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Application of Micro-single-hole Laparoscopy Combined with Hysteroscopy in Diagnosis and Treatment of Complex Uterine Cavity Diseases

Received: 18 January 2021     Accepted: 6 February 2021     Published: 27 February 2021
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Abstract

Object: To investigate the feasibility and safety of hysteroscopic surgery for diagnosis and treatment of complex uterine cavity diseases under the monitor of 5mm-mini-incision micro-single-hole laparoscopic surgery. Methods: A retrospective analysis of 15 patients with complex uterine cavity diseases undergoing hysteroscopic surgery underwent 5mm-mini-incision micro-single-hole laparoscopic surgery was performed in the Department of Obstetrics and Gynecology, the Affiliated Changzhou NO. 2 People’s Hospital of Nanjing Medical University from April 2018 to March 2019. Among them, 8 cases were intrauterine adhesion, 3 cases were uterine submucosal fibroid, 3 cases were uterine septum, 1 case was post-cesarean scar pregnancy, ages from 23 to 45 years old, BMI 17.65-25.48kg/m2. The operation was performed through a 5mm-mini-incision from the midline of the umbilicus. The 40/50 small abdominal retractor was used to expand the incision approach. A 3-mm small lens (A cystoscope or a hysteroscope was used for some patients) was placed into the single-port approach to perform the laparoscopic surgery; hysteroscopic surgery was performed by hysteroscopy through the cervix. Results: All the 15 patients were successfully operated. One patient with severe intrauterine adhesion had uterine perforation during operation. The uterus was repaired and sutured under micro-single-hole laparoscopy perfectly. No other channels were added during operation, and no laparotomy was performed. The operation time was 20-125 min, in which the surgical path establishment time was 5-10 min, the umbilical reconstruction time was 3-5 min; the intraoperative blood loss was 5-10 ml, and the postoperative hospital stay was 3-7 days. The postoperative umbilical incision healed well, and there was no surgical scar in the abdomen after surgery. No postoperative umbilical hernia and other serious complications occurred. Conclusion: Under the premise of mature umbilical single-port laparoscopy, it is safe and effective to use 5mm-mini-incision micro-single-hole laparoscopic surgery as a monitor during hysteroscopy for the diagnosis and treatment of complex uterine cavity diseases. It will achieve a better cosmetic result than traditional laparoscopy.

Published in Journal of Gynecology and Obstetrics (Volume 9, Issue 1)
DOI 10.11648/j.jgo.20210901.13
Page(s) 9-13
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

5mm-mini-incision, Micro-single-Hole Laparoscopy, Hysteroscopy, Complex Uterine Cavity Diseases

References
[1] Centini G, Troia L, Lazzeri L, Petraglia F, Luisi S. Modern operative hysteroscopy. Minerva Ginecol. 2016; 68 (2): 126-132.
[2] Vigoureux S, Fernandez H, Capmas P, Levaillant JM, Legendre G. Assessment of Abdominal Ultrasound Guidance in Hysteroscopic Metroplasty. Journal of minimally invasive gynecology. 2016; 23 (1): 78-83.
[3] Bradford LS, Boruta DM. Laparoendoscopic single-site surgery in gynecology: a review of the literature, tools, and techniques. Obstet Gynecol Surv. 2013; 68 (4): 295-304.
[4] Matanes E, Lauterbach R, Boulus S, Amit A, Lowenstein L. Robotic laparoendoscopic single-site surgery in gynecology: A systematic review. Eur J Obstet Gynecol Reprod Biol. 2018; 231: 1-7.
[5] Yen CF, Chou HH, Wu HM, Lee CL, Chang TC. Effectiveness and appropriateness in the application of office hysteroscopy. J Formos Med Assoc. 2019; 118 (11): 1480-1487.
[6] Deffieux X, Gauthier T, Menager N, et al. Hysteroscopy: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. Eur J Obstet Gynecol Reprod Biol. 2014; 178: 114-122.
[7] Hoshino T, Yanagawa M, Matsubayashi AU, Yoshioka S. Useful technique for submucous myomectomy under direct transcervical resectoscope observation. Gynecol Minim Invasive Ther. 2017; 6 (3): 120-122.
[8] Xia EL, Duan H, Zhang J, et al. Zhonghua Fu Chan Ke Za Zhi. 2003; 38 (5): 280-283.
[9] Chen J, Lin X, Gao H, Ding Y, Deng Y, Yuan X, et al. Application of laparoendoscopic single-site surgery using conventional laparoscopic instruments in gynecological diseases. International Journal of Clinical and Experimental Medicine. 2016; 9 (7): 13099-104.
[10] Fader AN, Rojas-Espaillat L, Ibeanu O, Grumbine FC, Escobar PF. Laparoendoscopic single-site surgery (LESS) in gynecology: a multi-institutional evaluation. American Journal of Obstetrics and Gynecology. 2010; 203 (5): 501e1-e6.
[11] Ichikawa M, Akira S, Mine K, Ohuchi N, Iwasaki N, Kurose K, et al. Evaluation of Laparoendoscopic Single-site Gynecologic Surgery with a Multitrocar Access System. Journal of Nippon Medical School. 2011; 78 (4): 235-40.
[12] Ki EY, Park EK, Jeong IC, et al. Laparoendoscopic Single Site Surgery for the Treatment of Huge Ovarian Cysts Using an Angiocatheter Needle. Yonsei Med J. 2019; 60 (9): 864-869.
[13] Gunderson CC, Knight J, Ybanez-Morano J, Ritter C, Escobar PF, Ibeanu O, et al. The Risk of Umbilical Hernia and Other Complications with Laparoendoscopic Single-Site Surgery. Journal of minimally invasive gynecology. 2012; 19 (1): 40-5.
[14] Boruta DM. Laparoendoscopic single-site surgery in gynecologic oncology: An update. Gynecol Oncol. 2016; 141 (3): 616-623.
[15] Koo YJ. Recent advances in minimally invasive surgery for gynecologic indications. Yeungnam Univ J Med. 2018; 35 (2): 150-155.
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    Yilin Sun, Ying Cao, Jiming Chen, Zhiyong Dong, Yafeng Zheng, et al. (2021). Application of Micro-single-hole Laparoscopy Combined with Hysteroscopy in Diagnosis and Treatment of Complex Uterine Cavity Diseases. Journal of Gynecology and Obstetrics, 9(1), 9-13. https://doi.org/10.11648/j.jgo.20210901.13

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    ACS Style

    Yilin Sun; Ying Cao; Jiming Chen; Zhiyong Dong; Yafeng Zheng, et al. Application of Micro-single-hole Laparoscopy Combined with Hysteroscopy in Diagnosis and Treatment of Complex Uterine Cavity Diseases. J. Gynecol. Obstet. 2021, 9(1), 9-13. doi: 10.11648/j.jgo.20210901.13

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    AMA Style

    Yilin Sun, Ying Cao, Jiming Chen, Zhiyong Dong, Yafeng Zheng, et al. Application of Micro-single-hole Laparoscopy Combined with Hysteroscopy in Diagnosis and Treatment of Complex Uterine Cavity Diseases. J Gynecol Obstet. 2021;9(1):9-13. doi: 10.11648/j.jgo.20210901.13

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  • @article{10.11648/j.jgo.20210901.13,
      author = {Yilin Sun and Ying Cao and Jiming Chen and Zhiyong Dong and Yafeng Zheng and Yunfen Jiang and Ruxia Shi},
      title = {Application of Micro-single-hole Laparoscopy Combined with Hysteroscopy in Diagnosis and Treatment of Complex Uterine Cavity Diseases},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {9},
      number = {1},
      pages = {9-13},
      doi = {10.11648/j.jgo.20210901.13},
      url = {https://doi.org/10.11648/j.jgo.20210901.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20210901.13},
      abstract = {Object: To investigate the feasibility and safety of hysteroscopic surgery for diagnosis and treatment of complex uterine cavity diseases under the monitor of 5mm-mini-incision micro-single-hole laparoscopic surgery. Methods: A retrospective analysis of 15 patients with complex uterine cavity diseases undergoing hysteroscopic surgery underwent 5mm-mini-incision micro-single-hole laparoscopic surgery was performed in the Department of Obstetrics and Gynecology, the Affiliated Changzhou NO. 2 People’s Hospital of Nanjing Medical University from April 2018 to March 2019. Among them, 8 cases were intrauterine adhesion, 3 cases were uterine submucosal fibroid, 3 cases were uterine septum, 1 case was post-cesarean scar pregnancy, ages from 23 to 45 years old, BMI 17.65-25.48kg/m2. The operation was performed through a 5mm-mini-incision from the midline of the umbilicus. The 40/50 small abdominal retractor was used to expand the incision approach. A 3-mm small lens (A cystoscope or a hysteroscope was used for some patients) was placed into the single-port approach to perform the laparoscopic surgery; hysteroscopic surgery was performed by hysteroscopy through the cervix. Results: All the 15 patients were successfully operated. One patient with severe intrauterine adhesion had uterine perforation during operation. The uterus was repaired and sutured under micro-single-hole laparoscopy perfectly. No other channels were added during operation, and no laparotomy was performed. The operation time was 20-125 min, in which the surgical path establishment time was 5-10 min, the umbilical reconstruction time was 3-5 min; the intraoperative blood loss was 5-10 ml, and the postoperative hospital stay was 3-7 days. The postoperative umbilical incision healed well, and there was no surgical scar in the abdomen after surgery. No postoperative umbilical hernia and other serious complications occurred. Conclusion: Under the premise of mature umbilical single-port laparoscopy, it is safe and effective to use 5mm-mini-incision micro-single-hole laparoscopic surgery as a monitor during hysteroscopy for the diagnosis and treatment of complex uterine cavity diseases. It will achieve a better cosmetic result than traditional laparoscopy.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Application of Micro-single-hole Laparoscopy Combined with Hysteroscopy in Diagnosis and Treatment of Complex Uterine Cavity Diseases
    AU  - Yilin Sun
    AU  - Ying Cao
    AU  - Jiming Chen
    AU  - Zhiyong Dong
    AU  - Yafeng Zheng
    AU  - Yunfen Jiang
    AU  - Ruxia Shi
    Y1  - 2021/02/27
    PY  - 2021
    N1  - https://doi.org/10.11648/j.jgo.20210901.13
    DO  - 10.11648/j.jgo.20210901.13
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
    SP  - 9
    EP  - 13
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20210901.13
    AB  - Object: To investigate the feasibility and safety of hysteroscopic surgery for diagnosis and treatment of complex uterine cavity diseases under the monitor of 5mm-mini-incision micro-single-hole laparoscopic surgery. Methods: A retrospective analysis of 15 patients with complex uterine cavity diseases undergoing hysteroscopic surgery underwent 5mm-mini-incision micro-single-hole laparoscopic surgery was performed in the Department of Obstetrics and Gynecology, the Affiliated Changzhou NO. 2 People’s Hospital of Nanjing Medical University from April 2018 to March 2019. Among them, 8 cases were intrauterine adhesion, 3 cases were uterine submucosal fibroid, 3 cases were uterine septum, 1 case was post-cesarean scar pregnancy, ages from 23 to 45 years old, BMI 17.65-25.48kg/m2. The operation was performed through a 5mm-mini-incision from the midline of the umbilicus. The 40/50 small abdominal retractor was used to expand the incision approach. A 3-mm small lens (A cystoscope or a hysteroscope was used for some patients) was placed into the single-port approach to perform the laparoscopic surgery; hysteroscopic surgery was performed by hysteroscopy through the cervix. Results: All the 15 patients were successfully operated. One patient with severe intrauterine adhesion had uterine perforation during operation. The uterus was repaired and sutured under micro-single-hole laparoscopy perfectly. No other channels were added during operation, and no laparotomy was performed. The operation time was 20-125 min, in which the surgical path establishment time was 5-10 min, the umbilical reconstruction time was 3-5 min; the intraoperative blood loss was 5-10 ml, and the postoperative hospital stay was 3-7 days. The postoperative umbilical incision healed well, and there was no surgical scar in the abdomen after surgery. No postoperative umbilical hernia and other serious complications occurred. Conclusion: Under the premise of mature umbilical single-port laparoscopy, it is safe and effective to use 5mm-mini-incision micro-single-hole laparoscopic surgery as a monitor during hysteroscopy for the diagnosis and treatment of complex uterine cavity diseases. It will achieve a better cosmetic result than traditional laparoscopy.
    VL  - 9
    IS  - 1
    ER  - 

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Author Information
  • Department of Obstetrics and Gynecology, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Obstetrics and Gynecology, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Obstetrics and Gynecology, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Obstetrics and Gynecology, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Obstetrics and Gynecology, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Obstetrics and Gynecology, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Obstetrics and Gynecology, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China

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