Apr 15, 2019 | 244 Views
This video reviews the surgical vascular anatomy and techniques for ligating the uterine arteries at their original, or the anterior division of the internal iliac arteries.
Apr 15, 2019 | 204 Views
The video outlines the factors for success in completing a single-port subtotal hysterectomy, along with a description of the surgical technique used and its advantages.
Apr 15, 2019 | 213 Views
This video outlines a technique for performing ligation of the proximal uterine arteries. This is a technique that can be used to mitigate blood loss during hysterectomy.
Jul 5, 2019 | 193 Views
This video outlines the approach to radiofrequency ablation of uterine fibroids through the Acessa Procedure
Jul 5, 2019 | 260 Views
The bladder is the most common site of injury during laparoscopic hysterectomy. This video provides an approach to help avoid bladder injury during hysterectomy.
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 8, 2019 | 177 Views
This video reiews an interoperative thermal injury to the ureter followed by an attempt at concervative management.
Jul 10, 2019 | 297 Views
This video demonstrates laparoscopic resection and repair of a ceasarean section niche defect for the treatment of abnormal uterine bleeding.
Jul 12, 2019 | 228 Views
This video demonstrates a novel in which a tourniquet is applied during laparoscopic myomectomy to achieve hemostasis.
Sep 27, 2019 | 229 Views
Myomectomy is a common procedure performed by gynecologists for the conservative management of leiomyomas (fibroids). The surgical removal of fibroids can be associated with significant intraoperative blood loss and subsequent blood transfusion, which is an important morbidity associated with this elective procedure in reproductive-aged women. This video demonstrates various evidence-based strategies aimed at minimizing surgical bleeding during myomectomy. Techniques covered in this presentation include: (1) Preoperative use of medications such as vaginal/rectal misoprostal and intravenous tranexamic acid, (2) Intramyometrial injection of dilute vasopressin and (3) Temporary uterine artery occlusion with pericervical tourniquet. We demonstrate how these techniques can be used to minimize blood loss during abdominal, laparoscopic and robotic myomectomy.
Sep 27, 2019 | 330 Views
In this video, we demonstrate three approaches to uterine artery occlusion at time of laparoscopic myomectomy as a blood-sparing intra-operative technique. A step-wise approach is applied prior to beginning the myomectomy which includes the following: 1) Selecting the appropriate approach to uterine artery occlusion (lateral vs. posterior vs. anterior) based on individual anatomy; 2) identification of relevant anatomy and important landmarks for the procedure 3) isolating the uterine artery and identifying the ureter; 4) occluding the uterine artery. As illustrated in this video, uterine artery occlusion can be performed by three different approaches, depending on both surgeon preference and unique patient anatomy. A systematic review and meta-analysis of the literature supports the efficacy of this procedure in terms of limiting blood loss, blood transfusion, and fibroid recurrence, albeit at slightly longer operative times.
Sep 24, 2020 | 25 Views
In this video we present a laparoscopic approach to trachelectomy following supracervical hysterectomy. We outline statistics regarding supracervical versus total hysterectomy, the reasons why some patients may initially choose to keep their cervix, and the sequelae that eventually prompt trachelectomy in several cases. The main purpose of the video is to demonstrate a stepwise approach to trachelectomy using a relatively uncomplicated patient case. The five steps are to restore anatomy, create a bladder flap, perform anterior and posterior colpotomy, lateralize the uterine artery pedicles and finally, to close the vaginal cuff. We highlight this straightforward five-step process as potentially feasible for any practitioner who is already performing total laparoscopic hysterectomy. Although other cases may bear more complexity than the one demonstrated in this video, adherence to our approach can also be successfully applied in those situations.