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Clinical efficacy review on cases of laparoscopic myomectomy.

Jung Mi BYUN ; Dae Hoon JEONG ; Young Nam KIM ; Young Jin SEO ; Su Sun KIM ; Moon Su SUNG ; Ki Tae KIM ; Kyung Bok LEE

Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery.2012;24(1):14-20.

OBJECTIVE: To report the safety and clinical efficacy of laparoscopic myomectomy. METHODS: We analyzed retrospectively the data for 74 laparoscopic myomectomy performed at Inje University Busan Paik Hospital beween 2005 and 2009. With medical records, we analyzed data on the patient's age, parity, BMI, size, weight and location of myoma, previous operative history, preoperative indication, operating time, blood loss, change of hemoglobin concentration from preoperative to postoperative state, hospital stay. RESULTS: The mean age of the patients was 39.5+/-6.9 years, parity was 1.4+/-1.0 and BMI was 22.1+/-2.6 kg/m2. The size of myoma by preoperative ultrasonography was 5.2+/-1.9 cm, the weight of removed myoma was 95.1+/-88.1 g. Most myomas were subserosal and intramural type. The operating time was 95.9+/-34.4 minutes, the change of hemoglobin concentration was 1.3+/-0.78 g/dL, and the hospital stay was 4.7+/-1.1 days. Postoperatively, transfusion was done in 2 cases, one patient was pregnant and underwent an cesarean section delivery during follow-up. CONCLUSION: Laparoscopic myomectomy was performed regardless of the size, the location of the myoma or the previous operative history and had good outcomes without complications in our hospital. Laparosocpic myomectomy is considered safe and reliable procedure in various types of myoma.
Cesarean Section ; Female ; Hemoglobins ; Humans ; Length of Stay ; Medical Records ; Myoma ; Parity ; Pregnancy ; Retrospective Studies

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Single port laparoscopic surgery in gynecologic field.

Jung Ryeol LEE ; Ji Hyun KIM ; Chang Suk SUH ; Seok Hyun KIM

Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery.2012;24(1):1-13.

Nowadays, various techniques of minimally invasive surgery have been developed and a trend to perform less invasive surgery is accelerated. Reducing number of trocar insertion sites and scars is one example of this trend. Recently, single port laparoscopic surgery (SPLS) through one umbilical incision has been developed. This technique is adopted to various operations for adnexal and uterine surgery and initial reports on this novel technique have been published. Single port laparoscopic surgery is a novel technique of minimally invasive surgery and it has become more popular in gynecologic surgery field during recent years. In this article we review instrument and techniques for SPLS and we also review recent published articles for elucidating the evidence of this novel technique.
Cicatrix ; Female ; Gynecologic Surgical Procedures ; Laparoscopy ; Surgical Instruments

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A large paraovarian cyst torsion in a 73-year-old patient: case report and review of the literature.

Kylie Hae-jin CHANG ; Young Lan LEE ; Kong Ju CHOI ; Jin Young KANG ; Sung Ho PARK

Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery.2011;23(2):99-102.

Although paraovarian cysts rarely cause symptoms, they may be complicated due to massive size, torsion or internal hemorrhage from rupture. Moreover, benign or malignant neoplasms may occasionally develop in paraovarian cysts. We present a case of a 73-year-old patient who suffered from a twisted large left paraovarian cyst. The patient visited emergency room with a chief complaint of acute abdominal pain. The patient was treated with good result by laparoscopic surgery. The maximum diameter of the mass was 10cm which was twisted 3 1/2 times clockwise. In conclusion, paraovarian cysts, even in elderly patients, can reach large sizes requiring awareness of the possible complications caused by large cyst which could be treated successfully by laparoscopy.
Abdominal Pain ; Aged ; Emergencies ; Hemorrhage ; Humans ; Laparoscopy ; Rupture

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A case of ipsilateral ruptured cornual pregnancy after salpingectomy for tubal pregnancy: 2-port pelviscopic cornual resection using a multichannel port.

Young Jae LEE ; Sang Wook YI

Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery.2011;23(2):94-98.

Cornual pregnancy is a rare type of ectopic pregnancy. Its incidence is 2-4% of all tubal pregnancy. Cornual pregnancy is relatively rare in the woman who has the history of ipsilateral salpingectomy. The standard treatment of cornual pregnancy was cornual resection or hysterectomy through laparotomy. Recently, pelviscopic cornual resection has been performed with the advance of technique and instruments. We performed 2-port pelviscopy using a multichannel port in the case of ipsilateral ruptured cornual pregnancy after salpingectomy for tubal pregnancy. This method was relative safe and easy and offers the advantages in reduced surgical morbidity, less bleeding and less operation time. Therefore, we present a case of ipsilateral cornual pregnancy after salpingectomy that surgically treated under 2-port pelviscopy with a brief review of literature.
Female ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Laparotomy ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Salpingectomy

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A case of laparoscopic assisted suture of small bowel perforation.

Sun Wook JUNG ; Jun Yong CHOI ; So Jin SHIN ; Sang Hoon KWON ; Gun Ho LEE ; Chi Heum CHO ; Soon Do CHA

Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery.2011;23(2):89-93.

The use of laparoscopic surgical techniques is now being applied to a variety of operations traditionally performed in an open fashion. The indication for surgery included polyps, obstruction, bleeding, and perforation. Small bowel perforation was usually treated with open surgery, but now, laparoscopic-guided bowel surgery is technically feasible and should translate into shorter hospitalization and less patient discomfort. Recently, we successfully treated a case of laparoscopic assisted suture of small bowel perforation. Here we report this case with a brief review of literature.
Hemorrhage ; Hospitalization ; Humans ; Polyps ; Sutures

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Two cases of torsion of subserosal leiomyoma and literature review.

Young Joo KIM ; Yong Wook JUNG ; Young Se PARK ; Du Sik KONG ; Gun Ho LEE

Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery.2011;23(2):84-88.

Leiomyoma is the most common benign uterine tumor, but acute torsion of myoma is extremely rare. We experienced two patients admitted to our hospital for acute abdominal pain, who diagnosed with torsion of subserosal myoma. Although ultrasonogram revealed a subserosal myoma in both cases, it could not confirm torsion of uterine fibroid. Laparoscopic surgery confirmed the diagnosis of acute torsion of myoma and resected the lesion successfully.
Abdominal Pain ; Humans ; Laparoscopy ; Leiomyoma ; Myoma

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Vaginal vault evisceration after total laparoscopic hysterectomy.

Daehyun PARK ; Hyangjin JEONG

Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery.2012;24(2):120-126.

OBJECTIVE: Fourteen cases of vaginal vault evisceration after total laparoscopic hysterectomy were presented. We review pertinent literature, discuss precipitating causes, clinical manifestations, and management that was performed. METHODS: We reviewed medical records of 14 women with vaginal vault evisceration after total laparoscopic hysterectectom between March 2000 and October 2012 at 4 hospitals of CHA University. RESULTS: Between March 2000 and March 2006, 1,887 women underwent total laparoscopic hysterectomy and 12 vaginal vault eviscerations (0.6%) were presented. Thereafter, only two new cases were presented. The precipitating event was coitus in nine cases (64%), sit-ups in two cases (14%), spontaneous (urine ascites), lymphatic ascites, and unknown in one case (7%) each. Prolapsed organs were small bowels, omentum, and salpinx. Common presenting symptoms were pain, bleeding, watery discharge, and protruded mass (bowels). Eleven women underwent transvaginal repair (79%) - two laparotomic (14%) and one laparoscopic (7%), and none have exhibited sequelae. CONCLUSION: Coitus was the triggering event in most cases. For vaginal vault evisceration following total laparoscopic hysterectomy, vaginal repair should be first considered.
Ascites ; Coitus ; Fallopian Tubes ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Medical Records ; Omentum

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The review of laparoscopic adnexa tumor surgery through Douglas pouch.

So Young PARK ; Hyuk JUNG

Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery.2012;24(2):115-119.

OBJECTIVE: To evaluated the result of laparoscopic surgery of adnexal tumors and removing excised tissue through Douglas pouch incision. METHODS: 110 patient who had visited Chosun University Hospital department of Obstetrics and Gynecology between January, 2011 to April, 2012 were involved in the study. Patient had laparoscopic surgery on the adnexal tumor and excised tissue was removed through Douglas pouch incision by single surgeon. RESULTS: The mean age of patients were 41.5 years. The size of the tumor varied from 3 cm to 27 cm in size using ultrasonography. The mean operation time was 61.3 minutes and the mean admission period was 4.2 days. 82 patient had salpingo-oophorectomy or oophorectomy, 19 had ovarian cystectomy, 2 had wedge resection and 4 had tumor enucleation. Histologic result reveal endometriosis in 23 patients (20.9%). teratoma in 21 (19%), serous cystadenoma in 14 (12.7%) and mucinous cystadenoma in 10 (9.1%). Other histologic finding includes hemorrhagic cyst, luteal cyst and paratubal cyst. There was no complication including bladder or rectal injury, suture site infection. CONCLUSION: Laparoscopic surgery of adnexal tumor and removal by Douglas pouch incision is a simple, safe and efficient method that could be considered as an alternative minimally invasive technique.
Cystadenoma, Mucinous ; Cystadenoma, Serous ; Cystectomy ; Douglas' Pouch ; Endometriosis ; Female ; Gynecology ; Hospital Departments ; Humans ; Laparoscopy ; Obstetrics ; Ovariectomy ; Parovarian Cyst ; Sutures ; Teratoma ; Urinary Bladder

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Clinical experiences of the levonorgestrel-releasing intrauterine system in Korean women with adenomyosis.

Da Hee KIM ; Dong Soo PARK ; Mi La KIM ; Bo Sung YOON ; Taejong SONG ; Mi Kyung KIM ; Hye Sun JUN ; Seok Ju SEONG

Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery.2012;24(2):108-114.

OBJECTIVE: To analyze the clinical experiences of patients who treated with levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis associated with dysmenorrhea and/or menorrhagia. METHODS: The LNG-IUS was inserted into 103 patients who were diagnosed with adenomyosis on ultrasound examination and suffered from dysmenorrhea or menorrhagia at CHA Gangnam Medical Center between January 2009 and December 2009. Symptomatic changes of dysmenorrhea and menorrhagia, side effects, and failure rates were evaluated, retrospectively. RESULTS: During the follow-up periods, dysmenorrhea was improved in 91.4% and menorrhagia was improved in 90.4% of patients. Most common side effects were prolonged vaginal spotting in 41 (39.8%), and expulsion of LNG-IUS in 32 (31.1%) patients. Six (5.7%) patients were premature removal of LNG-IUS and 9 (8.5%) patients were underwent hysterectomy. Overall 77 (74.8%) patients continued to use of LNG-IUS. CONCLUSION: The LNG-IUS is effective treatment option for management of dysmenorrhea and menorrhagia for patients with clinical diagnosis of adenomyosis. It seemed to be an alternative treatment method before hysterectomy.
Adenomyosis ; Dysmenorrhea ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Menorrhagia ; Metrorrhagia

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Laparoscopic management of endometrial cancer according to body mass index; a Korean Outcome Research & Analysis in Gynecologic Cancers (KORAGCs) Study.

In Ho LEE ; Byoung Gie KIM ; Jong Hyeok KIM ; Myong Cheol LIM ; Dae Gy HONG ; Kwang Beom LEE ; Jung Hun LEE ; Seok Ju SEONG ; Chi Heum CHO ; Sang Wun KIM ; Kyung Taek LIM

Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery.2012;24(2):100-107.

OBJECTIVE: To compare clinicopathologic characteristics and surgical outcomes of laparoscopic surgery in women with endometrial cancer according to body mass index (BMI). METHODS: From June 2009 to October 2010, prospective observational study without randomization of 159 patients treated by laparoscopic surgery from 10 hospitals nationwide. RESULTS: Patients were divided according to the WHO guidelines for Asia-Pacific populations and the distributions of BMI were as follows: 3 patients (1.9%) in underweight (BMI < 18.5 kg/m2), 50 patients (31.4%) in normal weight (BMI, 18.5-22.9 kg/m2), 45 patients (28.3%) in overweight (BMI, 23.0-24.9 kg/m2), 49 patients (30.8%) in obese (BMI, 25.0-29.9 kg/m2), and 12 patients (7.5%) in morbid obese (BMI > or = 30.0 kg/m2). Age, history of previous surgery, surgery extend, and history of previous surgery were not different between non-obese patients (BMI < 25.0 kg/m2) and obese patients (BMI > or = 25.0 kg/m2). Co-morbidities were more common in obese patients but marginally significant (23.5% vs. 37.7%, p=0.072). Four patients (2.5%) were converted to abdominal surgery because of severe adhesion. Regarding to surgical outcomes, operation time was significantly longer in obese patients (199 min vs. 235 min, p=0.013) but blood loss, lymph node yield, hospital stay, Foley removal, transfusion rate and peri-operative complication were not statistically significant. Regarding to pathologic results, there were no difference in terms of lymphovasucular space invasion, tumor grade, histologic type, lymph node metastasis and FIGO stage. CONCLUSION: Clinicopathologic characteristics and surgical outcomes does not seem to be significantly influenced by BMI except operation time. So the laparoscopic approach can be the alternative method for obese patients.
Body Mass Index ; Endometrial Neoplasms ; Female ; Humans ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Neoplasm Metastasis ; Obesity ; Overweight ; Prospective Studies ; Random Allocation ; Thinness

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