Presentation is loading. Please wait.

Presentation is loading. Please wait.

Staring down the mouth of progress. Total Laparoscopic Hysterectomy with a Transvaginal Tube Tony McCartney & Andreas Obermair The Journal of the American.

Similar presentations


Presentation on theme: "Staring down the mouth of progress. Total Laparoscopic Hysterectomy with a Transvaginal Tube Tony McCartney & Andreas Obermair The Journal of the American."— Presentation transcript:

1 Staring down the mouth of progress

2 Total Laparoscopic Hysterectomy with a Transvaginal Tube Tony McCartney & Andreas Obermair The Journal of the American Association of Gynecologic Laparoscopists February 2004, Volume 11, Number 1:

3 Laparovaginal hysterectomy: A decade of evolution. Jennifer R. Cook, Robert T. O'Shea and Elvis I. Seman Australian and New Zealand Journal of Obstetrics and Gynaecology Volume 44 Issue 2 Pages , April 2004

4 Robert A. Jones (1993): Laparoscopic hysterectomy: a technique Australian and New Zealand Journal of Obstetrics and Gynaecology Volume 33: pages Laparoscopic hysterectomy: a series of 100 cases Medical Journal of Australia Volume 159: pages

5 Total Laparoscopic Hysterectomy with a Transvaginal Tube Tony McCartney & Andreas Obermair The Journal of the American Association of Gynecologic Laparoscopists February 2004, Volume 11, Number 1: The technique [of Total Laparoscopic Hysterectomy] has improved by the use of bipolar diathermy rather than laparoscopic stapling devices.

6 Laparovaginal hysterectomy: A decade of evolution Jennifer R. Cook, Robert T. O'Shea and Elvis I. Seman Australian and New Zealand Journal of Obstetrics and Gynaecology Volume 44 Issue 2 Pages , April 2004 With regard to one of the major aims of Laparoscopic hysterectomy of enhanced ureteric protection: staples are no longer used to achieve pedicle haemostasis in the vicinity of the ureter.

7 Tyco EndoGIA

8 A Review of Laparoscopic Ureteral Injury in Pelvic Surgery. Ostrzenski A, Radolinski B, Ostrzenski KM. Obstetrical and Gynecological Survey December 2003, Volume58: pages

9 Laparovaginal hysterectomy: A decade of evolution. Jennifer R. Cook, Robert T. O'Shea and Elvis I. Seman Australian and New Zealand Journal of Obstetrics and Gynaecology Volume 44 Issue 2 Pages , April 2004

10 Endo GIA UNIVERSAL

11 - DVD -

12

13 OUR URETERIC INJURY RATE FOR THE LAST 1,000 LAPAROSCOPIC HYSTERECTOMIES 0.1%

14 Incidence and management of gynaecological-related ureteric injuries. Aslan P, Andrew Brooks, Drummond M. Australian and New Zealand Journal of Obstetrics and Gynaecology April 1999, Volume 39: pages Abdominal hysterectomy ureteric injury rate of 0.24% Western Sydney

15 Urinary tract injuries after hysterectomy. Harkki-Siren P, Sjoberg J, Tiitinen A. Obstetrics and Gynecology July 1998, Volume 92: pages Abdominal hysterectomy ureteric injury rate of 0.4% - Finland

16 IN EXPERIENCED HANDS AND WITH THE RIGHT TECHNIQUE THE URETERIC INJURY RATE IS NO HIGHER FOR LAPAROSCOPIC HYSTERECTOMY THAN FOR ABDOMINAL HYSTERECTOMY

17 THE SECURING OF UTERINE VESSELS AT LAPAROSCOPIC HYSTERECTOMY WITH STAPLES IN EXPERIENCED HANDS MAY WELL OFFER SIMILAR IF NOT LOWER RATES OF URETERIC INJURY THAN DOES BIPOLAR DIATHERMY

18 IN THE EARLY DAYS OF LAPAROSCOPIC HYSTERECTOMY URETERIC INJURY RESULTED MORE FROM SURGICAL INEXPERIENCE AND TECHNIQUE DEVELOPMENT THAN OF INSTRUMENT FAILURE

19 WITH THE DEVELOPMENT OF APPROPRIATE TECHNIQUES AND SURGICAL EXPERTISE, THE CUTTER STAPLING DEVICE HAS A VALUABLE PART TO PLAY IN THE PERFORMANCE OF LAPAROSCOPIC HYSTERECTOMY

20 LEFT OVARY UTERUS: 510g

21 Total Laparoscopic Hysterectomy for Very Enlarged Uteri Arnaud Wattiez, M.D., D. Soriano, M.D., A. Fiaccavento, M.D., et al. The Journal of the American Association of Gynecologic Laparoscopists May 2002, Volume 9, Number 2: pp The main challenge is securing uterine vessels.

22 Laparoscopically-Assisted Vaginal Hysterectomy for Fibroid Uteri Weighing at least 500 grammes. Nesrin Salmanli and Peter Maher Australian and New Zealand Journal of Obstetrics and Gynaecology April 1999, Volume 39: pages

23 Endoscopic Stapling of Large Uterine Vessels at Laparoscopic Hysterectomy for Uterine Fibroid Masses Of 500g or more: a pilot study. Roger McMaster-Fay Gynecology Surgery 2004, Volume 1: pages

24

25 UTERUS: 1,255g


Download ppt "Staring down the mouth of progress. Total Laparoscopic Hysterectomy with a Transvaginal Tube Tony McCartney & Andreas Obermair The Journal of the American."

Similar presentations


Ads by Google