112,195 research outputs found
Laparoscopic para-aortic lymphadenectomy in cases of retro-aortic left renal vein
No full textVascular anomalies involving the renal veins are rare;
the overall prevalence for a retro- aortic renal vein is
3%.
A patient diagnosed with serous ovarian cancer
underwent a laparoscopic surgical restaging,
including hysterectomy, omentectomy, peritoneal
biopsies, bilateral pelvic lymphadenectomy, and para-aortic
lymphadenectomy. After identification of the
right ureter, inferior vena cava, and aorta, the para-caval
lymph node dissection was completed. The left
lumbo- aortic retroperitoneal spaces were dissected,
but the left renal vein was not found while the left renal
artery was identified. Further inspection revealed the
retro- aortic left renal vein (Figures 1 and 2). The vein
converged into the inferior vena cava after passing
under the abdominal aorta immediately above the
common iliac vein bifurcation. No other vascular
anomalies were found . The surgery was uneventful.
An accurate identification of the renal vessels is
crucial when performing surgical procedures around the inferior vena cava due to the significant risk of vascular injury in
cases of vascular anomalies
Laparoscopic radical hysterectomy for malignant indications: Laparoscopic trachelectomy
No full textCervical cancer is the third most common female cancer and the fourth leading cause of female cancer death worldwide [1]. Approximately 15 % of all cervical cancers are diagnosed in women under the age of 40 years who wish to preserve their fertility [2, 3]. For these reasons, although radical hysterectomy with lymph node dissection represents the standard treatment for early-stage cervical cancer, alternative surgical approaches able to spare reproductive organs have been develope
Peritoneal sarcomatosis 5 years after laparoscopic morcellation of uterine leiomyoma
No full textIn 2011, a 40-year-old woman underwent laparoscopic myomectomy with intraabdominal morcellation. Histology report showed leiomyoma without atypia, necrosis, or mitosis. In 2016, she complained of left lower quadrant pain; ultrasound examination revealed a left hypogastric mass in the site of trocar placement. Percutaneous biopsy results showed a low-grade endometrial stromal sarcoma (LGESS). At laparoscopy, we observed: multiple nodules on uterine serosa, left annex, vesical peritoneum (Figure 1), Douglas pouch (Supplementary Video1), previous left pelvic trocar site (Figure 2), greater omentum (Figure 3), and right/left diaphragm
Neuromodulation of the superior hypogastric plexus: a new option to treat bladder atonia secondary to radical pelvic surgery?
No full textBackground: The aim of this study is to report on the impact of neuromodulation to the superior hypogastric plexus in patients with bladder atonia secondary to pelvic surgery. Methods: In 4 consecutive patients with bladder atonia secondary to pelvic surgery, we performed a laparoscopic implantation of a neurostimulator-LION procedure-to the entire superior hypogastric plexus. Results: Of the 4 reported patients, 3 are able to partially void or empty their bladder. Conclusions: If the presented results could be obtained in further patients and maintained in long-term follow-up, the LION procedure to the superior hypogastric plexus could change the management of bladder function in patients with bladder atoni
Isolated infiltrative endometriosis of the sciatic nerve: a report of three patients
No full textObjective: To report that isolated endometriosis of the sciatic nerve without further manifestation of endometriosis does exist. Design: We describe our technique of laparoscopic neurolysis of the sciatic nerve and the sacral plexus. Setting: Department of Gynecology and Obstetrics, St. Elisabeth Hospital, affiliated with the University of Cologne, Cologne, Germany. Patient(s): Three female patients with isolated endometriotic infiltration of the endopelvic portion of the sciatic nerve. Intervention(s): Elective laparoscopic neurolysis of the sciatic nerve with removal of endometriosis. Main Outcome Measure(s): Disparition of pain in the patients and histologic information of the endometriosis. Result(s): Isolated endometriosis of the sciatic nerve and/or the sacral plexus does exist without any further endometriosis genitalis externa manifestations. Conclusion(s): In young patients with sciatica of an unknown genesis, an endometriosis of the sciatic nerve must be evoked, and a laparoscopic exploration of the sciatic nerve must be discussed. © 2007 American Society for Reproductive Medicine
Laparoscopic total mesometrial resection (L-TMMR)
No full textAbdominal radical hysterectomy and pelvic lymph node dis- section as introduced by Wertheim and Meigs [1–2] first in the beginning of the century is still regarded as “gold stan- dard” in the surgical treatment of the uterine cervix carci- noma, FIGO stages IA2-IB and IIA. The resection of the parametrial and paracervical tissues proposed by the conventional radical hysterectomy is based on a “centrifu- gal diffusion” from the center of the tumor on the direction of the parametrial (dorsal, lateral and ventral) highways. This imply a classic functional and ligament-focused view of the surgical anatomy
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