Single port access laparoscopic subtotal hysterectomy using contained manual morcellation: Experience from a tertiary referral center in Taiwan
| Autor: | Fang-Ju Sun, Shih-Shien Weng, Yi-Chun Chou |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Single port access Umbilicus (mollusc) Forceps Taiwan Trachelectomy Morcellation Hysterectomy lcsh:Gynecology and obstetrics Laparoscopic subtotal hysterectomy Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine Port (medical) Humans Medicine Adenomyosis Contained morcellation lcsh:RG1-991 Uterine Diseases 030219 obstetrics & reproductive medicine Leiomyoma business.industry Uterus Surgical outcomes Obstetrics and Gynecology Middle Aged medicine.disease Uterine Ligament Surgery Dissection Treatment Outcome 030220 oncology & carcinogenesis Female Laparoscopy business |
| Zdroj: | Taiwanese Journal of Obstetrics & Gynecology, Vol 57, Iss 1, Pp 28-31 (2018) |
| ISSN: | 1028-4559 |
| Popis: | Objective To describe the surgical outcomes of single port access laparoscopic subtotal hysterectomy (LSH) using in-bag manual morcellation and evaluate the feasibility of this procedure. Materials and Methods Thirty patients with symptomatic leiomyoma or adenomyosis were enrolled. A 2-cm transverse incision was made at the umbilicus and single port apparatus (LagiPort) was applied. After dissection of vesicouterine peritoneum from the uterus, the uterine ligaments and vessels were secured and transected by Gyrus PK cutting forceps. Cervical amputation at the level of internal os was made by SupraLoop (Karl Storz). The uterine corpus was put into an Endobag before morcellation. The opening of Endobag was exteriorized from the umbilical incision and the uterine corpus was removed in a contained manner by manual morcellation with a scalpel. Results This procedure was successfully performed on all patients. Neither laparotomic conversion nor additional port was needed. The mean age and mean BMI of the patients were 43.63 years and 24.02 kg/㎡. The mean operative time was 148 min and the estimated blood loss in most patients was less than 150 ml. The median weight of uterine corpus was 214 g. No intraoperative complications occurred in any patient. One patient was diagnosed with unexpected endometrioid adenocarcinoma FIGO grade 1 postoperatively. One patient reported cyclic bleeding and underwent a transvaginal trachelectomy 17 months later. Conclusion Single port access LSH using contained manual morcellation represents a safe and feasible alternative to conventional LSH using open power morcellation. |
| Databáze: | OpenAIRE |
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