Hysteroscopic Management of a Stenotic Cervix

Apr 20, 2019 | 364 Views

Michael Suen, Olga Bougie, Sukhbir Sony Singh

This video outlines the approach to the hysteroscopic management of a stenotic cervix using video from cases performed in an outpatient hysteroscopy setting.

Approach to Laparoscopic Cerclage

Jul 8, 2019 | 373 Views

Aisling Clancy, Nicholas Leyland, Sukhbir Sony Singh

This video outlines an approach to performing a laparoscopic cervical cerclage.

Laparoscopic Hysterectomy with Cervicovaginal Agenesis

Sep 26, 2019 | 318 Views

Rupinder Dhaliwal, Liane Belland

We present a laparoscopic surgical approach for hysterectomy in Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome with cervicovaginal agenesis. Laparoscopic approaches for removal of uterine remnants have been published with only reports of laparotomy described for hysterectomy with cervicovaginal agenesis. We discuss the diagnosis, management considerations and preoperative planning for definitive surgical treatment of a patient with MRKH with cervicovaginal agenesis presenting initially with hematometra and pain. We show that laparoscopic hysterectomy is a viable and safe option in patients with cervicovaginal agenesis. The importance of preoperative imaging to rule out associated anomalies and assist in surgical planning is stressed. We highlight necessary alterations in surgical technique to overcome the lack of traction, identify potential anomalous vasculature and ultimately maintain hemostasis, clear delineation of surgical anatomy, and avoid injury. Tissue extraction through laparoscopic in bag morcellation is performed thus avoiding mini laparotomy altogether.

Laparoscopic Cerclage

Oct 26, 2019 | 351 Views

Chandrew Rajakumar

This video outlines cervical insufficiency and an approach to laparoscopic cerclage using 5mm Mersilene suture.

Laparoscopic Cervical Myomectomy with Pre-operative Uterine Artery Embolization and Concomitant Cerclage

Sep 24, 2020 | 120 Views

Vanille Simon, Marie-Eve Bergeron, Philippe Laberge, Sarah Maheux-Lacroix

Cervical myomectomy is a surgical challenge and the risk of subsequent cervical incompetence is unknown. We presented the case of a 30-year-old woman, nulligravida, with a 12 cm cervical leiomyoma, who consulted for heavy menstrual bleeding and pelvic pain. After failure of multiple medical therapies, a laparoscopic cervical myomectomy was successfully performed. Adjuvant pre-operative uterine artery embolization with gelatin sponges was used to reduce surgical blood loss, as an alternative to intra-operative ligation of uterine arteries when access to the retroperitoneum is limited by the size and location of leiomyomas. In order to prevent cervical incompetence, a concomitant laparoscopic cerclage was achieved since the integrity of the cervix has been compromised by the myomectomy.