Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota (Dr. Schmitt). Department of Obstetrics and Gynecology, SUMMA Health Systems, Akron, Ohio (both authors).

ABSTRACT

Introduction: Hysterectomies are the second most common major surgical procedure among women in their reproductive years. Ureteral injury is a known complication of this surgery. Intraoperative cystoscopy is not yet used routinely to evaluate the ureteral function before concluding a benign hysterectomy.

Case Description: A 40-year-old woman had a laparoscopy-assisted vaginal hysterectomy with intraoperative cystoscopy that noted unilateral absence of ureteral dye spill. Urology was consulted and diagnosed an incidental, complete, obstructing kidney stone in the ureter, which was removed and stented during an exploratory laparotomy.

Conclusion: Although the chance of ureteral obstruction secondary to a kidney stone is small, either during or after gynecologic surgery, this case suggests that it should remain on the list of differential diagnoses.

Key Words: Cystoscopy, Hysterectomy, Kidney stone, Laparoscopy, Ureteral obstruction.

[gview file=”https://crsls.sls.org/wp-content/uploads/2015/03/jls101153480001.pdf”]

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Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana (both authors).

ABSTRACT

Intra-abdominal adhesions are a common complication of abdominal surgery and can lead to further complications including bowel obstruction, infertility, and pain. We describe a novel technique of performing transvaginal laparoscopic lysis of adhesions following a total vaginal hysterectomy in a 41-year-old woman with periumbilical pain and menorrhagia. This natural orifice transluminal endoscopic surgical procedure was tolerated well, did not add considerable overall operating time, and did not require extensive additional training. The patient reported no periumbilical pain at 1 year.

Key Words: Surgery-induced tissue adhesions, Laparoscopic surgery, Natural orifice transluminal endoscopic surgery, Hysterectomy, Vaginal

[gview file=”https://crsls.sls.org/wp-content/uploads/2014/12/14-00220.pdf”]

The post Transvaginal Adhesiolysis Using Laparoscopic Instruments first appeared on JSLS.

Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, TX, USA (Drs. Guan, Walsh). Department of Obstetrics & Gynecology, Brown University, Providence, RI, USA (Dr. Urh). Department of Obstetrics & Gynecology, St. Luke’s Women’s Center, San Francisco, CA, USA (Dr. Ng).

ABSTRACT

Introduction: Hysterectomy is one of the most common gynecologic procedures performed. Minimally invasive laparoscopic techniques are preferred; however, laparotomy is still commonly performed for large uteri.

Case Description: We performed hand-assisted total laparoscopic hysterectomy of a 5200-g uterus.

Discussion: Hand-assisted laparoscopy is an alternative approach to laparotomy for large uteri and has similar benefits to traditional laparoscopic surgery. To our knowledge, the uterus in our patient is the largest uterus reported to have been removed laparoscopically.

Key Words: Large uterus, Fibroids, Hysterectomy, Laparoscopic hysterectomy, Hand assist.

[gview file=”https://crsls.sls.org/wp-content/uploads/2014/11/13-00313-.pdf”]

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