• Title/Summary/Keyword: Laparoscopic Myomectomy

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Clinical experience with single-port access laparoscopic cystectomy and myomectomy

  • Jeong, Jae-Hyeok;Kim, Yu-Ri;Hong, Kil-Pyo;Ha, Jae-Eun;Kim, Eun-Jeong;Hong, Da-Kyo;Lee, Kyu-Sup
    • Clinical and Experimental Reproductive Medicine
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    • v.43 no.1
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    • pp.44-50
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    • 2016
  • Objective: This study was performed to assess our clinical experience with single-port access (SPA) laparoscopic cystectomy and myomectomy and the surgical outcomes of those procedures at our institution. Methods: The authors evaluated the surgical outcomes of SPA laparoscopic cystectomy in 293 patients and SPA laparoscopic myomectomy in 246 patients. The surgical outcomes comprised operation time, the amount of blood loss during the operation, the change in hemoglobin (before and after the operation), the change in hematocrit (before and after the operation), switching to the multi-port access method, complications, transfusions, and the duration of the postoperative hospital stay. Results: The Pearson correlation coefficient and the Spearman correlation coefficient between the operation time and the amount of blood loss were 0.312 and 0.321 for SPA laparoscopic cystectomy, respectively, and 0.706 and 0.674 for SPA laparoscopic myomectomy, respectively. The drops in hemoglobin and hematocrit were $1.33{\pm}0.78g/dL$ and $4.14%{\pm}2.45%$, respectively, in SPA laparoscopic cystectomy, while the corresponding figures were $1.34{\pm}1.13g/dL$ and $4.17%{\pm}3.24%$ in SPA laparoscopic myomectomy, respectively. Conclusion: This study reported the surgical outcomes of SPA laparoscopic cystectomy and myomectomy and compared them to previously published findings on traditional laparoscopic cystectomy and myomectomy. No significant differences were found in the surgical outcomes between SPA and traditional laparoscopic cystectomy and myomectomy.

Combination Treatment of Korean Medicine with Ohrim-san for Lower Urinary Tract Symptoms (LUTS) after Laparoscopic Myomectomy Patient : A Case Report (복강경하 근종적출술 후 발생한 하부요로증상에 대한 오림산을 포함하는 복합한의진료의 경과 : 증례보고)

  • Jeong, So-Mi;Jo, Hee-Geun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.3
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    • pp.187-197
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    • 2020
  • Objectives: This case report aims to report the clinical effectiveness of the combination treatment of Korean medicine on a post-laparoscopic myomectomy patient's lower urinary symptoms (LUTS). Methods: The patient who diagnosed with uterine myoma had Laparoscopic myomectomy. After the operation, the patient complained of dysuria, nocturia, frequent urination, urgent urination and urinary retention. The patient received combination treatment of Korean medicine during 14 days of hospitalization. The treatment included Ohrim-san, acupuncture, moxibustion, and pharmacoacupuncture. The effects were evaluated through the Numeric Rating Scale (NRS), Overactive Bladder Symptom Score (OABSS), Frequency-Volume chart, and 5-Level version of EuroQol-Five Dimension (EQ-5D-5L). Results: After the treatment, the clinical symptoms such as dysuria, nocturia, frequent urination, urgent urination, urinary retention were improved. Also, the quality of life was enhanced. Conclusions: This case report shows that the combination treatment of Korean Medicine with Ohrim-san may be effective for treating lower urinary tract symptoms (LUTS) after laparoscopic myomectomy.

Influence of Duration of Prophylactic Antibiotics Therapy on Uncertainty of Recovery in Elective Laparoscopic Uterine Myomectomy Patients (선택적 복강경하 자궁근종절제술 환자의 예방적 항생제 투여기간이 회복에 대한 불확실성에 미치는 영향)

  • Jung, Mi Young;Park, Kyung-Yeon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.25 no.4
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    • pp.240-249
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    • 2018
  • Purpose: The study was done to explore whether the duration of perioperative prophylactic antibiotics therapy influenced uncertainty of recovery in patients with elective laparoscopic uterine myomectomy. Methods: A prospective study was conducted using self-report questionnaires and electrical medical records for patients with uterine myomectomy. According to the length of the perioperative prophylactic antibiotics therapy, the patients were divided into three groups: single-dose antibiotic treatment group, short-term antibiotic treatment group, and long-term antibiotic treatment group. Data were collected from December 20, 2016 to July 31, 2017 from 161 patients who underwent laparoscopic myomectomy at a metropolitan city general hospital. Results: Level of uncertainty of recovery was $2.98{\pm}0.22$. The uncertainty was highest in the long-term antibiotic treatment group, followed by the short-term antibiotic treatment group and the single-dose antibiotic treatment group (F=89.40, p<.001). In the regression analysis, factors influencing uncertainty of recovery among uterine myomectomy patients were duration of perioperative prophylactic antibiotic therapy (${\beta}=.70$, p<.001) and duration of NPO (${\beta}=-.11$, p=.047) which explained 51.5% of the variance (F=83.75, p<.001). Conclusion: Based on these results, information including the administration of antibiotics before surgery should be provided to the patients to help reduce the uncertainty of postoperative recovery.

Effects of Postoperative Oral Care Using Cold Therapy on Nausea, Vomiting and Oral Discomfort in Patients with Laparoscopic Myomectomy (냉요법을 이용한 수술 후 구강간호가 복강경 자궁근종절제술 환자의 오심, 구토 및 구강 불편감에 미치는 효과)

  • Jung, Mi-Young;Choi, Hyo-Sun;Park, Kyung-Yeon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.3
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    • pp.292-301
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    • 2012
  • Purpose: The purpose of the study was to evaluate the effects of postoperative oral care using cold therapy on nausea, vomiting and oral discomfort after laparoscopic myomectomy. Method: The study was conducted with an experimental group (n=29) and a control group (n=35) sampled from patients admitted to a women's hospital in a metropolitan city in Korea. Data were collected between October 10, 2011 and January 31, 2012 and analyzed using Chi-square, Fisher's exact test, t-test, and repeated measure ANCOVA with SPSS/WIN 19.0. Results: After the intervention, postoperative nausea (p<.001) and oral discomfort for patients in the experimental group were significantly lower than in the control group. There were significant differences in the presence of vomiting between both groups at 12 hours (p<.001) and 24 hours (p=.003) after leaving the recovery room. Conclusion: Oral care using cold therapy was found to be an effective nursing intervention for reducing postoperative nausea, vomiting and oral discomfort up to 24 hours after recovery in patients with laparoscopic myomectomy.

Effect of intravenous ascorbic acid administration on fatigue after laparoscopic myomectomy: A randomized, double-blind, placebo-controlled trial (복강경 자궁근종절제술을 받은 여성에서 정맥 내 아스코르브산 투여가 피로에 미치는 영향: 무작위 배정 양측맹검 위약대조 임상시험)

  • Hwang, Woo Yeon;Kim, Kidong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.2
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    • pp.434-439
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    • 2021
  • We assessed the effects of intravenous (IV) ascorbic acid administration on fatigue in women undergoing laparoscopic myomectomy. We analyzed the secondary endpoint results of a randomized, double-blind, placebo-controlled trial. Fifty patients undergoing laparoscopic myomectomy received IV ascorbic acid (2g) or placebo (randomly 1:1 ratio) intravenously during surgery. On day 2 post-surgery, we measured the level of fatigue using the Brief Fatigue Inventory-Korean version. Forty-five women (experimental arm 23, control arm 22) were eligible for analysis after 5 women (experimental arm 2, control arm 3) were excluded due to withdrawal of consent, cancellation of surgery or non-measurement of the endpoints. The baseline and operative characteristics were similar between arms and the global fatigue score of the experimental arm (4.56 ± 2.63) was not significantly different from that of the control arm (5.21 ± 2.02, P = 0.351). However, the fatigue score of the experimental arm tended to be lower than that of the control arm in most domains. IV ascorbic acid administration did not significantly reduce the level of fatigue in women undergoing laparoscopic myomectomy as compared to placebo. More research is needed to better understand the effects of ascorbic acid on fatigue in surgical patients.

Disseminated Peritoneal Leiomyomatosis with Atypical Features and Comorbid Uterine STUMP: a Case Report and Review of the Literature

  • Ryu, Kyunghwa;Lee, Eun Ji;Chang, Yun-Woo;Hong, Seong Sook;Hwang, Jiyoung;Oh, Eunsun;Nam, Bo Da;Choi, Inho;Lee, Hyo-Pyo
    • Investigative Magnetic Resonance Imaging
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    • v.24 no.3
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    • pp.162-167
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    • 2020
  • Disseminated peritoneal leiomyomatosis (DPL) is a very rare benign disease, characterized by multiple solid subperitoneal or peritoneal smooth muscle nodules in abdominopelvic cavity and malignant transformation is extremely rare. Also, uterine smooth muscle tumors of unknown malignant potential (STUMP) is a rare tumor, which is regarded as subclassification in uterine smooth muscle tumors between benign and malignant criteria. Pathogenesis of DPL is uncertain, but increasing evidence of iatrogenic cause including laparoscopic myomectomy has been reported. We report a case of a 28-year-old female with previous history of laparoscopic myomectomy diagnosed with DPL with atypical feature and concurrent uterine STUMP using computed tomography (CT) and magnetic resonance imaging (MRI), as well as present a review of the literature.

Parasitic Leiomyoma with Lymphatic Dilatation in Trocar Port-Site of Abdominal Wall: A Case Report (트로카 삽입 부위에 생긴 림프관 확장을 동반한 기생 평활근종: 증례 보고)

  • Gayoung Jeon;Seo Young Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.280-285
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    • 2023
  • Uterine leiomyoma is the most common benign pelvic tumor in female and being symptomatic is an indication for surgical removal. As laparoscopic surgery has been developed, some cases related to parasitic leiomyomas in the port site have been reported. A 40-year-old female who a history of previous laparoscopic surgery to remove uterine myoma 2 years ago visited in outpatient clinic of general surgery with palpable mass in left lower abdomen. Contrast enhanced abdomen CT and pelvis MRI were done to evaluate the mass. It was diagnosed parasitic leiomyoma in pathologic study after surgical removal and parasitic leiomyoma should be considered when patient visited presenting abdominal mass with the history of laparoscopic myomectomy.

Influence of Gas Pain, Post-operative Resilience, and Body Temperature Discomfort in Laparoscopic Myomectomy Patients after Thermotherapy (복강경하 자궁근종절제술 후 적용한 온열요법이 가스 통증, 수술 후 회복력 및 체온불편감에 미치는 효과)

  • Lee, JeongAe;Jeon, MyoungHwa;Park, EunJu;Lee, JinAh;Ahn, GonMyoung;Lee, SeungShin;Kim, JiIn
    • Women's Health Nursing
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    • v.25 no.1
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    • pp.4-18
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    • 2019
  • Purpose: The purpose of this study was to investigate the effects of thermotherapy on gas pain, post-operative resilience, and body temperature discomfort among patients who received laparoscopic myomectomies. Methods: The experimental group consisted of 62 patients with thermotherapy and the control group consisted of 60 patients. Thermotherapy was applied individually to the experimental group four hours after surgery. The collected data was analyzed using descriptive statistics, t-tests, ${\chi}^2$-tests, and repeated measures of analysis of variance, using IBM SPSS Statistics version 18. Results: The results showed no significant interaction effect between the group and time of measurement in gas-related pain in the experimental group. For gas-related pain, there was significant difference in right shoulder pain at 24 hours (t=-4.222, p=.000), 48 hours (t=-3.688, p=.000), 72 hours (t=-2.250, p=.028), and left at 24 hours (t=-3.727, p=.000), 48 hours (t=-4.150, p=.000), and 72 hours (t=-2.482, p=.016) and both shoulders at 24 hours (t=-2.722, p=.009) and 48 hours (t=-2.525, p=.014). There was no significant difference in epigastric pain, excluding both epigastric pain at 48 hours (t=2.908, p=.005), 72 hours (t=3.010, p=.004), but there was a significant difference in objective body temperature discomfort (t=2.895, p=.008). Conclusion: Thermotherapy relieved shoulder gas-related pain and objective body temperature discomfort. It needs to be developed and applied to improve post-operative discomfort in patients with laparoscopic hysterectomies.

The three-point crossover technique for immediate reconstruction of the umbilicus

  • Lee, Cho Long;Yang, Ho Jik
    • Archives of Plastic Surgery
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    • v.48 no.2
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    • pp.175-178
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    • 2021
  • The umbilicus is an important aesthetic component of the abdomen; therefore, its absence is both cosmetically and psychologically distressing to the patient. However, loss of the umbilicus during abdominal surgical procedures is often unavoidable. Umbilical reconstruction is aimed at obtaining a natural, three-dimensional appearance. We propose a simple method for immediate umbilical reconstruction with good long-term results. This technique was used successfully on a patient who underwent tumor excision. A 49-year-old woman presented with a large mass, measuring 5.8×4.0 cm, on her umbilicus. The mass, an epidermal cyst, developed after laparoscopic uterine myomectomy 5 years earlier. Complete excision of the mass resulted in a large defect, and immediate umbilical reconstruction was planned. Our procedure involved apposing and anchoring two opposing flaps onto the abdominal wall, so that the umbilicus would retain its depth over a long period of time. Negative-pressure wound therapy was applied for 72 hours as a mild compressive dressing. No complications were encountered. The healing process was uneventful and the aesthetic outcome was pleasing; a natural-appearing navel was created. The patient was satisfied with the end result. This technique provides a permanent and sufficient depression for the umbilicus.