Appendectomy in Gynecology

Apr 15, 2019 | 86 Views

Elissa Tepperman, Mara Sobel, Ally Murji, Nicholas Leyland

This video reviews the gynecologic indications for appendectomy, the relevant anatomy, steps of the procedure, and possible complications.

Laparoscopic Presacral Neurectomy

Apr 15, 2019 | 86 Views

Mara Sobel, Ally Murji, Nicholas Leyland

This video reviews the indications for presacral neurectomy along with the anatomy, procedural steps, and potential complications.

Restoring Anatomy in Deep Infiltrating Endometriosis

Apr 15, 2019 | 93 Views

Ari Sanders, Jonathon Solnik

Through a single surgical case, this video discusses technical tips in restoring anatomy in the setting of deep infiltrating endometriosis.

Minimizing Ovarian Damage When Resecting Endometriomas

Apr 15, 2019 | 106 Views

Andrew Zakhari, Jessica Papillon-Smith, Jonathon Solnik, Ally Murji

In this video, the authors review techniques to help minimize ovarian damage when resecting endometriomas.

A Video on Appendectomy in Gynecologic Surgery

Jul 5, 2019 | 200 Views

Mina Wesa, Sukhbir Sony Singh

This video outlines the indications for appendectomy during gynecologic surgery, discusses the surgical technique, and is presented in the context of clinical case scenarios.

Endometriosis Patient Education

Jul 8, 2019 | 94 Views

Sukhbir Sony Singh

This video outlines the surgical management of an endometrial niche (isthmocele) through a laparoscopic approach.

Ureteric Thermal Injury: An Attempt at Conservative Management

Jul 8, 2019 | 76 Views

Neeraj Mehra, Sukhbir Sony Singh, John Mahoney, Hassan Shenassa

This video reiews an interoperative thermal injury to the ureter followed by an attempt at concervative management.

Deep Endometriosis of the Bowel: A Surgical Approach

Sep 27, 2019 | 96 Views

Cici Zhu, Michael Suen, Shaheer Tadros, Sukhbir Sony Singh

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.

A Step-wise Approach to Laparoscopic Cystectomy of Ovarian Endometrioma

Sep 27, 2019 | 134 Views

Caroline Lee, Catherine Allaire

A 37-year-old G1P0 woman presented with dysmenorrhea and pelvic pain in the context of known bilateral endometriomas. She was being treated with dienogest as suppressive therapy. She requested conservative surgery for treatment of her endometriosis due to the presence of persistent pelvic pain despite medical therapy. Here, we present a step-by-step approach to laparoscopic cystectomy of ovarian endometriomas.

Genitofemoral Nerve Sparing Adhesiolysis

Sep 27, 2019 | 90 Views

Tina Ngan, John Thiel, Darrien Rattray

The Genitofemoral nerve originates from the ventral rami of L1-L2. Its injury is uncommon in benign minimally invasive gynecologic surgery. However, when there is distorted anatomy due to adhesions or severe endometriosis, the risk of injury is higher. Therefore, it is important to recognize the anatomical landmarks early in the surgery to prevent injury. In this video, the genitofemoral nerve location, innervation, and mechanisms of injury will be reviewed. The points will be illustrated by demonstrating dissection of this nerve in a case with significant adhesions.

Keep Your Landmarks Close, and the Hypogastric Nerve Closer: An Approach to Nerve-sparing Endometriosis

Sep 28, 2019 | 170 Views

Andrew Zakhari, Mohamed Mabrouk, Diego Raimondo, Manuela Mastronardi, Renato Seracchioli, Benedetta Mattei, Jessica Papillon-Smith, Meir Jonathon Solnik, Ally Murji, Nucelio Lemos

Extensive resections for endometriosis can cause damage to the autonomic nervous system of the pelvis resulting in urinary, anorectal, and sexual dysfunction. This educational video seeks to describe the autonomic neuroanatomy of the pelvis, illustrate the predictable location of the hypogastric nerve in relation to other pelvic landmarks, and demonstrate a technique for identifying, dissecting, and ultimately sparing the hypogastric nerve and consequently, the inferior hypogastric plexus. With laparoscopic footage, we detail: 1) transperitoneal identification of the hypogastric nerve, assisted by the pulling maneuver 2) Opening of the retroperitoneum at the level of the pelvic brim and retroperitoneal identification of the ureter 3) Medial dissection and identification of the hypogastric nerve 4) Lateralization of the hypogastric nerve, allowing for safe peritoneal resection.The hypogastric nerve follows a predictable course and can identified, dissected, and spared during pelvic surgery and is an important landmark for the preservation of pelvic autonomic innervation.