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Laparoscopic Surgery in Infertility and Gynecology
Nutan Jain
CHAPTER 1:
OR Set-up and Basic Instrumentation for Gynecology Endoscopy
INTRODUCTION
Laminar Flow System
EDUCATION AND TRAINING
CONCLUSION
CHAPTER 2:
Laparoscopic Entry and Exit
INTRODUCTION
STEPS
PORT REMOVAL
Steps
SPECIAL MENTION OF OUR INNOVATIVE TECHNIQUE OF ENTRY
Use of Veress for CO2 Insufflation
CONCLUSION
USEFUL TIPS
CHAPTER 3:
Energy Sources
TYPES OF INSTRUMENTS
Monopolar
Bipolar
Argon Plasma Coagulator
Advantage
Disadvantages
Bipolar Vessel Sealing
Principle
Bipolar Cutting Electrodes
Ultrasonic Generators
Electrosurgical Complications
How to Minimize the Complications
Special Precaution with Monoplar
CONCLUSION
CHAPTER 4:
Anesthesia for Gynecological Laparoscopic Surgery
INTRODUCTION
ANESTHESIA FOR LAPAROSCOPY
Preoperative Assessment
Anesthesia Techniques
Local Anesthesia
Regional Anesthesia
General Anesthesia
Postoperative Care
IMPORTANT ANESTHETIC CONSIDERATIONS
Respiratory Complications
Reduced Compliance
Venous Gas Embolism
Other Infrequent Complications
Circulatory Complications
Patient Position
Obesity
Postoperative Benefits and Consequences of Laparoscopy
Postoperative Pain
Pulmonary Dysfunctions
Postoperative Nausea and Vomiting
Complication of Laparoscopy
SUMMARY
CHAPTER 5:
Laparoscopic Suturing
INTRODUCTION
INSTRUMENTS REQUIRED
PORT PLACEMENT
TECHNIQUE
Loading the Needle
Aligning the Needle
Making the Knot
Benefits of Letter V
CONCLUSION
CHAPTER 6:
Benign Ovarian Cyst
INTRODUCTION
PREOPERATIVE EVALUATION
INTRAOPERATIVE LAPAROSCOPIC EVALUATION
OPERATIVE PROCEDURES FOR BENIGN ADNEXAL MASSES
OVARIAN CYSTECTOMY
Intact Removal of the Cyst
Instruments Required
Steps of the Surgery
Aspiration and Excision of the Cyst Wall
Steps of the Surgery
Aspiration with Cyst Wall Ablation
Postoperative Course
Possible Complications
Special Precautions
CONCLUSION
CHAPTER 7:
Laparoscopic Surgery for Infertility
INTRODUCTION
GENERAL CONSIDERATION
PREOPERATIVE WORK-UP
Hysterosalpingography
Laparoscopy
Salpingoscopy
CLASSIFICATION OF TUBAL AND ADHESION SCORE
Tubal Score
Equipment
Equipment for Conventional Techniques
Technique of CO2 Laser
ADHESIOLYSIS
Indications
Special Cases
Salpingo-ovariolysis
Results
Neosalpingostomy
EVERSION OF FIMBRIA
COMPLICATIONS
RESULTS
Adhesion Prevention
Management of Hydrosalpinx
Postoperative of Course
DISCUSSION
Future Fertility Management
CONCLUSION
CHAPTER 8:
Ovarian Drilling
INTRODUCTION
PRESENT SCENARIO
MECHANISM OF ACTION
Changed Hormonal Melieu following Ovarian Drilling
TECHNIQUE
POSTOPERATIVE COURSE
ADVANTAGES
DISADVANTAGES
Possible Complications
Special Precautions
Future Fertility
FOLLOW-UP
CONCLUSION
CHAPTER 9:
Laparoscopic Management of Ectopic Pregnancy
INTRODUCTION
INCIDENCE
RISK FACTORS
SYMPTOMS
SIGNS
DIAGNOSIS
TREATMENT
LAPAROSCOPIC LINEAR SALPINGOSTOMY
Indication
Special Instruments
Surgical Steps
MILKING OUT
SEGMENTAL RESECTION
LAPAROSCOPIC SALPINGECTOMY (FIGS 9.9 TO 9.12)
Indication
Surgical Steps
Laparoscopy for Acute/Massive Ruptured Ectopic
Postoperative Course
Complications
Future Fertility
CONCLUSION
CHAPTER 10:
Management of Endometriotic Cyst
INTRODUCTION
INSTRUMENTS REQUIRED
Steps
Complications
Thoughts on Prevention
Postoperative Management
Future Fertility Management
CONCLUSION
CHAPTER 11:
Rectovaginal Endometriosis
INTRODUCTION
CLINICAL PRESENTATION
DIAGNOSIS
Transrectal Sonography
TREATMENT OPTIONS
Medical Management
Surgery
Special Instruments
Surgical Goal
Surgical Steps
Postoperative Course
Possible Complications
Results
SPECIAL PRECAUTIONS
CONCLUSION
CHAPTER 12:
Laparoscopic Myomectomy
INTRODUCTION
INDICATIONS
PREOPERATIVE SONOGRAPHY
PREOPERATIVE PREPARATION
Position of the Patient
Anesthesia
OPERATIVE STEPS
LAPAROSCOPIC-ASSISTED MINILAP MYOMECTOMY
Technique
Postoperative Course
Postoperative Follow-up and Pregnancy Rates
Complications
Special Precautions
CONCLUSION
CHAPTER 13:
Total Laparoscopic Hysterectomy
INTRODUCTION
ADVANTAGES OF TOTAL LAPAROSCOPIC HYSTERECTOMY
Various Manipulators
KOH Colpotomizer System
Clermont Ferrand Manipulator
Silicon Curved Tube
Patient's Positioning
Position of Trocars
TECHNIQUE OF TLH
BENEFITS OF TLH
Postoperative Course
Special Cases
Multiple Myomas
Multiple Previous Cesarean Sections
Lateral Dissection
Results
CONCLUSION
CHAPTER 14:
Prevention and Management of Complications of Laparoscopy
INTRODUCTION
RISK FACTORS
CONTRAINDICATIONS
Absolute
Relative
COMPLICATIONS
Anesthesia Related
Cardiothoracic Embarrassment
Detection
Management
Thoughts on Prevention
VENOUS GAS EMBOLISM
Detection
Clinical Signs
Monitors
Management
Thoughts on Prevention
Position Related Complications
Neuropathies
Thoughts on Prevention
Deep Vein Thrombosis
Management
Thoughts on Prevention
VERESS NEEDLE RELATED
Pre-peritoneal Placement
Detection
Management
Thoughts on Prevention
INJURY TO VESSEL AND VISCERA
Detection
Management
Thoughts on Prevention
PRIMARY TROCAR RELATED
Injury to Vessel and Viscera
Detection
Management
Thoughts on Prevention
ACCESSORY TROCAR RELATED INJURY
Injury to Vessel and Viscera
Detection
Management
Thoughts on Prevention
Electrosurgical Injury
Richter's Hernia or Sliding Hernia
Management
Thoughts on Prevention
Bowel Injury
Management
Thoughts on Prevention
Rectal Injury
Management
Thoughts on Prevention
Bladder Injury
Detection
Management
Thoughts on Prevention
URETERIC INJURY
Types of Injury
Detection
Management
Thought on Prevention
POSTOPERATIVE COURSE AND CHECKLIST FOR DETECTION OF COMPLICATIONS
CONCLUSION
INDEX
TOC
Index
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