- Email: [email protected]
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Journal of Minimally Invasive Gynecology, Vol 12, No 5, September/October Supplement 2005
after hysterectomy and prolapse with intact uterus were managed by this technique. Measurements and Main Results: All these cases have been followed for three years and found to have satisfactory anatomical and functional correction. Conclusion: Laparoscopic approach to pelvic organ prolapse ensures good surgical out come as pelvic support anatomy is clearly identified with the magnification offered by operating laparoscopy.
scarring and pain, shorter hospitalization and recovery time. Disadvantages are longer operating time, greater expenses and it is technically more demanding procedure. Benefits of improved visualization and smaller incisions are obvious. The hospitalization and recovery period is shorter. We believe that it is justified to use these operations for the treatment of urinary incontinence.
FRIDAY, NOVEMBER 11, 2005 (4:39 PM– 4:45 PM)
Open Communications 8 —Urogynecology
Open Communications 8 —Urogynecology
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179
Combined and Simultaneous Operations in Gynecologic Patients Kiselev SI, Chuprynin VD, Makiyan ZN, Adamyan LV. Scientific Center for Ob/Gyn & Perinatology, Moscow, Russia
Burch Laparoscopic Colposuspension Maricic I, Kopjar M, Scuric I, Zadro M. Zagreb, Croatia; Sv. Kriz Zacretje, Croatia; Zagreb, Croatia; Croatian Society for Gynaecological Endoscopy of CMA, Zagreb, Croatia Study Objective: To evaluate the success of laparoscopic (extraperitoneal and intraperitoneal) laparoscopic Burch colposuspension. Design: Retrospective analysis of 26 extraperitoneal laparoscopic Burch colposuspensions and 33 intraperitoneal laparoscopic Burch colposuspensions. Setting: Obstetric and gynecological department in county hospital. Patients: Fifty nine women with stress urinary incontinence, three patients had recidivist uroinfections. Stress incontinence was confirmed by urodynamic evaluation. Intervention: There were 26 extraperitoneal and 33 intraperitoneal laparoscopic Burch colposuspensions. Intraperitoneal operations were performed after the other gynecological operations (TLH, lpsc adnexectomy etc.). For extraperitoneal approach-in 18 patients MESH (Polypropylene MESH, Atrium Medical Corporation) was used for suspension, and in other patients sutures were used. For intraperitoneal approach-operations were performed after the laparoscopic hysterectomy or adnexectomy; “MESH” was used for 29 patients and in other 4 patients sutures were used. Measurements and Main Results: There were 2 serious intraoperative complications, in one patient conversion was made due to abundant bleeding, and in other patients bladder was injured and sutured laparoscopically. Subcutaneous emphysema developed during the operations in one patient; it was resolved 24 hours after the operation. Two patients were febrile for two days after the operations. Catheter was removed the second day after the operation for all patients (bladder injury ten days). Residual urine was checked with ultrasound; in all patients was less than 50 ml. At one year follow up by urodynamic evaluation 96,1% were continent and after two years 92,2%. Conclusion: Laparoscopic Burch colposuspension is one of the most common operations for treatment of stress urinary incontinence. Its advantages are better visualization, less
FRIDAY, NOVEMBER 11, 2005 (4:51 PM – 4:57 PM)
Study Objective: To evaluate the results of surgery for associated gynecologic and extragenital conditions. Design: Retrospective analysis of 97 cases of associated gynecologic and extragenital conditions, managed by simultaneous surgery. Setting: Department of Reproductive Medicine and Surgery of Moscow State Medical-Stomatologic University, Moscow, Russia. Patients: Ninety-seven patients (aged 18 – 62 yrs) with associations of gynecologic (myoma, endometrial hyperplasia, adenomyosis, ovarian mass, endometriosis, pelvic floor relaxation) and extragenital pathology (appendicitis, cholecystitis, stress urinary incontinence, thyroid struma). Intervention: Sixty-two patients underwent simultaneous laparoscopic and/or vaginal procedures (cholecystectomy plus hysterectomy, salpingoophorectomy or pelvic floor reconstruction [33 patients], appendectomy plus hysterectomy, myomectomy, ovarian resection, [29 patients]); laparoscopic gynecologic surgery was combined with resection of thyroid gland in 16 women, with TVT in 19 cases. Measurements and Main Results: Operating time, blood loss, postoperative hospital stay were evaluated and compared to the parameters of analogous procedures performed alone, showing reduction of total operating time by 1,4 times, blood loss by 1,4 times, hospital stay – by 2 times. No intra- or postoperative complications occurred. Conclusion: The study advocates for simultaneous surgery in patients with associated gynecologic and extragenital conditions, allowing to carry out treatment of all pathology within one procedure and anesthesia, thus reducing overall trauma, psychological distress, and negative impact on the patient’s quality of life.
Journal of Minimally Invasive Gynecology, Vol 12, No 5, September/October Supplement 2005
after hysterectomy and prolapse with intact uterus were managed by this technique. Measurements and Main Results: All these cases have been followed for three years and found to have satisfactory anatomical and functional correction. Conclusion: Laparoscopic approach to pelvic organ prolapse ensures good surgical out come as pelvic support anatomy is clearly identified with the magnification offered by operating laparoscopy.
scarring and pain, shorter hospitalization and recovery time. Disadvantages are longer operating time, greater expenses and it is technically more demanding procedure. Benefits of improved visualization and smaller incisions are obvious. The hospitalization and recovery period is shorter. We believe that it is justified to use these operations for the treatment of urinary incontinence.
FRIDAY, NOVEMBER 11, 2005 (4:39 PM– 4:45 PM)
Open Communications 8 —Urogynecology
Open Communications 8 —Urogynecology
180
179
Combined and Simultaneous Operations in Gynecologic Patients Kiselev SI, Chuprynin VD, Makiyan ZN, Adamyan LV. Scientific Center for Ob/Gyn & Perinatology, Moscow, Russia
Burch Laparoscopic Colposuspension Maricic I, Kopjar M, Scuric I, Zadro M. Zagreb, Croatia; Sv. Kriz Zacretje, Croatia; Zagreb, Croatia; Croatian Society for Gynaecological Endoscopy of CMA, Zagreb, Croatia Study Objective: To evaluate the success of laparoscopic (extraperitoneal and intraperitoneal) laparoscopic Burch colposuspension. Design: Retrospective analysis of 26 extraperitoneal laparoscopic Burch colposuspensions and 33 intraperitoneal laparoscopic Burch colposuspensions. Setting: Obstetric and gynecological department in county hospital. Patients: Fifty nine women with stress urinary incontinence, three patients had recidivist uroinfections. Stress incontinence was confirmed by urodynamic evaluation. Intervention: There were 26 extraperitoneal and 33 intraperitoneal laparoscopic Burch colposuspensions. Intraperitoneal operations were performed after the other gynecological operations (TLH, lpsc adnexectomy etc.). For extraperitoneal approach-in 18 patients MESH (Polypropylene MESH, Atrium Medical Corporation) was used for suspension, and in other patients sutures were used. For intraperitoneal approach-operations were performed after the laparoscopic hysterectomy or adnexectomy; “MESH” was used for 29 patients and in other 4 patients sutures were used. Measurements and Main Results: There were 2 serious intraoperative complications, in one patient conversion was made due to abundant bleeding, and in other patients bladder was injured and sutured laparoscopically. Subcutaneous emphysema developed during the operations in one patient; it was resolved 24 hours after the operation. Two patients were febrile for two days after the operations. Catheter was removed the second day after the operation for all patients (bladder injury ten days). Residual urine was checked with ultrasound; in all patients was less than 50 ml. At one year follow up by urodynamic evaluation 96,1% were continent and after two years 92,2%. Conclusion: Laparoscopic Burch colposuspension is one of the most common operations for treatment of stress urinary incontinence. Its advantages are better visualization, less
FRIDAY, NOVEMBER 11, 2005 (4:51 PM – 4:57 PM)
Study Objective: To evaluate the results of surgery for associated gynecologic and extragenital conditions. Design: Retrospective analysis of 97 cases of associated gynecologic and extragenital conditions, managed by simultaneous surgery. Setting: Department of Reproductive Medicine and Surgery of Moscow State Medical-Stomatologic University, Moscow, Russia. Patients: Ninety-seven patients (aged 18 – 62 yrs) with associations of gynecologic (myoma, endometrial hyperplasia, adenomyosis, ovarian mass, endometriosis, pelvic floor relaxation) and extragenital pathology (appendicitis, cholecystitis, stress urinary incontinence, thyroid struma). Intervention: Sixty-two patients underwent simultaneous laparoscopic and/or vaginal procedures (cholecystectomy plus hysterectomy, salpingoophorectomy or pelvic floor reconstruction [33 patients], appendectomy plus hysterectomy, myomectomy, ovarian resection, [29 patients]); laparoscopic gynecologic surgery was combined with resection of thyroid gland in 16 women, with TVT in 19 cases. Measurements and Main Results: Operating time, blood loss, postoperative hospital stay were evaluated and compared to the parameters of analogous procedures performed alone, showing reduction of total operating time by 1,4 times, blood loss by 1,4 times, hospital stay – by 2 times. No intra- or postoperative complications occurred. Conclusion: The study advocates for simultaneous surgery in patients with associated gynecologic and extragenital conditions, allowing to carry out treatment of all pathology within one procedure and anesthesia, thus reducing overall trauma, psychological distress, and negative impact on the patient’s quality of life.