Uterine & Internal Iliac Artery Ligation: Anatomy and Clinical Applications for Benign Gynecology

Apr 15, 2019 | 451 Views

Ally Murji, Mara Sobel, Nicholas Leyland

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.

Appendectomy in Gynecology

Apr 15, 2019 | 372 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.

Proximal Uterine Artery Ligation: Navigating Anatomical Distortion of Large Fibroids During Hysterectomy

Apr 15, 2019 | 369 Views

Wilson Chan, Chandrew Rajakumar

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.

Approach to Excision of Superficial Endometriosis

Apr 15, 2019 | 482 Views

Michael Suen, Cici Zhu, Kristina Arendas, Sukhbir Sony Singh

This video describes a two-step approach to the excision of superficial endometriosis.

Laparoscopic Single-Port Subtotal Hysterectomy – Technique & Advantages

Apr 15, 2019 | 397 Views

Chandrew Rajakumar, Chantal Brace, M. Burns, Jackie Thurston

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.

Approach to the Difficult Laparoscopic Hysterectomy: Bladder Adhesions

Jul 5, 2019 | 509 Views

Neeraj Mehra, Sukhbir Sony Singh

The bladder is the most common site of injury during laparoscopic hysterectomy. This video provides an approach to help avoid bladder injury during hysterectomy.

Radiofrequency Ablation of Symptomatic Uterine Fibroids: The Acessa Procedure

Jul 5, 2019 | 430 Views

David J. Levine

This video outlines the approach to radiofrequency ablation of uterine fibroids through the Acessa Procedure

En Bloc Resection of Deep Infiltrating Endometriosis with a Novel Tissue Extraction and Anastomotic

Jul 8, 2019 | 362 Views

Brigid Nee, Sarah Mah

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.

Approach to the Obliterated Cul-De-Sac

Jul 8, 2019 | 815 Views

Devon Evans, Michael Suen, Vincent della Zazzera, Sukhbir Sony Singh

This video describes a laparoscopic approach to the obliterated cul-de-sac in the setting of endometriosis

Novel Management of Ureteral Endometriosis

Jul 8, 2019 | 402 Views

W. Al-Shayeji, Brian Blew, Hisham Khalil, Hassan Shenassa, Sukhbir Sony Singh

This video demonstrates a unique approach to the management of ureteral endometriosis.

Ureteric Thermal Injury: An Attempt at Conservative Management

Jul 8, 2019 | 351 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.

Surgical Management of Diaphragmatic Endometriosis

Jul 8, 2019 | 401 Views

Cici Zhu, Michael Suen, Sebastien Gilbert, Margaret Ann Fraser, Sukhbir Sony Singh

This video demonstrates the surgical management of diaphragmatic endometriosis.

Laparoscopic Resection of a Caesarean Section Niche Defect for Treatment of Abnormal Uterine Bleeding

Jul 10, 2019 | 540 Views

Kirsti Ziola, Darrien Rattray, John Thiel

This video demonstrates laparoscopic resection and repair of a ceasarean section niche defect for the treatment of abnormal uterine bleeding.

Novel Technique for Hemostasis at Laparoscopic Myomectomy: Tourniquet Application

Jul 12, 2019 | 436 Views

Katie Phillips, Caitlin Dunne, Neeraj Mehra

This video demonstrates a novel in which a tourniquet is applied during laparoscopic myomectomy to achieve hemostasis.

Uterine Artery Occlusion at Myomectomy

Sep 27, 2019 | 636 Views

Andrew Zakhari, Ari Sanders, Ally Murji

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.

Intraoperative Strategies to Minimize Blood Loss During Myomectomy

Sep 27, 2019 | 701 Views

Alysha Nensi, Deborah Robertson

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.

A Stepwise Approach to Trachelectomy

Sep 24, 2020 | 259 Views

Leah Rusnell, Deanna Buitenhuis, Darrien Rattray

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.