STI Volume 32

 

$195.00

Surgical Technology International

 

32nd Edition

 

New Online Studies

 

Online First - April, 2018

 

 

1 year Institutional Subscription 

both electronic and print versions

 

Gynecology

Total Laparoscopic Hysterectomy in the Setting of Prior Bilateral Renal Transplant, a Case Report and Review of the Literature
Nupur Tamhane, MD, Research Scholar, Entidhar Al Sawah, MD, Assistant Professor, Department of Obstetrics and Gynecology, University of South Florida, Tampa, Florida, Emad Mikhail, MB, ChB, MD, FACOG, FACS, Assistant Professor, Minimally Invasive Gynecologic Surgeon, Department of Obstetrics and Gynecology, University of South Florida/Morsani College of Medicine, Tampa, Florida

974

Abstract


In recent years, more women are undergoing renal transplantation as a treatment for end-stage renal disease. Women with kidney transplants are prone to certain gynecologic issues which might necessitate hysterectomy. Laparoscopic hysterectomy can safely be performed in patients with prior unilateral or bilateral renal transplantation. Laparoscopy offers magnification of anatomy, decreased wound-related problems, and continuation of immunosuppression therapy. We present a case report and review of the literature for total laparoscopic hysterectomy and bilateral salpingectomy for a patient with prior bilateral renal transplant.

 

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Endometrial Ablation: Past, Present, and Future, Part I
Morris Wortman, MD, FACOG, Director, Center for Menstrual Disorders, Clinical Associate Professor Gynecology, University of Rochester Medical Center, Rochester, New York

987

 

Abstract


Endometrial ablation (EA) is a commonly performed minimally invasive technique to manage intractable uterine bleeding that is unresponsive to medical therapy. It originated in ancient times when chemical astringents were used to control uterine hemorrhage associated with childbirth and a variety of other gynecologic conditions. In the late 19th century, the use of astringents and chemical cauterants gave way to the application of a variety of thermal energy technologies to cause selective destruction of the endometrium. These energy sources—steam, electricity, and even gamma rays—were applied blindly and were, by all accounts, quite effective at a time when hysterectomy was unsafe, infrequent, and generally unavailable.
With the emergence of improved optics and laser and video technology in the late 20th century, a resurgence of interest in endometrial ablation began—coinciding with a time when hysterectomy was commonly performed in developed countries. Endometrial ablation underwent a revolutionary change as physicians searched for new techniques to perform selective endometrial destruction under direct visual—hysteroscopic—control. In this first of a two-part series, we will explore the first and second generations of endometrial ablation to understand how this procedure has evolved into its present status and what issues remain to be solved.

 

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Successful Treatment of Endometriosis-Related Hemorrhagic Ascites: A Report of Three Cases
Sofia Mendes, MD, Chief Resident, Catarina Carvalho, MD, Chief Resident, Gonçalo Rodrigues, MD, Clinical Assistant, Sónia Barata, MD, Clinical Assistant, Centro Hospitalar Lisboa Norte, Hospital Santa Maria, Lisboa, Portugal, Carlos Calhaz-Jorge, PhD, MD, Chief of Gynecology Department, Obstetrics and Gynecology Department, Centro Hospitalar Lisboa Norte, Hospital Santa Maria, Lisboa, Portugal, Faculdade de Medicina de Lisboa, CAML, Centro Académico de Medicina de Lisboa, Lisboa, Portugal, Filipa Osório, MD, Head of Minimally Invasive Surgery Unit, Hospital da Luz, Minimally Invasive Surgery Department/Obstetrics and Gynecology Department, Centro Hospitalar Lisboa Norte - Hospital de Santa Maria, Lisboa, Portugal

992

 

Abstract


Endometriosis-related ascites is rare and is frequently confused with an ovarian malignancy. Since it affects women in reproductive age, its diagnosis and therapy are even more challenging. These patients usually present with abdominal distension, pelvic pain, and weight loss, but a careful questioning usually reveals the typical endometriosis symptoms—such as dysmenorrhea and dyspareunia. We present three cases of endometriosis-related ascites, one of them with pleural effusion. All cases were associated with extensive disease and required laborious laparoscopic surgery, medical therapy with gonadotropin releasing hormone analogs, and long-term follow-up. One of the patients delivered twins following an in vitro fertilization (IVF) cycle without recurrence of ascites. We aim to raise awareness toward the importance of considering endometriosis in a patient with ascites of unknown origin.

 

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