Advanced Gynecologic Endoscopy by A. darwish

By A. darwish

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Once recognised there are different methods for lingation : use of bipolar or monopolar current, use of metallic clips or falop ring bands, and resection with the use of sutures to ligate. When complications occur they are most commonly haemorrhage from the fallopian tube or the mesosalpinx, and they rate from 0,1 to 4,6 % . [3-7]. The occurrence of major complications (0,6 % ) like vascular injury, bowel perforation Laparoscopy in Gynecology - How Why When 35 or damage to the genitourinary tract is really rare.

Laparoscopic procedures are contraindicated in patients suffering important and acute (traumatic, tumor, hydrocephalus) cranial hypertension. Pharmacological treatment or temporal shunting can be performed to control the hypertension. If a recent ventriculoperitoneal shunt has been performed there is no contraindication because a non return valve is present. The leakage tests of these valves are not totally reliable when they are suspended in cephaloraquideum liquid. Cerebral and retinal vascular accidents can occur.

The remainder of the broad ligament is dissected to the utero-ovarian ligament, which is ligated securely. In both of the previous cases the dissected tissue is securely placed in endo bag and is usually removed via a10 mm trocar port. There are different kind of cases in this phase of the operation : The cyst being small enough to be removed directly from the trocar port, or the the cyst being too large, but then we can aspire it's content through the trocar port shrinking it enough so it can exit more easily.

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