Single port access surgery can be the next generation of minimally invasive surgery. It has been tried in various diseases of surgery, urology, and gynecology. It was introduced in Korea and its field is widening. Total hysterectomy is the most common operation in gynecology. However, single port total laparoscopic hysterectomy (TLH) had been hardly performed due to technical difficulties. Author has successfully performed single port transumbilical TLH and right adnexectomy in a patient who had adenomyosis, uterine myoma, and right ovarian serous cystadenoma. One laparoscope and 2 instruments were inserted in 3 cannulas of the port that was made up with a wound retractor and a surgical glove. Laparoscopic suturing was done after total hysterectomy and right adnexectomy. During the operation, only commonly used laparoscopic instruments (straight and rigid) were used. All the procedures were completed without any complications and there were neither postoperative complications nor visible scars. Author reports the first single port transumbilical TLH case in Korea that showed satisfying results.
Adenomyosis ; Catheters ; Cicatrix ; Cystadenoma, Serous ; Gloves, Surgical ; Gynecology ; Humans ; Hysterectomy ; Korea ; Laparoscopes ; Myoma ; Postoperative Complications ; Urology

Serous cystadenoma of the pancreas is a rare disease and is usually benign. Mucinous cystadenoma, another cystic neoplasm of the pancreas, has a malignant potential. Serous cystadenoma is usually composed of many small cysts lined by small, cuboidal or flattened cells containing abundant glycogen. With the finding of endoscopic retrograde pancreatography, a communication between the cyst and pancreatic duct is observed occasionally in the mucinous cystadenoma, but rarely in the case of serous cystadenoma of the pancreas. We experienced a case of serous cystadenoma of the pancreas that had a communication between a cyst and the pancreatic duct.
Adult ; Cystadenoma, Serous/*complications ; Digestive System Fistula/*complications ; Female ; Humans ; Pancreatic Diseases/complications ; *Pancreatic Ducts ; Pancreatic Neoplasms/*complications

OBJECTIVE: To evaluate the feasibility and effectiveness of laparoscopic adnexal surgery in posthysterectomy patients and review clinical characteristics including comparison of the adhesion score of left with that of right adnexal mass. METHODS: From February 2004 to January 2007, we reviewed the medical records of 23 post-hysterectomy patients who received laparoscopic adnexal surgery including age, parity, type of hysterectomy, operative indications, histopathological diagnosis, operating time, size of the adnexal mass, adhesion score, change in the hemoglobin level, hospital stay, and any complications. RESULTS: The median age of patients was 48 years (range 35-69 years), and median parity was 2 (0-3). The median operating time was 100 minutes (range 35-180 minutes), and the median size of the adnexal mass was 7.1 cm (range 4-12 cm). The median change in hemoglobin level was 1.8 g/dL (range 0.6-4.1 g/dL). The median hospital stay was 4 days (range 3-19 days). The adhesion score was significantly higher in the left adnexal mass than in the right adnexal mass. Histopathological diagnosis included 6 cases of mucinous cystadenoma, 6 cases of functional cyst, 4 cases of hydrosalpinx, 3 cases of serous cystadenoma, 1 case of fibrothecoma, 1 case of mucinous adenofibroma, 1 case of endometrioma, and 1 case of tubo-ovarian abscess. There were no intraoperative complications or conversion to laparotomy. One case of postoperative ileus was noted. CONCLUSION: The skilled laparoscopic surgeon is capable of achieving successful result by performing laparoscopic surgery primarily to patients with adnexal mass for posthysterectomy patients who are expected to suffer severe adhesion. In posthysterectomy patients, left adnexal mass has more extensive adhesion than right adnexal mass, and these finding was represented as a high adhesion score of left adnexal mass.
Abscess ; Adenofibroma ; Cystadenoma, Mucinous ; Cystadenoma, Serous ; Diagnosis ; Endometriosis ; Female ; Humans ; Hysterectomy ; Ileus ; Intraoperative Complications ; Laparoscopy ; Laparotomy ; Length of Stay ; Medical Records ; Mucins ; Parity

OBJECTIVE: To evaluate the feasibility and outcome of surgical management of large benign ovarian cysts using ultra-minilaparotomy. METHODS: Twenty-five patients underwent ultra-minilaparotomy that involved a <3 cm skin incision for benign ovarian cysts with maximum diameter > or =10 cm. Patients' characteristics, operative time, estimated amount of blood loss (EBL), operative complications, postoperative outcomes and the pathological findings were examined. RESULTS: The mean age was 37 years (range 19 to 78 years). Body mass index were 23 (range 16 to 34). The maximum diameter of the ovarian cysts ranged from 10 to 28 cm (mean of 12 cm). The mean (range) operative time was 38 minutes (25 to 80 minutes). The median (range) EBL was 40 mL (20 to 120 mL). No patients received blood transfusion. The median (range) post-operative hospital stay was 2 days (1 to 3 days). There were no operative or post-operative complications. The surgical procedures performed were ovarian cystectomy (17 cases), unilateral salpingo-oophorectomy (6 cases) and unilateral oophorectomy (2 cases). The pathology findings include eight endometriotic cysts, seven mucinous cystadenoma, five dermoid cysts, four serous cystadenoma and one ovarian fibroma. CONCLUSION: Utra-minilaparoptomy is feasible and safe minimally invasive strategy for managing patients with large ovarian cysts.
Blood Transfusion ; Body Mass Index ; Cystadenoma, Mucinous ; Cystadenoma, Serous ; Cystectomy ; Dermoid Cyst ; Female ; Humans ; Laparotomy ; Length of Stay ; Operative Time ; Ovarian Cysts ; Ovariectomy ; Postoperative Complications ; Skin

Genital tuberculosis involving the ovary in a non-immunocompromised individual is rare. We report a case of coexisting ovarian serous cystadenoma and tuberculosis in a 29-year-old Indian woman. Clinical examination revealed the presence of an abdominal mass suspicious for ovarian neoplasm. Histopathological evaluation revealed ovarian neoplasm and concomitant tuberculosis. To the best of our knowledge, and after an extensive search of the literature, the coexistence of benign ovarian neoplasm and tuberculosis has not been previously documented.
Adult ; Antitubercular Agents ; therapeutic use ; Cystadenoma, Serous ; complications ; surgery ; Female ; Humans ; Ovarian Diseases ; complications ; drug therapy ; surgery ; Ovarian Neoplasms ; complications ; surgery ; Tuberculosis, Female Genital ; complications ; drug therapy ; surgery