The opportunities for simultaneous gynecological laparoscopic operations

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Urgency of the problem. Extensive introduction of laparoscopy in surgery and operative gynecology, perfection of technique and low traumatic effect of endoscopic operations allow to expand indications for simultaneous laparoscopic interventions involving various abdominal organs.

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Urgency of the problem. Extensive introduction of laparoscopy in surgery and operative gynecology, perfection of technique and low traumatic effect of endoscopic operations allow to expand indications for simultaneous laparoscopic interventions involving various abdominal organs.

Material and methods. In the Municipal center of laparoscopic surgery of Elizavetinskaya hospital of Saint Petersburg we have performed 138 simultaneous laparoscopic interventions. Average age of the women was 36,4 ± 4,8 years.

Results of the study. In 29 cases (21,01%) the laparoscopic hysterectomy (LAVH or TLH) was combined with laparoscopic cholecystectomy in case of cholelithiasis (average duration of the operations was 115,7 minutes, the average number of days spent in the hospital - 4,9). The laparoscopic adnexectomies (cystadenomectomies) in case of benign tumors and tumor-like masses of the ovaries were combined with laparoscopic cholecystectomy in 57 (41,3%) patients (average duration of the operations was 35,4 minutes, the average number of days spent in the hospital - 3,9). In 52 patients (37,7%) the laparoscopic adnexectomies (cystadenomectomies) were combined with hernia repairs in case of incarcerated umbilical (32), femoral (4), inguinal (11) and postoperative ventral hernias (5). In the latter group we preferred to start the operation as a hernia repair and than we have been fixing optical trocar in hernial openings and carried out uterine appendages operation. The hernial openings were also used for removal of a macropreparation from abdominal cavity. The final stage of the operation was hemioplasty. In the postoperative period, there were no complications. The clinical course was typical. Average terms of hospitalization did not significantly differ from the parameters of usual laparoscopic hysterectomy or adnexectomy (cystadenomectomy).

Conclusion. Thus, simultaneous laparoscopic operations allow to carry out simultaneous radicalor reconstructive-plastic surgical treatment of several gynecologic and surgical diseases, it has good cosmetic effect, essentially reduces the terms of postoperative rehabilitation.

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作者简介

V. Bezhenar

Military Medical Academy

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faculty of obstetrics and gynecology

俄罗斯联邦, Saint Petersburg

G. Rutenburg

Elizavetinskaya hospital

Email: info@eco-vector.com

Municipal center of laparoscopic surgery

俄罗斯联邦, Saint Petersburg

V. Strizheletsky

Elizavetinskaya hospital

Email: info@eco-vector.com

Municipal center of laparoscopic surgery

俄罗斯联邦, Saint Petersburg

Т. Zhemchuzhina

Elizavetinskaya hospital

Email: info@eco-vector.com

Municipal center of laparoscopic surgery

俄罗斯联邦, Saint Petersburg

Т. Gordeeva

Regional clinical hospital to №1 named after S.V.Ochapovsky

Email: info@eco-vector.com
俄罗斯联邦, Krasnodar

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