• Title/Summary/Keyword: Gynecologic Laparoscopy

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Traditional Korean Medicine Management of Complications of Gynecologic Laparoscopy -A Case Report of Sciatic Neuropathy after Gynecologic Laparoscopy- (부인과 복강경 수술의 합병증에 대한 한의진료 방향에 대한 고찰 -부인과 복강경 수술 후 발생한 좌골신경병증 1례를 중심으로-)

  • Choi, Min-Sun;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.23 no.1
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    • pp.124-135
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    • 2010
  • Purpose: To report the patient with sciatic neuropathy after gynecologic laparoscopy, who improved by Traditional Korean Medical treatment and to study Traditional Korean Medicine(TKM) management of complications of gynecologic laparoscopy. Methods: A patient with sciatic neuropathy after gynecologic laparoscopy was managed with herbal medicine, acupuncture and moxibustion treatment. Results: After about 2 months treatment, patient's symptoms and signs were improved. TKM management was effective in recovery of neurologic complication after gynecologic laparoscopy. Conclusion: We need to actively participate in management of complications of gynecologic laparoscopy as primary or adjuvant therapy. And more study is needed for developing Traditional Korean Medical indication of complications of Gynecologic Laparoscopy.

Comparison of Perioperative and Oncologic Outcomes with Laparotomy, and Laparoscopic or Robotic Surgery for Women with Endometrial Cancer

  • Manchana, Tarinee;Puangsricharoen, Pimpitcha;Sirisabya, Nakarin;Worasethsin, Pongkasem;Vasuratna, Apichai;Termrungruanglert, Wichai;Tresukosol, Damrong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5483-5488
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    • 2015
  • Purpose: To compare perioperative outcomes and oncologic outcomes in endometrial cancer patients treated with laparotomy, and laparoscopic or robotic surgery. Materials and Methods: Endometrial cancer patients who underwent primary surgery from January 2011 to December 2014 were retrospectively reviewed. Perioperative outcomes, including estimated blood loss (EBL), operation time, number of lymph nodes retrieved, and intra and postoperative complications, were reviewed. Recovery time, disease free survival (DFS) and overall survival (OS) were compared. Results: Of the total of 218 patients, 143 underwent laparotomy, 47 laparoscopy, and 28 robotic surgery. The laparotomy group had the highest EBL (300, 200, 200 ml, p<0.05) while the robotic group had the longest operative time (302 min) as compared with laparoscopy (180 min) and laparotomy (125 min) (p<0.05). Intra and postoperative complications were not different with any of the surgical approaches. No significant difference in number of lymph nodes retrieved was identified. The longest hospital stay was reported in the laparotomy group (four days) but there was no difference between the laparoscopy (three days) and robotic (three days) groups. Recovery was significantly faster in robotic group than laparotomy group (14 and 28 days, p =0.003). No significant difference in DFS and OS at 21 months of median follow up time was observed among the three groups. Conclusions: Minimally invasive surgery has more favorable outcomes, including lower blood loss, shorter hospital stay, and faster recovery time than laparotomy. It also has equivalent perioperative complications and short term oncologic outcomes. MIS is feasible as an alternative option to surgery of endometrial cancer.

Combination Effects of Capsicum Plaster at the Korean Hand Acupuncture Points K-D2 with Prophylactic Antiemetic on Postoperative Nausea and Vomiting after Gynecologic Laparoscopy (고추파스를 이용한 수지요법 침점(K-D2) 자극과 예방적 항구토제의 병용요법이 부인과 복강경 수술 후 오심과 구토에 미치는 효과)

  • Jung, Hyun Jung;Park, Sang Youn
    • Journal of Korean Academy of Nursing
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    • v.43 no.2
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    • pp.215-224
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    • 2013
  • Purpose: This study was done to evaluate the combination effects of capsicum plaster at the Korean hand acupuncture points K-D2 with prophylactic antiemetic on Postoperative Nausea and Vomiting (PONV). Methods: An experimental research design (a randomized, a double-blinded, and a placebo-control procedure) was used. The participants were female patients undergoing gynecologic laparoscopy; the control group (n=34) received intravenous prophylactic ramosetron 0.3mg, while the experimental group (n=34) had Korean Hand Therapy additionally. In the experimental group, capsicum plaster was applied at K-D2 of both 2nd and 4th fingers by means of Korean Hand Therapy for a period of 30 minutes before the induction of anesthesia and removed 8 hours after the laparoscopy. Results: The occurrence of nausea, nausea intensity and need for rescue with antiemetic in the experimental group was significantly less than in the control group 2 hours after surgery. Conclusion: Results of the study show capsicum plaster at K-D2 is an effective method for reducing PONV in spite of the low occurrence of PONV because of the prophylactic antiemetic medication.

Current landscape and future perspective of sentinel node mapping in endometrial cancer

  • Bogani, Giorgio;Raspagliesi, Francesco;Maggiore, Umberto Leone Roberti;Mariani, Andrea
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.94.1-94.10
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    • 2018
  • Endometrial cancer (EC) represents the most common gynecological neoplasm in developed countries. Surgery is the mainstay of treatment for EC. Although EC is characterized by a high prevalence several features regarding its management are still unclear. In particular the execution of lymphadenectomy is controversial. The recent introduction of sentinel node mapping represents the mid-way between the execution and omission of node dissection in EC patients. In the present review we discuss the emerging role of sentinel node mapping in EC. In addition, we discussed how type of tracers utilized and site of injection impacted on sentinel node detection rates. Future perspective regarding EC management are also discussed.

Effect of the pulmonary recruitment maneuver on pain after laparoscopic gynecological oncologic surgery: a prospective randomized trial

  • Gungorduk, Kemal;Asicioglu, Osman;Ozdemir, Isa Aykut
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.92.1-92.9
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    • 2018
  • Objective: To evaluate the effectiveness of the pulmonary recruitment maneuver (PRM) at the end of the operation to decrease laparoscopy-induced abdominal or shoulder pain after gynecological oncologic surgery. Methods: In total, 113 women undergoing laparoscopic surgery for malignant or premalignant gynecological lesions were assigned randomly to two groups: the PRM group (the patient was placed in the Trendelenburg position ($30^{\circ}$) and the PRM, consisting of two manual pulmonary inflations to a maximum pressure of $40cmH_2O$) (n=54) and the control group (n=52). Postoperative shoulder and abdominal pain was assessed 12, 24, and 48 hours later using a visual analog scale (0-10). In addition, the incidence of post-discharge nausea and vomiting was recorded until 48 hours after discharge. Results: Postoperative shoulder pain at 12 and 24 hours was significantly less severe in the PRM group ($2.2{\pm}0.5$ and $2.0{\pm}0.4$) than in the control group ($4.0{\pm}0.5$ and $3.9{\pm}0.4$; both p<0.001). The PRM significantly reduced the severity of upper abdominal pain at 12 and 24 h compared with the control group ($3.1{\pm}0.4$ and $2.9{\pm}0.4$ vs. $2.9{\pm}0.5$ and $4.9{\pm}0.5$; both p<0.001). The analgesic requirement during the postoperative period was similar in the two groups (control group, 78.8%; PRM group, 75.9%; p=0.719). Conclusion: The PRM effectively and safely reduced postoperative shoulder and upper abdominal pain levels in patients undergoing laparoscopic gynecological oncologic surgery. Trial registry at ClinicalTrials.gov, NCT01940042.

Recent advances in minimally invasive surgery for gynecologic indications

  • Koo, Yu-Jin
    • Journal of Yeungnam Medical Science
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    • v.35 no.2
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    • pp.150-155
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    • 2018
  • Recently, an increasing interest in less invasive surgery has led to the advent of laparoendoscopic single-site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES). LESS and NOTES could be technically challenging, but available literature has demonstrated the feasibility and safety of LESS for benign gynecologic diseases. However, the evidence is not strong enough to recommend the use of LESS over that of conventional multiport laparoscopic surgery (MLS). As per the results of the most recently published meta-analysis, the majority of surgical outcomes are equivalent between LESS and MLS, except for the longer operative time in LESS for both adnexal surgery and hysterectomy. Although an increasing number of studies have reported on robotic LESS, NOTES, and LESS for gynecologic malignancy, definite conclusions have not been drawn owing to the lack of sufficient information.

Risk for Malignant and Borderline Ovarian Neoplasms Following Basic Preoperative Evaluation by Ultrasonography, Ca125 Level and Age

  • Karadag, Burak;Kocak, M.;Kayikcioglu, F.;Ercan, F.;Dilbaz, B.;Kose, M.F.;Haberal, A.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8489-8493
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    • 2014
  • Objective: To verify the basic preoperative evaluation in the discrimination between benign and malignant adnexal masses in our clinical practice. Materials and Methods: Data were collected on the records of 636 women with adnexal masses who had undergone surgery either by open or endoscopic approaches. Those with obvious signs of malignancy, any history of cancer, emergency surgeries without basic evaluation were excluded. The preoperative features by age, ultrasound and serum Ca125 level were compared with final histopathological diagnosis at the four departments of the institution. These are the general gynecology (Group 1: exploratory laparotomy), the gynecologic endoscopy (Group 2: laparoscopy and adnexectomy), the gynecological oncology (Group 3: staging laparotomy) and the gynecologic endocrinology and infertility (Group 4: laparoscopy and cystectomy). Results: There were simple and complex cyst rates of 22.3% and 77.2%, respectively. There were 86.3% benign, 4.1% (n:20) borderline ovarian tumor (BOT) and 6.4% (n:48) malignant lesions. There were 3 BOT and 9 ovarian cancers in Group 1 and one BOT and two ovarian cancer in the Group 2. During the surgery, 15 BOT (75%) and 37 ovarian cancer (77%) were detected in the Group 3, only one BOT was encountered in the Group 4. The risk of rate of unsuspected borderline or focally invasive ovarian cancer significantly increased by age, size, complex morphology and Ca125 (95% CI, OR=2.72, OR=6.60, OR=6.66 and OR=4.69, respectively). Conclusions: Basic preoperative evaluation by comprehensive ultrasound imaging combined with age and Ca125 level has proved highly accurate for prediction of unexpected malignancies. Neither novel markers nor new imaging techniques provide better information that allow clinicians to assess the feasibility of the planned surgery; consequently, the risk of inadvertent cyst rupture during laparoscopy may be significantly decreased in selected cases.

Two Cases of Extrapelvic endometriosis following Laparoscopy-assisted vaginal hysterectomy and Cesarean section (복강경하 질식 자궁적출술 및 제왕절개술 후 발생한 골반외 자궁내막증 2 예)

  • Bae, Jei-Jun;Lim, Mi-Sun;Koh, Min-Whan;Lee, Tae-Hyung;Kim, Mi-Jin
    • Journal of Yeungnam Medical Science
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    • v.24 no.1
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    • pp.91-96
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    • 2007
  • Extrapelvic endometriosis is a rare disease. The majority of extrapelvic endometriosis cases involve scar tissue following obstetric and gynecologic procedures. We have treated two cases of extrapelvic incisional endometriosis. A 39 year old female patient with cyclic vaginal spotting after laparoscopic assisted vaginal hysterectomy due to uterine myoma and a 35 year old female patient with a painful palpable abdominal mass after cesarean section. Both underwent complete excision and were proven to have endometriosis by pathology. Here we report on both cases and review the medical literatures.

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Traditional Korean Medicine(TKM) Management for the Recovery after Laparoscopic Gynecological Surgery (부인과 복강경 수술 후 한의진료 방향에 대한 고찰)

  • Jeong, Jae-Cheol;Choi, Min-Sun;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.4
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    • pp.218-227
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    • 2008
  • Purpose: The purpose of this study is to report the TKM Management for the recovery after laparoscopic gynecological surgery. Methods: The basic informations about laparoscopy and report 3 laparoscopic postoperative patients were managed with TKM. Patients had taken the surgery for the different gynecologic diseases. Results: The 3 patients' symptoms were improved gradually. TKM management is good for the recovery of laparoscopic surgery. And the management need to reflect postoperative complications. the cause and part of operation. and postoperative common symptoms. Conclusion: The TKM managements are effective in the postoperative recovery after laparoscopic gynecological surgery. And more study is needed for developing the model.

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Treatment of the chronic pelvic pain and complications of post-ovarian cystectomy with laparoscopy : a case report (난소낭종제거수술 후 내원한 만성골반통 환자 1례에 대한 증례보고)

  • Yang, Seoung-In;Han, In-Sun;Park, Hyun-Jae;Bae, Sang-Jin;Lee, Dong-Nyung;Yi, Youn-Ju
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.4
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    • pp.287-297
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    • 2006
  • Purpose : Chronic pelvic pain(CPP) is a common gynecologic symptoms. Recent research has been directed towards understanding the pathology of CPP, but many questions have existed. And the study for treating CPP has been tried by various manners. A Korean medicine(KM) also try to treat a various methods for treatment of CPP. It is often that a pelvic pain is continue a post-hysterectomy or a operating of gynecology. We have a case of CPP treatment by KM that is a patient continue pain after post-ovarian cystectomy with laparoscopy. So we report a case on pelvic pain and complication of post-ovarian cystectomy with laparoscopy. Methods : A 44 years old woman, who suffered from chronic pelvic pain, dizziness, nausea, dyspepsia, general weakness, insomnia after ovarian cystectomy, was enrolled in this study. She received KM therapies such as herbal medicine, moxibustion, acupuncture for 4 weeks. Results : CPP and symptoms after ovarian cystectomy were reduced by KM therapies. Conclusion : 'The present study suggests that KM therapies have a significant effect on CPP and complications of post-ovarian cystectomy with laparoscopy.

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