Practical Manual for LAPAROSCOPIC AND HYSTEROSCOPIC GYNECOLOGICAL SURGERY
Practical Manual for LAPAROSCOPIC AND HYSTEROSCOPIC GYNECOLOGICAL SURGERY
THIRD EDITION
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Practical Manual for Laparoscopic and Hysteroscopic Gynecological Surgery
First Edition: 2007
Second Edition: 2013
Third Edition: 2020
9789352701940
Printed at
All patients placing their trust in us
- Abhishek Mangeshikar MS
- Gynecologist
- Mangeshikars' MAGIC for Women
- Mumbai, Maharashtra, India
- Aishwarya Puntambekar
- Galaxy Laparoscopy Institute
- Pune, Maharashtra, India
- Alessandro Loddo MD
- Clinica Ginecologica Ostetrica e di Fisiopatologia della
- Riproduzione Umana
- Università degli studi di Cagliari
- Caligari, Italy
- Alexandros Bader MD FAAOCG FISCG
- Consultant (Obstetrician and Gynecologist)
- President of European Society of Aesthetic Gynecology (ESAG)
- Director
- Bader Medical Institute of London
- Pelvic Floor Reconstruction, Cosmetic and Aesthetic Gynecology, Endoscopy Surgery
- London, UK
- Alfonso Rossetti MD
- Priv. Doz. Dr. Andreas Hackethal
- Frauenklinik an der Elbe, Oberbaumbrücke 1, 20457 Hamburg, Germany
- Andrea Tinelli MD PhD
- Professor
- Department of Obstetrics and Gynecology
- Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy
- Vito Fazzi Hospital, Lecce, Italy
- The International Translational Medicine and Biomodelling Research Group, Department of Applied Mathematics,
- Moscow Institute of Physics and Technology
- (State University)
- Moscow Region, Russia
- Andreas Hackethal
- Department of Obstetrics and Gynecology
- Universitaetsklinikum Giessen und Marburg GmbH
- Giessen, Germany
- Antonio Malvasi MD
- Professor
- Department of Obstetrics and Gynecology
- Santa Maria Hospital
- GVM Care and Research
- Bari, Italy
- The International Translational Medicine and
- Biomodelling Research Group
- Artin Ternamian MD
- Department of Obstetrics and Gynecology
- Faculty of Medicine, University of Toronto
- Director, Gynecologic Endoscopy
- St Joseph's Health Centre, Toronto, Canada
- Bahareh Hamedi MD
- Department of Obstetrics and Gynecology
- Shiraz University of Medical Sciences
- Shiraz, Iran
- Bernd Bojahr Pasacica
- Head
- Department of Gyenocology of the Clinic for Minimal Invasive Surgery (MIC-Klinik)
- Deputy of the certified Endometriosis Center of the clinic for MIC-Klinik
- Founding Member of Minimally Invasive Teaching Academy of the Clinic for MICC Berlin, Germany
- Professor
- Department of Gynecology and Obstetrics
- University Medicine Greifswald
- Greifswald, Germany
- Bernd Holthaus MD
- Head
- Department of Obstetrics and Gynecology
- St Elisabeth Hospital
- Damme, Germany
- Bruno van Herendael
- ZNA Stuivenberg
- Lange Beeldekensstraat
- Antwerpen, Belgium
- Carolin Spüntrup MD
- Hohe Wacht 77
- 66119 Saarbrücken
- CY Liu MD
- Professor of Clinical Obstetrics and Gynecology
- Department of Obstetrics and Gynecology
- University of Tennessee College of Medicine
- Chattanooga, Tennessee, USA
- De Wilde RL MD PhD
- University Hospital for Gynecology
- Carl von Ossietzky University Oldenburg
- Germany
- Douglas E Ott MD MBA
- Adjunct Professor (Biomedical Engineering)
- Adjunct Professor (Business and Economics)
- Mercer University
- Macon, Georgia, USA
- Elmar Spüntrup Diplom-Physiker
- Hohe Wacht 77
- 66119 Saarbrücken
- Flemming Bjerrum MD PhD
- Resident
- Department of Surgery
- Herlev Hospital
- Denmark
- Frederike Egberts
- Department of Dermatology, Venereology and Allergology
- University Hospitals Schleswig-Holstein
- Kiel, Germany
- Garri Tchartchian MD
- Head
- Department of Gyenocology of the Clinic for Minimal Invasive Surgery (MIC-Klinik)
- Head
- Center for Difficult Cases of the Clinic for MIC-Klinik
- Berlin, Germany
- Goentje Peters MD
- Department of Obstetrics and Gynecology
- University Hospitals Schleswig-Holstein
- Kiel, Germany
- Guenter K Noé MD PhD
- Priv Doz Dr med
- University of Witten/Herdecke
- Communal Clinics Rhein Kreis Neuss
- Dormagen, Germany, NRW
- Hans-Rudolf Tinneberg
- Department of Obstetrics and Gynecology
- Universitaetsklinikum Giessen und Marburg GmbH
- Giessen, Germany
- Haytham Elmeligy MBBCH MSc (Alexandria)
- Senior Consultant
- St Elisabeth Hospital
- Damme, Germany
- Ibrahim Alkatout PhD MD
- Director
- Kiel School of Gynaecological Endoscopy
- Department of Obstetrics and Gynecology
- University Hospitals Schleswig-Holstein
- Kiel, Germany
- Ingo von Leffern MD
- Director of Albertinen Women's Clinics
- Head
- Department of Gynecology and Obstetrics
- Albertinen Hospital Hamburg, Germany
- Ivo Meinhold-Heerlein
- Professor
- Justus-Liebig-Universität Gießen
- Universitätsklinikum
- Klinikstr 32
- Giessen, Germany
- J Marek Doniec MD
- Private Office for Endoscopic Gastroenterology and Proctology
- Kiel, Germany
- Jan F Baekelandt MD
- Gynecologic Oncology Surgeon
- Imelda Hospital
- Bonheiden, Belgium
- Janesh Gupta MSc MD FRCOG
- Professor of Obstetrics and Gynecology
- Editor-in-Chief of EJOG
- Centre for Women's and Newborn Health
- Institute of Metabolism and Systems Research (IMSR)
- University of Birmingham
- Birmingham Women's and Children's NHS Foundation Trust
- Birmingham, England, UK
- Johannes Ackermann MD
- Department of Obstetrics and Gynecology
- University Hospitals Schleswig-Holstein
- Kiel, Germany
- John E Morrison MD
- Louisiana State University Health Sciences Center (LSUHSC)
- Department of Surgery
- New Orleans, Louisiana, USA
- Julia Ionesi-Pasacica MD
- Department of Obstetrics and Gynecology
- Universitaetsklinikum Giessen und Marburg GmbH
- Giessen, Germany
- Khulkar Abdusattarova MD
- Department of Obstetrics and Gynecology
- University Hospitals Schleswig-Holstein
- Campus Kiel, Germany
- Kubilay Ertan
- Department of Obstetrics and Gynecology
- Klinikum Leverkusen gGmbH
- Leverkusen, Germany
- Liselotte Mettler PhD MD
- Patroness
- Kiel School of Gynaecological Endoscopy
- Emeritus Professor
- Department of Obstetrics and Gynecology
- University Hospitals Schleswig-Holstein
- Kiel, Germany
- Lotte Clevin MD
- Senior Consultant
- Department of Gynecology
- Bornholm Hospital
- Denmark
- MacLeod Natalie MD
- Department of Obstetrics and Gynecology
- Faculty of Medicine, University of Toronto
- Director, Gynaecologic Endoscopy
- St Joseph's Health Centre, Toronto, Canada
- Manfred Schollmeyer MD
- Department of Obstetrics and Gynecology
- Oschatz, Germany
- Marc Banerjee MD
- Hohe Wacht 77
- 66119 Saarbrücken
- Maria Fernanda Brancalion MD
- Gynecologist
- Women Health Reference Centre
- Hospital Pérola Byington
- São Paulo, Brazil
- Mathias SS Löhnert MD PhD
- Head of Surgical Department,
- Medical Director
- Prof Dr med Habil Dr Hc
- Department of General and Colorectal Surgery
- Clinical Center
- Bielefeld, Germany
- Mauricio Simões Abrão MD PhD
- Professor–Gynecologist
- Faculty of Medicine
- University of São Paulo
- Endometriosis Division
- Department of Obstetrics and Gynecology
- São Paulo, Brazil
- Meenakshi Chate MD
- Galaxy Laparoscopy Institute
- Pune, Maharashtra, India
- Meenu Agarwal MD
- National Director
- Clinical Board Morpheus IVF
- Gen Sec POGS (2017–2018)
- Elected Board member-ISGE (2017–2020)
- Chairperson
- Imaging Science—FOGSI (2018–2020)
- Vice- President, POGS (2012–2014)
- Elected MCM, IAGE (2009–2011) and (2015–2017)
- Life Member, ISGE
- Member, SLS
- Editor, International Journal of Gynaecological Endoscopy
- Michael Stark MD
- Professor
- Department of Applied Mathematics
- Moscow Institute of Physics and
- Technology (State University)
- Moscow Region, Russia
- President
- New European Surgical Academy (NESA)
- Berlin, Germany
- Mohamed Elessawy MD
- Department of Obstetrics and Gynecology
- University Hospitals Schleswig-Holstein
- Kiel, Germany
- Munjal Pandya MS (Obstetrics and Gynecology)
- Assistant Professor (Obstetrics and Gynecology)
- LG Hospital and AMC MET Municipal Medical College
- Maninagar, Ahmedabad, India
- Nidhi Nagar MD
- Consultant Gynecologist and Endoscopy Surgeon
- Former Assistant Professor in Obstetrics and Gynecology
- LN Medical College
- Bhopal, Madhya Pradesh, India
- Ospan A Mynbaev MD PhD
- Professor
- Laboratory of Human Physiology
- Moscow Institute of Physics and Technology (State University)
- Moscow Region, Russia
- The Russian National Research Medical
- Moscow, Russia
- Parul Kotdawala MD FICOG FICMCH
- Endoscopy Surgeon
- Department of Obstetrics and Gynecology
- VS Hospital and NHL Municipal Medical College
- Ellisbridge, Ahmedabad, India
- Radmila Sparić MD
- Surgeon and Gynecologist
- Clinic for Obstetrics and Gynecology
- Clinical Center of Serbia
- Medical School
- University of Belgrade
- Belgrade, Serbia
- Raviraj Tiruke MD
- Galaxy Laparoscopy Institute
- Pune, Maharashtra, India
- RM Sathe MD
- Galaxy Laparoscopy Institute
- Pune, Maharashtra, India
- Rupinder Kaur Ruprai MBBS MD (Ob/Gyn) FMAS DMIS D Rep Med MA-Gyne MBA
- Specialist Gynecologist
- GMC Clinics
- Medcare Hospital
- Dubai, UAE
- Saeed Alborzi
- Department of Obstetrics and Gynecology
- Shiraz University of Medical Sciences
- Shiraz, Iran
- Sambit Nanda MD
- Galaxy Laparoscopy Institute
- Pune, Maharashtra, India
- Sanjay Patel MD
- Gynec-Endoscopic Surgeon
- Infertility and IVF Specialist
- Director
- Mayflower Women's Hospital
- Ahmedabad, Gujarat, India
- Saša Kadija MD PhD
- Surgeon and Gynecologist
- Clinic for Obstetrics and Gynecology,
- Clinical Center of Serbia
- Medical School
- University of Belgrade
- Belgrade, Serbia
- Seema Puntambekar MD
- Galaxy Laparoscopy Institute
- Pune, Maharashtra, India
- Shailesh Puntambekar
- Galaxy Laparoscopy Institute
- Pune, Maharashtra, India
- Shanti I Mohling MD FACOG
- Director of Gynecology
- Associate Director
- Fellowship in Minimally Invasive Gynecology
- Department of Obstetrics and Gynecology
- University of Tennessee College of Medicine
- Chattanooga, Tennessee, USA
- Susanne Denny MD
- Department of Obstetrics and Gynecology
- Krankenhaus St Elisabeth gGmbh
- Damme, Germany
- Svetlana Spremović Radjenović MD PhD
- Surgeon and Gynecologist
- Clinic for Obstetrics and Gynecology,
- Clinical Center of Serbia
- Medical School
- University of Belgrade,
- Belgrade, Serbia
- Tamer Seckin MD FACOG ACGE
- Department of Obstetrics and Gynecology
- Lenox Hill Hospital
- New York, NY, USA
- Tejashree Bakre MD
- Galaxy Laparoscopy Institute
- Pune, Maharashtra, India
- Thilo Wedel
- Institute of Anatomy
- University of Kiel
- Kiel, Germany
- Thomas Römer
- Evangelisches Krankenhaus Köln-Weyertal
- Köln, Germany
- Wael Sammur MD
- Director, Emirates Hospital
- Dubai, United Arab Emirates
Endoscopic surgery, despite its controversial application in the treatment of malignant tumors, has gained worldwide acceptance not only in gynecological surgery but also in general surgery, orthopedic surgery, urology, ENT and cardiac surgery.
As the Chairman of the Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, I wholeheartedly support the publication of the 3rd edition of the Practical Manual for Laparoscopic and Hysteroscopic Gynecological Surgery by the Kiel School. The 50 chapters reflect the current knowledge in the field and provide practical advice on the correct implementation of the minimal invasive surgical procedures. The Kiel School of Gynaecological Endoscopy offers training courses in laparoscopic and hysteroscopic surgery and has become an international forum for all the colleagues interested in this field. Our department and the Kiel School have a joint cooperation with the Kurt Semm Center for Laparoscopic and Robotic-assisted Surgery, founded in 2016 as a multispecialty project at the University Hospitals Schleswig-Holstein, Campus Kiel.
Nicolai Maass MD
Professor–Director
Kiel School of Gynaecological Endoscopy
Department of Obstetrics and Gynecology
University Hospitals Schleswig-Holstein
Kiel, Germany
Foreword
Minimally invasive gynecologic surgery has evolved rapidly over the past few decades. Given that, this mode of access is rapidly becoming the standard of care, the relevance of this textbook is greater than ever. We live in an era where the term minimally invasive is becoming redundant, and we have to thank the pioneers in the field for getting us there. One of those pioneers is Professor Liselotte Mettler. She has seen the incredible evolution of gynecologic surgery first hand and actively contributed to this evolution. I therefore cannot think of a better author for a textbook in the field. The collaboration between Drs Ibrahim Alkatout and Liselotte Mettler has created an outstanding textbook that offers practical and comprehensive information for the novice and advanced gynecologic surgeons alike. Every chapter is written by authorities in the field and the chapter topics cover the entire gamut of gynecologic surgery. This book is therefore an outstanding resource and will serve the reader well. I would like to congratulate the authors and editors for a well-done job.
Jon I Einarsson MD PhD MPH
Director
Minimally Invasive Gynecologic Surgery
Brigham and Women's Hospital
Associate Professor (Obstetrics and Gynecology)
Harvard Medical School
President
American Association of Gynecologic Laparoscopists (AAGL)
Preface
With pleasure I present this 3rd edition of the Practical Manual for Laparoscopic and Hysteroscoic Gynecological Surgery as global masterpiece of the KIEL School of Gynaecological Endoscopy now an integral part of the Kurt Semm Center for Laparoscopic and Robot-assisted Surgery, University Clinics Schleswig-Holstein, Kiel, Germany.
This time with 50 chapters I am rounding up surgical endoscopic challenges primarily in Gynecology, but also in Urology and General Surgery. Based on the ground-braking evolution in this field led by our late colleagues: Raoul Palmer, Kurt Semm and Thoralf Schollmeyer. This book is written by world-known specialists with dedication and passion. Their vigor is best reflected by the Tips and Tricks given for the individual surgical procedures, which are continuously improving the desired outcome. I whole-heartedly thank all authors or their wonderful contributions in text, pictures and videos. The endoscopic surgeons of the world are friends and family, and share their knowledge with the healthy input of new technical developments and recognitions.
The book intends to help all readers to become good surgeons, stay good doctors, and certainly gives a basis for new ideas and developments. All progress may only serve for the necessary treatment of our patients.
I thank our patients trusting in me and carry the responsibility of optimal care.
Liselotte Mettler
Acknowledgments
For the production of this edition, we thank the team of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, under Prerna Bajaj (Development Editor); the Executive Director of the Kiel School, Mr Dawn Rüther; and our Office Manager, Mr Nicole Guckelsberger, for their never-ending patience with the editors, authors, and co-authors.
Video Contents*
Instruments and Equipment for Laparoscopic Surgery: Apparatus and Optic Holders Liselotte Mettler Video 3.1: Laparoscopic Adhesiolysis Video 3.2: Laparoscopic Adhesiolysis and Foreign Body Resection | |
Current Training Models in Hysteroscopy Flemming Bjerrum, Lotte Clevin Video 8.1: Demonstration of an Endometrial Resection Performed in a Pig Heart Video 8.2: Demonstration of a Myoma Resection Simulation on the HystSim Video 8.3: Demonstration of Bleeding and Fluid Management on the HystSim | |
General Surgery Conditions and Techniques for Gyne-endoscopic Surgeons John E Morrison Video 14.1: Inguinal Floor with Direct Hernia Video 14.2: Femoral Hernia Video 14.3: Ligation of Appendix Base Video 14.4: Transection of Appendix Base | |
Benign Ovarian Tumors Saeed Alborzi, Bahareh Hamedi Video 16.1: Laparoscopic Ovarian Cystectomy Video 16.2: Laparoscopic Resection of Ovarian Endometrioma and Release of Adhesions | |
Endoscopy Techniques for Tubal Sterilization Parul Kotdawala, Janesh Gupta, Munjal Pandya Video 21.1: Essure Video Video 21.2: Filshie Clip Video 21.3: Lap TL 2 Puncture Cautery Cut (1) Video 21.4: Lap TL 3 Puncture Cautery Cut (2) Video 21.5: Lap TL Demo Ring Video 21.6: Lap TL Fallope Ring Demo Video 21.7: Lap TL Ring | |
Endometriosis Maria Fernanda Brancalion, Ibrahim Alkatout, Liselotte Mettler Video 23.1: Surgical Treatment—Infiltrating Endometriosis (Rectosigmoid, Ileum, Vermiform Appendix, Ovary, Uterosacral Ligaments) Video 23.2: Surgical Treatment—Infiltrating Endometriosis (Baldder) | |
Surgical Aspects and Therapeutic Modalities of Deep Infiltrating Diagnosis Ingo von Leffern Video 25.1: Pericardium | |
Laparoscopic Myomectomy Alfonso Rossetti, Alessandro Loddo Video 29.1: Myomectomy | |
Total Laparoscopic Hysterectomy Liselotte Mettler, Ibrahim Alkatout, Mohamed Elessawy Video 34.1: Laparoscopic Subtotal Hysterectomy (LASH) Video 34.2: Total Laparoscopic Hysterectomy (TLH) Technique 1 Video 34.3: Total Laparoscopic Hysterectomy | |
Surgery for Pelvic Floor Defects Shanti I Mohling, CY Liu Video 40.1: Uterosacral Ligament Suspension Video 40.2: Total Pelvic Floor Reconstruction with Mesh | |
Laparoscopic Pectopexy Guenter K Noé Video 41.1: How to do Noé Pectopexy? | |
Oncologic Surgery on the Ovary Ivo Meinhold-Heerlein Video 43.1: Fallopian Tube Carcinoma Video 43.2: Ovarian Tumor | |
Robot-assisted Surgery in Gynecology Kubilay Ertan Video 45.1: Simple Hysterectomy—Complex Case Video 45.2: Radical Hysterectomy |
*The videos are available on www.emedicine360.com.