Resectoscopic metroplasty with uterine septum excision. an histologic analysis of the uterine septum
ConclusionThis study allowed us, by removing the entire septum as a whole structure, to redefine the concept of the septum as a complex structure based on islands of muscle fibers irregularly arranged in vertex, in a context of collagen tissue, similar to the structure of myomas. It appears to deeply involve the anterior and posterior uterine wall, resembling a “reverse letter H”.
ConclusionBy removing the septum as a whole structure, this study allowed us to redefine the concept of the septum as a complex structure according to the islands of muscle fibers irregularly arranged in vertex, in a context of collagen tissue and similar to the structure of myomas. It appears to deeply involve the anterior and posterior uterine walls, resembling a “reverse letter H.”
We present a case of a 36-year-old G0P0 with Abnormal Uterine Bleeding-Leiomyoma and resultant anemia undergoing hysteroscopic resection of a large, submucous fibroid. During surgery, the patient was found to have a critically elevated level of carboxyhemoglobin, and accompanying ECG derangements. She was managed with prolonged intubation, 100% O2, and trending of her carboxyhemoglobin levels before extubation.This demonstrates the importance of being cognizant of the potentially toxic gaseous byproducts of bipolar resection, and to include intravasation of these byproducts in one's consideration of patient safety during e...
We present a case of a 36-year-old woman (Gravida 0, Para 0) with abnormal uterine bleeding-leiomyoma and resultant anemia, undergoing hysteroscopic resection of a large submucous myoma.
Publication date: Available online 27 April 2019Source: Journal of Minimally Invasive GynecologyAuthor(s): Julian A Gingold, Anna Chichura, Mary Pat Harnegie, Rosanne M KhoAbstractObjectiveHysterectomy for uterine leiomyoma is associated with significant morbidity including blood loss. A systematic review and meta-analysis was conducted to identify non-hormonal interventions, perioperative surgical interventions and devices to minimize blood loss at the time of hysterectomy for leiomyoma.Data SourcesLibrarian-led search of Embase, Medline, Web of Science, Scopus, CINAHL and Cochrane databases from 1946-2018, with hand-guid...
Objective: To present a variety of techniques to aid in hysteroscopic surgical management of type 2 submucosal leiomyomas.
Purpose of review Submucosal uterine leiomyomas are a common benign pelvic tumor that can cause abnormal uterine bleeding and may contribute to infertility and miscarriage. Hysteroscopic myomectomy is the treatment of choice to alleviate bleeding from these myomas and to normalize the uterine cavity. This review discusses the techniques and recent evidence for hysteroscopic myomectomy and examines the two primary surgical tools employed today: the bipolar resectoscope and hysteroscopic mechanical morcellator. Recent findings Hysteroscopic myomectomy has been a popular treatment for symptomatic submucosal fibroids for ...
Conclusions ACUMs are hypothesized to represent a previously under recognized Müllerian anomaly linked to gubernaculum dysfunction that occurs in premenopausal women with dysmenorrhea and chronic pelvic pain. Uterine and fertility sparing laparoscopic resection is possible but challenging due to poorly defined planes.
We present a comparison of these technologies to better practitioners understanding of the strengths and limitations of these devices. PMID: 28537350 [PubMed - as supplied by publisher]
Conclusion This technique, based in part on a previously published technique of leiomyoma release, allows the electromechanical morcellator improved access to leiomyomas previously not accessible, and minimizes myometrial trauma by dissecting the tumor via the relatively avascular pesudocapsule.
Conditions: Uterine Leiomyomas; Endometrial PolypsIntervention: Device: Symphion® Bipolar Hysteroscopic Tissue Resection SystemSponsor: Boston Scientific CorporationCompleted - verified August 2015