STI Volume 31

 

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Surgical Technology International

31nd Edition

 

Contains 59 peer-reviewed articles featuring the latest advances in surgical techniques and technologies.

408 pages

December-2017 - ISSN:1090-3941

 

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both electronic and print versions

 

Gynecology

A Simplified Novel Approach for Total Laparoendoscopic Single-Site (LESS) Hysterectomy
Emad Mikhail, MB, ChB, MD, FACOG, FACS, Assistant Professor, Minimally Invasive Gynecologic Surgeon, Elisabeth Sappenfield, MD, Assistant Professor, Allison Wyman, MD, FACOG, Assistant Professor, Female Pelvic Medicine and Reconstructive Surgery, Stuart Hart, MD, MBA, MS, FACOG, FACS, Voluntary Faculty, Division of Female Pelvic Medicine and Reconstructive Surgery, University of South Florida/Morsani College of Medicine, Tampa, Florida, Director, Global Medical Affairs, Medical Director, Colorectal & Gynecologic Health, Medtronic PLC, Minneapolis, Minnesota

 

Abstract


Total laparoendoscopic single-site (LESS) hysterectomy is a technically challenging minimally-invasive gynecologic procedure. Multiple technological innovations assist surgeons to overcome the challenges that are usually encountered during this advanced approach. Simplifying the steps of this advanced surgery is an invaluable addition in overcoming associated challenges with this procedure. We present our novel technique for a total laparoscopic hysterectomy that will optimize a single-site approach (LESS) for surgeons.

903

2-08-2017

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Laparoscopic Excision of an Unusual Presentation of a Nabothian Cyst: Case Report and Review of the Literature
Joseph Nassif, MD, MBA, Associate Professor, Hasan Nahouli, Research Assistant, Faculty of Medicine, Ali Mourad, MD, Resident, Ryan Yammine, BS(C), Ali Khalil, MD, Professor, Obstetrics and Gynecology Department, American University of Beirut Medical Center, Beirut, Lebanon, Sally Khoury, MD, Obstetrician and Gynecologist, Bikhazi Medical Group, Trad Hospital Medical Center, Beirut, Lebanon

 

Abstract


Nabothian cysts are mucinous retention cysts formed through the accumulation of cervical mucus inside blocked cervical crypts leading to non-neoplastic mucinous cystic lesion in relation to the uterine cervix. The formation of Nabothian cysts is a common gynecological benign condition in women of reproductive age. While the presence of small-sized Nabothian cysts is usually clinically asymptomatic and requires no treatment or intervention, the diagnosis of larger Nabothian cysts can be mistaken with malignant tumors, including mucin producing carcinomas such as Adenoma malignum.
In this study, we report the case of a large Nabothian cyst that was correctly diagnosed preoperatively using ultrasonography and magnetic resonance imaging (MRI), and successfully treated through laparoscopic excision, avoiding the performance of unnecessary hysterectomy.
A 44-year old Lebanese patient presented with chronic dyspareunia and pelvic pain. An ultrasound was performed and revealed an 8cm multiloculated anechoic pelvic cystic lesion with no solid components. An MRI was performed and showed an 8cm mass lateral to the right vaginal wall, suggestive of a Nabothian cyst. The patient was scheduled for laparoscopic removal of the Nabothian cyst. The patient tolerated the procedure well and was discharged under stable condition a few hours after the operation.
Careful preoperative examination, including the use of imaging methods such as ultrasonogoraphy and MRI, is crucial for diagnosis and differentiation of atypical presentation of benign, but large and complex, Nabothian cysts from other differential conditions of malignancies, consequently avoiding unnecessary hysterectomy. Use of laparoscopy as a minimally-invasive technique to excise such cysts is considered a valid option, allowing for a fast recovery for the patients.

907

24-11-2017

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Polypropylene Mesh Sling for Stress Urinary Incontinence: Does Memory Shaping of the Polypropylene Mesh Matter?
Andrew Doering, MD, Obstetrician/Gynecologist, Mt. Carmel Health System, Columbus, Ohio, Ali Azadi, MD, MSc, MBA, Urogynecologist, Pelvic Health Center, St. Vincent Hospital for Women & Children, Evansville, Indiana, David Doering, MD, Assistant Medical Director, Norton Cancer Institute, Louisville, Kentucky, Donald R. Ostergard, MD, Professor-in-Residence, UCLA School of Medicine, Harbor/UCLA Medical Center, Torrance, California

 

Abstract


We report a case of a mid-urethral sling (Advantage Fit™, Boston Scientific Corporation, Marlborough, Massachusetts) freshly removed from its original package. Upon removal from the packaging, the sling was noted to have a deformation in positioning at the midpoint, with curvature opposite the natural curve of the sling in the body. The images show the comparison to a sling with the desired positioning. Mid-urethral slings are commonly made from polypropylene mesh which has memory properties. It is important that manufacturers ensure that any steps in the processing or packaging of slings do not result in changes in the shape of the sling that may have unknown impacts on its clinical outcome.

941

6-12-2017

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