Surgical Technology International
45th Edition
ISSN:1090-3941
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What Happens to Endometriosis During the Menstrual Cycle?
Ray Garry, BA, MD, FRCOG, FRANZCOG, Professor of Obstetrics and Gynecology (Retired) King Edward Hospital, University of Western Australia,Perth, Australia
1826
Introduction: The objective of this study is to determine the structural changes in endometriosis throughout the menstrual cycle. Materials and Methods: This retrospective comparative study was undertaken in a gynaecological unit of a university teaching hospital and looked at the immunohistochemical appearances of epithelial cells of the endometrium and endometriosis in 17 cases at various stages of the menstrual cycle, particularly during menstruation.
Results: The epithelium in endometriosis lesions undergoes the same cyclical morphologic changes that are observed in eutopic endometrium. In particular, each of the six cases of endometriosis observed during the active bleeding phase showed evidence of epithelial shedding of the terminally differentiated secretory-phase epithelial cells and their almost immediate replacement by small undifferentiated cells.
Conclusion: The cyclical shedding/regeneration of endometriotic epithelium during menstruation has not previously been recognised, and it may have significant implications for the understanding of the aetiology and best management of endometriosis.
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Robotic Assisted Lapendoscopic Single-Site Surgery for Ileal Deep Endometriosis. A Case Report and Review of Literature
Devon Marks, MD, University of South Florida/Morsani College of Medicine, Tampa, Florida, Ashley J. Alden, DO, Robert D. Bennett, MD, Associate Professor, Diana Encalada Soto, MD, Assistant Professor, Emad Mikhail, MD, FACOG, FAC, Associate Professor & Chief, University of South Florida/Morsani College of Medicine, Tampa, Florida
1827
The prevalence of deep endometriosis invading the bowel is unknown but has been estimated to affect between 3.8% and 37% of women with endometriosis. The most common locations of bowel endometriosis are the sigmoid colon and rectum. Endometriosis affecting the small bowel is exceedingly rare. Laparoendoscopic single-site port surgery (LESS) and robotic-assisted LESS (R-LESS) offer potential advantages in cosmesis and surgical recovery while safely and effectively treating disease. R-LESS is an effective and safe technique for surgical excision of deep endometriosis of the small bowel while utilizing the same access incision as a retrieval site for the surgical specimen. We present a case of a surgical excision of double nodules of deep endometriosis of the small bowel, that was managed using the R-LESS technique, and discuss the proposed advantages and technical challenges.
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Labia Majora Approach to Aesthetic and Functional Complaints. A Standardized Topographic Labia Majora Classification
Pablo González-Isaza, MD , Hospital Universitario San Jorge, Pereira, Colombia, Mauricio Wagner, MD, Hospital Universitario San Jose, Bogota, Colombia, Christine Hamori, MD, Cosmetic Surgery + Skin Spa, Boston, Massachusetts, Diana Vélez Rizo, MD, Fundacion Cardioinfantil Clinic, Bogota, Colombia, Gustavo Parra, MD, CES Hospital, Manizales, Colombia, Eva Guisantes, MD, Mandri Clinic, Barcelona, Spain, Derly Marcela Beltrán, MD, Compensar Clinic, Bogota, Colombia , Santiago Palacios, MD, Palacios Clinic for Women's Health, Madrid, Spain
1834
Functional and aesthetic aberrations of labia majora are poorly described in scientific literature, and there is a lack of standardization and algorithms for treatment. The labia majora differs from the labia minora in that it has transitional epithelium, fascia, erectile tissue, and adipose components connected to crural, pelvic, and perineal structures. Non-surgical treatments, such as radiofrequency and light-based therapy, must match the symptoms and target these unique structures to have an effect.
Our aim is to propose an algorithmic approach to the anatomical variants of the labia majora that are most bothersome to women and describe a step-by-step process to improve vulvar appearance and function.
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