A Simple Method For Ovarian Approximation and Hemostasis Cystectomy following

Abstracts / Journal of Minimally Invasive Gynecology 26 (2019) S1−S97 Open Communications 28: Laparoscopy (4:10 PM − 5:15 PM) 4:10 PM A Simple Method For Ovarian Approximation and Hemostasis Cystectomy following Moawad NS,1,* Salem Z2. 1Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics & Gynecology, University of Florida, Gainesville, FL; 2Obstetrics & Gynecology, University of Florida, Gainesville, FL *Corresponding author. Video Objective: This video describes a simple method for ovarian approximation and hemostasis following cystectomy. Setting: A 31 year old patient with 1 year history of LLQ pelvic pain, deep dyspareunia and nausea. She has had a simple left ovarian cyst that was managed conservatively for several years, but recently increased in size. Ultrasound showed a large cyst in the midline measuring 9.2 £ 6.3 £ 9.1 cm. Laparoscopy showed a large 10 cm left ovarian mass that is cystic with serous fluid. A laparoscopic cystectomy was performed. Interventions: A laparoscopic cystectomy was performed with ovarian approximation and hemostasis with polysorb endoloops. Conclusion: This video demonstrates a simple and efficient method for approximating the ovarian tissue after large cystectomy, that provides adequate hemostasis without excessive thermal damage to the ovarian tissue, as well as potentially minimizing the risk of postoperative adhesions. Open Communications 28: Laparoscopy (4:10 PM − 5:15 PM) 4:17 PM Ovarian Ectopic Pregnancy: Laparoscopic Excision and Ovarian Conservation Ma K,* Kaur N. Gynaecology, Manchester Foundation Trust, Manchester, United Kingdom *Corresponding author. Video Objective: Demonstrate technique of laparoscopic excision of ovarian ectopic pregnancy with ovarian conservation. Setting: Tertiary Referral Centre and University Teaching Hospital. Interventions: A 23-year-old primigravida presentation at 6 weeks of gestation with a 7-day history of light bleeding and intermittent abdominal pain. Examination findings were unremarkable and the serum human chorionic gonadotropin level was 7157 IU/L. An ultrasound scan showed an ectopic pregnancy in the right adnexa, and primary surgical management was recommended. At laparoscopy, both fallopian tubes were noted to be normal with an ectopic pregnancy within the right ovary. 20 IU argipressin diluted in 80 mL 0.9% sodium hypochlorite was injected between the normal ovarian tissue and the ectopic pregnancy to assist hemostasis and hydro dissection. An ultrasonic device was used to incise the ovarian cortex to identify a plane of dissection between the ectopic pregnancy and the normal ovarian tissue. The ectopic pregnancy was excised with conservation of the ovary. The ovary was subsequently closed with absorbable sutures to ensure hemostasis. The ectopic pregnancy was removed in a bag through a 10-mm incision. The patient made an uneventful recovery. The serum human chorionic gonadotropin level in 7 days was <5IU/L and no further medical management was indicated. Histology confirmed a primary ovarian ectopic pregnancy. Ovarian function was not assessed postoperatively; however, she conceived 6 weeks later with an intrauterine pregnancy. Conclusion: This case highlights the importance of considering nontubal ectopic pregnancies when making a diagnosis based on an ultrasound scan. Ovarian preservation with excision of ectopic pregnancy can be achieved using techniques commonly used for ovarian

S95 cystectomy. Recourse to oophorectomy should only be considered in the event of acute hemorrhage. Open Communications 28: Laparoscopy (4:10 PM − 5:15 PM) 4:24 PM Efficacy of the Block in the Transverse Abdominal Plane in Laparoscopic and Robot-assisted Hysterectomy. Systematic Review and Meta - Analysis Vargas CB*. Antioquia, Clinica Del Prado, Medellin, Colombia *Corresponding author. Study Objective: Effectiveness of TAP block both in pain reduction and opioid requirements in post-operative period and to identify the frequency of the associated effects in the use of opiates in patients who underwent laparoscopic or robotic hysterectomy Design: Systematic review with meta-analysis of randomized controlled clinical trials. the manual for systematic reviews of Cochrane was followed. Protocol was registered in PROSPERO CRD42018103573. Setting: N/A Patients or Participants: The search strategy identified 221 relevant bibliographical references: 43 Pubmed, 106 Embase, 67 Cochrane Library, 1 LILACS, 4 Gray. 7 were to perform a quantitative analysis, 227 patients with TAP block with 262 patients blockade with placebo or did not undergo intervention. Interventions: Eligibility criteria: Controlled clinical trials, TAP blockade was compared to placebo or no treatment patients who underwent laparoscopic or robot-assisted hysterectomy, benign or malignant pathology and evaluated as outcomes, postoperative pain and opioid requirements, without language restriction, until July 31, 2018 Measurements and Main Results: The weighted least squares meta-analysis model was used. Immediate post-surgical pain: 7 studies, 518 patients showed a difference in means (DM): - 1.17 (95% CI -1.87;, 46) I2 = 68%, which was statistically significant in favor of the TAP block, is considered minimal and without clinical relevance. Late Pain: 7 studies, 518 patients: DM 0.001 (95% CI -0.43;, 44) I2 = 69%; Opioides requirement: 6 studies, 447 patients: DM 0.36 (95% CI -0.94, 1.68) I2 = 80% and incidence of nausea and vomiting with a difference of 95% CI = -0.11 (-0.215; -0.006) in favor of the TAP. Conclusion: The TAP block slightly decreases early postoperative pain without being maintained over time and does not modify the opioid requirement Open Communications 28: Laparoscopy (4:10 PM − 5:15 PM) 4:31 PM Clinical Study of Nano-carbon Combined With 3D Laparoscopic Sentinel Lymph Node Biopsy for Early Cervical Cancer Guo X,1 Guan X,2 Liu J,3,* Wang Q4. 1Xinxiang City Central Hospital, Xinxiang, China; 2Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX; 3Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; 4Xinxiang City Central Hospital Gynecologic Oncology, Xinxiang, China *Corresponding author. Study Objective: To investigate the feasibility and clinical application of early cervical application of nano-carbon tracer imaging of sentinel lymph node (the SLN) under laparoscopic 3D. Design: 50 patients diagnosed with early cervical cancer patients, cervical injection nanometers from preoperative Carbon-suspended injection.3D