomy 0.15§0.36, p=0.017). The mean operating time was longer in HALS group (182.5§ 38.1 min), compared with other groups (vs. Laparoscopy 99.9§40.6min, p<0.001; Laparotomy 133.0§41.1 min, p<0.001). Conclusion: HALS adenomyomectomy with BUAL/ TOUA allows for complete excision of adenomyosis via extracorporeal & intracorporeal procedures while retaining the advantages of minimally invasive surgery. Furthermore, this approach could easily perform the additional pelvic surgery for benign uterine and adnexal pathology without compromising surgical outcomes.
Davenport ER,1,* Stockwell EL2. 1Obstetrics & Gynecology, Las Vegas Minimally Invasive Surgery, Las Vegas, NV; 2Gynecology, Las Vegas Minimally Invasive Surgery, Las Vegas, NV *Corresponding author. Video Objective: To demonstrate a novel technique in removing large adnexal masses in a contained fashion. To reduce the risk of ovarian cyst spillage and or chemical peritonitis. Setting: In Hospital. Interventions: Ovarian Cystectomy. Conclusion: Minimally invasive surgery is the preferred technique for ovarian cystectomies. By using this novel approach to completing cystectomies in a specimen bag will allow extraction of large adnexal masses reducing the risks of spillage. Virtual Poster Session 1: Laparoscopy (10:30 AM — 10:40 AM) 10:30 AM: STATION B 3009 The Role of Patient Education in the Success of Same Day Discharge after Minimally Invasive Gynecologic Surgery Eisenstein DI,1 Chan C,2,* Zwain O3. 1OB/GYN, Henry Ford Medical Center, West Bloomfield, MI; 2Women’s Health, Henry Ford Health System, West Bloomfield, MI; 3Women’s Health, Ascension Providence Hospital, Southfield, MI *Corresponding author.
Video Objective: To demonstrate our procedure for single site laparoscopic salpingectomy in a patient desiring permanent sterilization. Setting: Tubal ligation and salpingectomy are associated with a decrease incidence of ovarian cancer. Salpingectomy for sterilization has been shown to be safe and not increase complications. Single-site laparoscopy is used in a variety of gynecologic procedures and allows for minimization of incisions and opportunity for improved cosmesis. Here we demonstrate our procedure for single site laparoscopic salpingectomy at an academic affiliated gynecology practice The patient is a 34yo G3P3 who has completed child bearing and desires permanent sterilization. She has no previous abdominal surgeries. Interventions: The patient underwent a single-site laparoscopic bilateral salpingectomy for sterilization through an umbilical incision. A single site gel platform, 30 degree laparoscope, atraumatic grasper and articulating energy device are used to facilitate this surgery. The fascia is repaired with 0 vicryl and the umbilicus is rebuilt with 2-0 vicryl and 4-0 monocryl for a cosmetic appearance. Conclusion: Single site laparoscopy, as an alternative for multi-port, can easily and safely be used for salpingectomy with favorable cosmetic outcome.
Study Objective: To assess the impact of preoperative education success and patient satisfaction for same day discharge after laparoscopic surgery. Design: Prospective survey. Setting: Academic tertiary referral center. Patients or Participants: Twenty-four women undergoing minimally invasive hysterectomy or myomectomy with two surgeons between May 2018 and March 2019 Interventions: Patients completed a questionnaire regarding same day surgery before and after an educational video. They also received a phone call four to six weeks postoperative regarding their postoperative experience. Measurements and Main Results: Twenty-four patients were enrolled in the study although only twenty patients have currently undergone surgery. Among patients who completed the pre-education questionnaire 15 of 23 (65%) were agreeable to same day discharge and 8 of 23 (35%) were not agreeable. After watching the educational video and completing the posteducation questionnaire 17 of 23 (74%) were agreeable to same day discharge and 6 of 23 (26%) were not agreeable. After the educational video among those who were originally not agreeable to same day discharge 3 of 8 (38%) changed to agreeable. Postoperatively 11 of 20 (55%) were discharged same day, 8 of 20 (40%) patients were discharged POD #1 and 1 of 20 (5%) discharged POD #3. Of 9 patients discharged same day, 5 (56%) were happy to be discharged, 3 (33%) were nervous but did well, 7 (78%) felt it was the right to do, 2 (22%) would not do it again and 1 (11%) was not happy to be discharged. Conclusion: In this study, the majority of patients were agreeable to same day discharge after undergoing education, which also favorably changed the opinions of some who were not initially agreeable to same day discharge. Postoperatively, the majority of patients were happy to be discharged the same day and felt it was appropriate.
Virtual Poster Session 1: Laparoscopy (10:30 AM — 10:40 AM)
Virtual Poster Session 1: Laparoscopy (10:30 AM — 10:40 AM)
10:30 AM: STATION A
10:30 AM: STATION C
2925 A Novel Technique: Contained Adnexal Mass Extraction
1749 Laparoscopic Rectovaginal Fistula Repair Following Benign Gynaecological Procedure
Virtual Poster Session 1: Laparoscopy (10:20 AM — 10:30 AM) 10:20 AM: STATION T 2190 Single Site Salpingectomy Technique Small Layne AN,* Gutierrez MM. Las Vegas Minimally Invasive Surgery, Las Vegas, NV *Corresponding author.
S121
imaging showed multiple submucosal fibroids. This patient had a hysteroscopic myomectomy two years prior for abnormal bleeding. She was taken for a laparotomy/myomectomy and intraoperatively, the fibroids were found to be subendothelial; nearly 40 fibroids were resected. Case 2: A 37 year old female presented with primary infertility. This patient had a previous hysteroscopic myomectomy but was still unable to conceive. Imaging studies reported multiple submucosal and intramural fibroids. Intraoperatively the entire endometrial cavity was lined with 2cm subendothelial fibroids; over 30 fibroids were removed. Case 3: A 37 year old female presented with abnormal uterine bleeding. The patient had imaging that demonstrated multiple submucosal fibroids. The bleeding was not well managed with medical therapy. Intraoperatively she was found to have multiple 1cm subendothelial fibroids. She was managed with Lupron and multiple hysteroscopic procedures for resection for these fibroids. Conclusion: Intracavitary subendothelial leiomyomas have not been widely described in the literature. The diagnosis can be challenging as transvaginal ultrasound, sonohysterogram and MRI are unable to distinguish subendothelial from submucosal leiomyomas. These patients also had hysteroscopic procedures prior to development of intracavitary leiomyomatosis. In all our cases, the diagnosis was made intraoperatively, and resulted in the removal of a large number of leiomyomas.
operative complications, operating time, length of hospital stay or hospital re-admission.
Virtual Poster Session 1: Laparoscopy (10:20 AM — 10:30 AM) 10:20 AM: STATION Q 1665 Trends in Extraction Techniques in Minimally Invasive Myomectomies: A Retrospective Study Evans C,1,* Becker D,2 Templeman C3. 1Ob/Gyn, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA; 2Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA; 3Obstetrics and Gynecology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA *Corresponding author. Study Objective: Our study aims to evaluate how the FDA’s 2014 recommendation against the use of power morcellation for tissue extraction in minimally invasive myomectomies changed surgical approach at our hospital system. Our study investigated rates of laparoscopic versus abdominal myomectomies, and for laparoscopy, trends in mode of tissue extraction and resultant perioperative outcomes. Design: Retrospective cohort study. Setting: Southern California Kaiser Foundation Hospitals. Patients or Participants: Women undergoing a laparoscopic or robotassisted laparoscopic myomectomy involving tissue morcellation from 2008 to 2018. Interventions: One of 3 morcellation techniques: electronic power morcellation (PM), manual morcellation via minilaparotomy (ML), or contained power morcellation in a bag (CM). Measurements and Main Results: A total of 3259 myomectomies were performed at our hospital system from 2008 to 2018. Rate of abdominal versus minimally invasive myomectomies, estimated blood loss, length of operation and hospital stay, major post-operative complications, and hospital re-admission were compared in the six years before and the four years after the FDA warning. A total of 151 laparoscopic cases were performed during the study period. The cohort was 38% Hispanic, 32% Black, 15% White, and 12% Asian. Mean age was 37 (SD 7.31). Mean BMI was 28 (SD 7.16). Prior to the FDA announcement, tissue extraction methods were 75% PM, 5% ML, and 9% CM. After the announcement, 0% PM, 34% ML, and 57% CM (Pearson chi = 93.28). There was no difference in complications in aggregate or individually between tissue extraction method. Conclusion: Minimally invasive myomectomies make up a small portion of total myomectomies performed. For these cases, however, the FDA notice did, nonetheless, change surgical practice in regards to tissue extraction methods. There were no significant differences found among the tissue extraction techniques with regard to estimated blood loss, major post-
Virtual Poster Session 1: Laparoscopy (10:20 AM — 10:30 AM) 10:20 AM: STATION R 1828 Surgical Management of a Fused NonCommunicating Rudimentary Uterine Horn with Significant Myometrial Connection Kaiserman J,* Allen LM. Hospital for Sick Children, Toronto, ON, Canada *Corresponding author. Video Objective: In this video we present the surgical management of a fused non communicating, rudimentary uterine horn with significant myometrial invasion. The objectives of this video are to review the diagnostic imaging features that are suggestive of surgical complexity with non communicating fused rudimentary horn resections. And review the steps involved in their resection. Setting: A 12 year old previously healthy female presenting with 8 months of progressively worsening, severe dysmenorrhea. Onset 5 months post menarche. Her pain was not alleviated with ibuprofen, naproxen or acetaminophen. Initial Abdominal & Pelvic US: possible uterine fibroid, unremarkable kidneys. A Repeat US suggestive of a unicornuate uterus with an obstructed left rudimentary horn. She was started on menstrual suppression with a continuous combined oral contraceptive. A MRI was done confirming the presence of a left fused, non communication rudimentary horn, with significant myometrial invasion. Interventions: A laparoscopic left uterine horn resection was performed. The surgery was divided into four steps. These include to perform a anatomical survey to confirm the patients anatomy, lateral isolation of hemi-uterus, division of the myometrial connection and finally, myometrial reconstruction. Conclusion: In summary, the surgical steps in the management of a fused non communicating rudimentary uterine horn with significant myometrial connection include: To perform a anatomical survey to confirm the patients anatomy, lateral isolation of hemi-uterus, division of the myometrial connection and finally, myometrial reconstruction. A non-communicating functional fused rudimentary horn with significant myometrial invasion can present as a surgical challenge to gynecologists. It is important to do a preoperative MRI in adolescents or with complex anomalies to assess the complexity of anticipated surgery. Post operative imaging with a MRI can assess for any residual endometrium from the resected horn. Virtual Poster Session 1: Laparoscopy (10:20 AM — 10:30 AM) 10:20 AM: STATION S 2440 Efficacy of Hand Assisted Laparoscopic Adenomyomectomy with Manipulation of Uterine Artery Comparing with Classical Laparoscopic and Laparotomic Adenomyomectomy Go EB,1,* Kim HE,1 Kim JS,1 Lee SJ,1 Ahn JW,1 Lee SH,1 Cho HJ,2 Roh HJ1. 1Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea, Republic of (South); 2Department of Obstetrics and Gynecology, University of Inje College of Medicine, Haeundae Paik Hospital, Busan, Korea, Republic of (South) *Corresponding author. Study Objective: To assess the safety and benefit of Hand-assisted laparoscopic (HALS) adenomyomectomy compared with laparoscopic and laparotomic adenomyomectomy. Design: Single-center, nonrandomized, comparative study. Setting: University hospital, tertiary referral center.
S122
Abstracts / Journal of Minimally Invasive Gynecology 26 (2019) S98−S231
Patients or Participants: 20 patients underwent HALS adenomyomectomy with bilateral uterine artery ligation (BUAL) or transient occlusion of uterine artery (TOUA). HALS group was compared with laparoscopic adenomyomectomy (n=82) and laparotomic adenomyomectomy (n=170) with or without BUAL/ TOUA between January 2016 and January 2019. Interventions: HALS adenomyomectomy was performed via laparoscopic and/or extracorporeal approach through suprapubic incision (about 5cm). Other groups underwent laparoscopic adenomyomectomy or laparotomic adenomyomectomy alone. Measurements and Main Results: HALS and laparotomic groups were comparable with average estimated blood loss (217.5§136.0 vs, 193.6§ 193.0 mL, p=0.858), weight of removed mass (89.0 §75.2 vs 108.2§ 91.9 g, p=0.699), postoperative hospital day (HD) (4.6§1.1 vs 4.7§ 0.8 days, p=0.922). Laparoscopic group was lower in all of them (EBL 119.5§79.6 ml, mass weight 39.3§25.9 g, HD 3.6§0.8 days). The three groups did not differ significantly in transfusion rates, hemoglobin change, febrile morbidity, and perioperative complications. Additional procedures were more frequently performed in HALS (0.33§0.48) than other groups such as myomectomy, pelvic adhesiolyis, adnexa & pelvic endometriosis excision (vs. laparosopy 0.16§0.36, p=0.024; vs. laparotomy 0.15§0.36, p=0.017). The mean operating time was longer in HALS group (182.5§ 38.1 min), compared with other groups (vs. Laparoscopy 99.9§40.6min, p<0.001; Laparotomy 133.0§41.1 min, p<0.001). Conclusion: HALS adenomyomectomy with BUAL/ TOUA allows for complete excision of adenomyosis via extracorporeal & intracorporeal procedures while retaining the advantages of minimally invasive surgery. Furthermore, this approach could easily perform the additional pelvic surgery for benign uterine and adnexal pathology without compromising surgical outcomes.
Davenport ER,1,* Stockwell EL2. 1Obstetrics & Gynecology, Las Vegas Minimally Invasive Surgery, Las Vegas, NV; 2Gynecology, Las Vegas Minimally Invasive Surgery, Las Vegas, NV *Corresponding author. Video Objective: To demonstrate a novel technique in removing large adnexal masses in a contained fashion. To reduce the risk of ovarian cyst spillage and or chemical peritonitis. Setting: In Hospital. Interventions: Ovarian Cystectomy. Conclusion: Minimally invasive surgery is the preferred technique for ovarian cystectomies. By using this novel approach to completing cystectomies in a specimen bag will allow extraction of large adnexal masses reducing the risks of spillage. Virtual Poster Session 1: Laparoscopy (10:30 AM — 10:40 AM) 10:30 AM: STATION B 3009 The Role of Patient Education in the Success of Same Day Discharge after Minimally Invasive Gynecologic Surgery Eisenstein DI,1 Chan C,2,* Zwain O3. 1OB/GYN, Henry Ford Medical Center, West Bloomfield, MI; 2Women’s Health, Henry Ford Health System, West Bloomfield, MI; 3Women’s Health, Ascension Providence Hospital, Southfield, MI *Corresponding author.
Video Objective: To demonstrate our procedure for single site laparoscopic salpingectomy in a patient desiring permanent sterilization. Setting: Tubal ligation and salpingectomy are associated with a decrease incidence of ovarian cancer. Salpingectomy for sterilization has been shown to be safe and not increase complications. Single-site laparoscopy is used in a variety of gynecologic procedures and allows for minimization of incisions and opportunity for improved cosmesis. Here we demonstrate our procedure for single site laparoscopic salpingectomy at an academic affiliated gynecology practice The patient is a 34yo G3P3 who has completed child bearing and desires permanent sterilization. She has no previous abdominal surgeries. Interventions: The patient underwent a single-site laparoscopic bilateral salpingectomy for sterilization through an umbilical incision. A single site gel platform, 30 degree laparoscope, atraumatic grasper and articulating energy device are used to facilitate this surgery. The fascia is repaired with 0 vicryl and the umbilicus is rebuilt with 2-0 vicryl and 4-0 monocryl for a cosmetic appearance. Conclusion: Single site laparoscopy, as an alternative for multi-port, can easily and safely be used for salpingectomy with favorable cosmetic outcome.
Study Objective: To assess the impact of preoperative education success and patient satisfaction for same day discharge after laparoscopic surgery. Design: Prospective survey. Setting: Academic tertiary referral center. Patients or Participants: Twenty-four women undergoing minimally invasive hysterectomy or myomectomy with two surgeons between May 2018 and March 2019 Interventions: Patients completed a questionnaire regarding same day surgery before and after an educational video. They also received a phone call four to six weeks postoperative regarding their postoperative experience. Measurements and Main Results: Twenty-four patients were enrolled in the study although only twenty patients have currently undergone surgery. Among patients who completed the pre-education questionnaire 15 of 23 (65%) were agreeable to same day discharge and 8 of 23 (35%) were not agreeable. After watching the educational video and completing the posteducation questionnaire 17 of 23 (74%) were agreeable to same day discharge and 6 of 23 (26%) were not agreeable. After the educational video among those who were originally not agreeable to same day discharge 3 of 8 (38%) changed to agreeable. Postoperatively 11 of 20 (55%) were discharged same day, 8 of 20 (40%) patients were discharged POD #1 and 1 of 20 (5%) discharged POD #3. Of 9 patients discharged same day, 5 (56%) were happy to be discharged, 3 (33%) were nervous but did well, 7 (78%) felt it was the right to do, 2 (22%) would not do it again and 1 (11%) was not happy to be discharged. Conclusion: In this study, the majority of patients were agreeable to same day discharge after undergoing education, which also favorably changed the opinions of some who were not initially agreeable to same day discharge. Postoperatively, the majority of patients were happy to be discharged the same day and felt it was appropriate.
Virtual Poster Session 1: Laparoscopy (10:30 AM — 10:40 AM)
Virtual Poster Session 1: Laparoscopy (10:30 AM — 10:40 AM)
10:30 AM: STATION A
10:30 AM: STATION C
2925 A Novel Technique: Contained Adnexal Mass Extraction
1749 Laparoscopic Rectovaginal Fistula Repair Following Benign Gynaecological Procedure
Virtual Poster Session 1: Laparoscopy (10:20 AM — 10:30 AM) 10:20 AM: STATION T 2190 Single Site Salpingectomy Technique Small Layne AN,* Gutierrez MM. Las Vegas Minimally Invasive Surgery, Las Vegas, NV *Corresponding author.