- Email: [email protected]
398: Office Operative Vaginoscopic Hysteroscopy
S142
Journal of Minimally Invasive Gynecology, Vol 14, No 6, November/December Supplement 2007
anatomic position, operation time was approximately 40 minutes, and bleeding was minimal. The patient went home on post-operative day 4 without complications.
naculum, can be performed. This video will demonstrate a few selected operative hysteroscopy procedures performed in the office with the vaginoscopic approach.
396
399
Laparoscopic Broad Ligament Myomectomy 1 Cholkeri-Singh A, 2Goldsmith G. 1Chicago, Illinois; 2 Mount Auburn Hospital, Cambridge, Massachusetts
Laparoscopic Versus Robotic Radical Hysterectomy and Pelvic Lymphadenectomy: A Visual Comparison Datta MS, Nagarsheth N. Mount Sinai Medical Center, New York, New York
This video demonstrates a technique for resection of a large myoma in the broad ligament. The broad ligament contains vessels and the ureter. Dissection in the broad ligament can cause injury to these structures. Injury to the vessels can cause a broad ligament hematoma with extension into the retroperitoneal space, potentially causing a large blood loss for the patient. Injury to the ureter can potentially cause loss of renal function if not identified in a timely fashion. This video demonstrates a technique for the resection of a broad ligament myoma so that injuries to the adjacent abdominal structures are minimized. 397 Laparoscopic Ovarian Cancer Staging 1 Cholkeri-Singh A, 2Awtrey C, 2DiSciullo A. 1Chicago, Illinois; 2Mount Auburn Hospital, Cambridge, Massachusetts Staging for ovarian cancer is traditionally performed through a midline, vertical abdominal incision. Patients with an incidental finding of ovarian cancer from a previous procedure are subject to the traditional staging approach. The patients are then hospitalized for three to five days for their recovery. An additional six to eight weeks are expected for a patient’s full recovery from the surgical procedure. However, by utilizing the laparoscopic approach, the patient’s recovery can be shortened to an overnight observation, with a full recovery expected between two to six weeks. This video will demonstrate the feasibility of the staging procedure through laparoscopy. 398 Office Operative Vaginoscopic Hysteroscopy 1 Cholkeri-Singh A, 2Isaacson KB, 3DiSciullo A, 1Chicago, Illinois; 2Newton-Wellesley Hospital, Newton, Massachusetts; 3Mount Auburn Hospital, Cambridge, Massachusetts Operative hysteroscopy are outpatient procedures usually performed in the operating room due to patient discomfort from a vaginal speculum and cervical tenaculum. Although these are short procedures, the patient must take time away from their daily activities and can have increased anxiety from a hospital environment. These factors can be minimized when the procedure is performed in the office. To decrease patient discomfort, a vaginoscopic approach, which does not utilize a vaginal speculum or cervical te-
This video demonstrates a step by step comparison of radical hysterectomy when performed by both laparoscopic and robotic methods. Key points of this analysis are a side by side contrast of the following: trocar placement, rectovaginal space development, opening the pelvic sidewall, uterine artery ligation, developing the obturator fossa, unroofing the ureters, creating the vesicovaginal space, pelvic lymphadenectomy, colpotomy, and vaginal cuff closure. At this time, the role of robotics in gynecology is still developing. While both modalities can be utilized to achieve radical hysterectomy safely, the use of telerobotics offers visible advantages of tremor filtration and surgical dexterity with precision that lends itself nicely to advanced dissections and intracorporeal suturing. 400 Robotic Technique for Radical Hysterectomy and Bilateral Pelvic Lymphadenectomy: A Case Presentation Datta MS, Steiner N. Mount Sinai Medical Center, New York, New York The first laparoscopic radical hysterectomy with pelvic and paraaortic lymphadenectomy was reported by Nezhat et al in 1992. The technique has undergone modification over time, the latest being the application of telerobotics. This is a case presentation of a 42 year old with early stage cervical adenocarcinomas. After extensive counseling, she underwent robot assisted radical hysterectomy with pelvic lymphadenectomy. Robotic assistance during this procedure exemplified the advantages of surgical dexterity and precision afforded by this new modality. Final pathology showed scattered foci of adenocarcinoma in situ with negative resection margins and 22 negative pelvic lymph nodes. In conclusion, robotic radical hysterectomy and pelvic lymphadenectomy appears to be feasible with acceptable outcome when performed by an experienced gynecologic oncologist. 401 Conservative Laparoscopic Ablation of a Large CervicoIsthmic Leiomyoma 1 Dubuisson JB, 2Sandrine J. 1Hopitaux Universitaires de Geneve, Geneve, Switzerland; Geneva University Hospital, Geneva, Switzerland; 2Universita` Campus Biomedico di Roma, Rome, Italy
Journal of Minimally Invasive Gynecology, Vol 14, No 6, November/December Supplement 2007
anatomic position, operation time was approximately 40 minutes, and bleeding was minimal. The patient went home on post-operative day 4 without complications.
naculum, can be performed. This video will demonstrate a few selected operative hysteroscopy procedures performed in the office with the vaginoscopic approach.
396
399
Laparoscopic Broad Ligament Myomectomy 1 Cholkeri-Singh A, 2Goldsmith G. 1Chicago, Illinois; 2 Mount Auburn Hospital, Cambridge, Massachusetts
Laparoscopic Versus Robotic Radical Hysterectomy and Pelvic Lymphadenectomy: A Visual Comparison Datta MS, Nagarsheth N. Mount Sinai Medical Center, New York, New York
This video demonstrates a technique for resection of a large myoma in the broad ligament. The broad ligament contains vessels and the ureter. Dissection in the broad ligament can cause injury to these structures. Injury to the vessels can cause a broad ligament hematoma with extension into the retroperitoneal space, potentially causing a large blood loss for the patient. Injury to the ureter can potentially cause loss of renal function if not identified in a timely fashion. This video demonstrates a technique for the resection of a broad ligament myoma so that injuries to the adjacent abdominal structures are minimized. 397 Laparoscopic Ovarian Cancer Staging 1 Cholkeri-Singh A, 2Awtrey C, 2DiSciullo A. 1Chicago, Illinois; 2Mount Auburn Hospital, Cambridge, Massachusetts Staging for ovarian cancer is traditionally performed through a midline, vertical abdominal incision. Patients with an incidental finding of ovarian cancer from a previous procedure are subject to the traditional staging approach. The patients are then hospitalized for three to five days for their recovery. An additional six to eight weeks are expected for a patient’s full recovery from the surgical procedure. However, by utilizing the laparoscopic approach, the patient’s recovery can be shortened to an overnight observation, with a full recovery expected between two to six weeks. This video will demonstrate the feasibility of the staging procedure through laparoscopy. 398 Office Operative Vaginoscopic Hysteroscopy 1 Cholkeri-Singh A, 2Isaacson KB, 3DiSciullo A, 1Chicago, Illinois; 2Newton-Wellesley Hospital, Newton, Massachusetts; 3Mount Auburn Hospital, Cambridge, Massachusetts Operative hysteroscopy are outpatient procedures usually performed in the operating room due to patient discomfort from a vaginal speculum and cervical tenaculum. Although these are short procedures, the patient must take time away from their daily activities and can have increased anxiety from a hospital environment. These factors can be minimized when the procedure is performed in the office. To decrease patient discomfort, a vaginoscopic approach, which does not utilize a vaginal speculum or cervical te-
This video demonstrates a step by step comparison of radical hysterectomy when performed by both laparoscopic and robotic methods. Key points of this analysis are a side by side contrast of the following: trocar placement, rectovaginal space development, opening the pelvic sidewall, uterine artery ligation, developing the obturator fossa, unroofing the ureters, creating the vesicovaginal space, pelvic lymphadenectomy, colpotomy, and vaginal cuff closure. At this time, the role of robotics in gynecology is still developing. While both modalities can be utilized to achieve radical hysterectomy safely, the use of telerobotics offers visible advantages of tremor filtration and surgical dexterity with precision that lends itself nicely to advanced dissections and intracorporeal suturing. 400 Robotic Technique for Radical Hysterectomy and Bilateral Pelvic Lymphadenectomy: A Case Presentation Datta MS, Steiner N. Mount Sinai Medical Center, New York, New York The first laparoscopic radical hysterectomy with pelvic and paraaortic lymphadenectomy was reported by Nezhat et al in 1992. The technique has undergone modification over time, the latest being the application of telerobotics. This is a case presentation of a 42 year old with early stage cervical adenocarcinomas. After extensive counseling, she underwent robot assisted radical hysterectomy with pelvic lymphadenectomy. Robotic assistance during this procedure exemplified the advantages of surgical dexterity and precision afforded by this new modality. Final pathology showed scattered foci of adenocarcinoma in situ with negative resection margins and 22 negative pelvic lymph nodes. In conclusion, robotic radical hysterectomy and pelvic lymphadenectomy appears to be feasible with acceptable outcome when performed by an experienced gynecologic oncologist. 401 Conservative Laparoscopic Ablation of a Large CervicoIsthmic Leiomyoma 1 Dubuisson JB, 2Sandrine J. 1Hopitaux Universitaires de Geneve, Geneve, Switzerland; Geneva University Hospital, Geneva, Switzerland; 2Universita` Campus Biomedico di Roma, Rome, Italy