Jul 5, 2019 | 390 Views
This video outlines the indications for appendectomy during gynecologic surgery, discusses the surgical technique, and is presented in the context of clinical case scenarios.
Jul 8, 2019 | 191 Views
This video demonstrates the use of natural orifice vaginal extraction for the completion of a laparoscopic bowel resection in the setting of deep infiltrating endometriosis.
Jul 12, 2019 | 197 Views
This video outlines techniques the optimize visualization during gynecologic surgery. It focuses on techniques to suspend the ovaries, navigate excess adipose tissue, and retract sigmoid colon.
Sep 27, 2019 | 179 Views
The objectives of this video are to define bowel endometriosis and to explore various surgical parameters for the different types of surgical excision. Then, a specific surgical approach will be demonstrated. When planning a surgical approach to deep endometriosis of the bowel, patient characteristics such as age and BMI, as well as their specific symptoms and level of pain, quality of life and fertility goals must be considered. As well, the actual lesion must be investigated with respect to size, number, location, depth of infiltration, and amount of intestinal wall circumference involved. Then, various surgical techniques can be performed depending on these specific characteristics, such as nodule shaving, nodular resection and segmental resection and re-anastomosis. A surgical case is then utilized to demonstrate a nerve sparing and blood supply conserving technique of segmental resection after intra-operative sigmoidoscopy demonstrated luminal obstruction.
Sep 24, 2020 | 27 Views
Bowel injuries complicate 0.13% of laparoscopic gynecologic surgeries. Intraoperative diagnosis is critical to preventing mortality. A high index of suspicion should be maintained when patients present postoperatively with signs and symptoms suggesting bowel injury, and these patients should be promptly evaluated with imaging. The general approach to bowel injury includes involving consultants early if needed, intraoperative antibiotics if appropriate, thorough evaluation of the injury, surgical repair, and monitoring for possible postoperative complications. The specific approach to repair depends on the type of bowel injury. Veress needle injuries can be managed expectantly. Superficial, small thermal and partial thickness injuries can be oversewn or repaired with a one layer closure. Full thickness injuries should be closed in one or two layers. Large or infected injuries often require bowel resection with re-anastomosis and a possible diverting stoma. Considerations for postoperative care are also reviewed.