Extraperitoneal Laparoscopy in Severe Intra-abdominal Adhesions: A Safe Alternative to Laparotomy.

Autor:	Noor N; Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India., Das A; Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India., Roy KK; Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India., Bharti J; Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India., Nair VG; Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India., Rai R; Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
Jazyk:	angličtina
Zdroj:	Gynecology and minimally invasive therapy [Gynecol Minim Invasive Ther] 2021 Aug 03; Vol. 10 (3), pp. 181-183. Date of Electronic Publication: 2021 Aug 03 (Print Publication: 2021).
DOI:	10.4103/GMIT.GMIT_54_20
Abstrakt:	Surgery in a frozen abdomen can be difficult and dangerous with a significant risk of visceral injuries. We report a case of a 26-year-old lady with chronic pelvic pain diagnosed to have large bilateral adnexal cysts on magnetic resonance imaging with normal tumor markers. She had previous two laparotomies for benign conditions. Laparoscopy was planned, but pneumoperitoneum could not be created due to dense intraperitoneal adhesions. Direct entry was done into the preperitoneal space followed by insufflation of gas in this space. Blunt and sharp dissection of this space was done without breaching the peritoneum to reach the adnexa. The adnexal cyst was found to be encysted collection due to adhesions from previous surgeries. Deroofing was done followed by the visualization of pelvic structures intraperitoneally. Extraperitoneal laparoscopy may be used as a safe alternative to laparotomy in patients with dense intra-abdominal adhesions with the advantage of faster postoperative recovery. Competing Interests: There are no conflicts of interest. (Copyright: © 2021 Gynecology and Minimally Invasive Therapy.)
Databáze:	MEDLINE
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