دانلود کتاب Gynaecological Endoscopic Surgery: Basic Concepts

فهرست مطالب :

Preface
Contents
Contributors
Part I: General Topics
History of Minimal Access Surgery (MAS)
1 Introduction
2 Historical Perspectives
References
Laparoscopy and Hysteroscopy Surgery Instruments/Equipment
1 Introduction
2 Types of MAS Equipment/Instruments
2.1 Optics
2.2 Laparoscopic Hand Instruments
2.2.1 Dissecting Forceps
2.2.2 Grasping Forceps
2.2.3 Scissors
2.2.4 Biopsy Forceps
2.2.5 Suction/Irrigation Cannula
2.2.6 Energy Delivery Instruments
2.2.7 Hysteroscopic Hand Instruments and Units
2.2.8 Hysteroscopy Sheaths
2.2.9 Resectoscopes
2.2.10 Media Delivery Systems
3 Instruments for Special Applications in Gynaecology
3.1 Uterine Manipulator
3.2 Uterine Cannula
3.3 Tissue Morcellators
3.4 Monopolar Drill
3.5 Probes
3.6 Myoma Screw and Striper
4 Instruments for Tissue Approximation and Haemostasis
5 Instruments for Access
5.1 Veress Needle
5.2 Trocar and Cannula/Sleeve
5.3 Single-Port Access Devices
6 Endoscopy Units and Endovision System
6.1 Insufflators
6.2 Electrosurgical Unit/Diathermy
6.3 Endovision System
6.3.1 Light Sources
6.3.2 Light Cable
6.3.3 Camera Systems
6.3.4 Monitors
6.3.5 Video Recorder
6.4 Other Devices
6.4.1 Specimen Retrieval Bag
6.5 LASER Devices
7 Robotics
8 Conclusion
References
Sterilization of Endoscopic Instruments
1 Introduction
2 General Infection Risks and Rates in Minimal Access Surgery (MAS)
2.1 The Types of Infections in Endoscopic Surgery
3 Organisms Responsible for Infections in MAS
3.1 Non-Mycobacterial Isolates
3.2 Mycobacterial Isolates
4 Classification of Devices Based on their Processing Needs
5 General Principles of Infection Control in Endoscopic Surgery
5.1 Definition of Terms
5.2 When Should Instrument Processing Begin?
5.3 Where Should Instrument Processing Be Done?
5.4 Who Should be Responsible for Instrument Care and Processing?
6 Steps in Endoscopic Instrument Reprocessing [21]
6.1 Dismantling
6.2 Decontamination
6.3 Pre-Cleaning
6.4 Cleaning and Rinsing
6.5 Drying
6.6 Sterilization or Disinfection
6.6.1 Sterilization
6.6.2 Disinfection
6.6.3 Quality Control Measures for Sterilization and Disinfection
7 Storage of Processed Endoscopic Instruments
8 Notes on Emerging Disease Pathogens Related to Endoscopic Surgery
9 Conclusion
References
The Electrosurgical Unit: Basic Principles for Practice
1 Historical Perspective
2 Biophysical Principles
3 Types of Current
3.1 Direct Current
3.2 Alternating Current
3.3 Thermal Effects on Tissue
4 The Electrosurgical Generator (Electrosurgical Unit [ESU])
4.1 Cutting Mode
4.2 Coagulation Mode
4.3 Desiccation
4.4 Fulguration
4.5 Blended Current (Cut/Coagulation)
5 The System
5.1 Monopolar Circuits
5.2 Bipolar Circuits
5.3 Advanced Bipolar Systems (Aka Tripolar Systems)
6 Complications of Electrosurgery
6.1 Direct Application
6.2 Stray Current
6.3 Direct Coupling
6.4 Capacitive Coupling
6.5 Return Electrode or Alternative Site Burns
6.6 Infection Spread
6.7 Carcinogenic Smoke
7 Advances in Electrosurgery
7.1 Advanced Bipolar Vessel Sealers
7.2 Ultrasonic Devices
7.3 (Hybrid Technology) Thunderbeat Technology
8 Conclusion
References
Anatomy of the Female Pelvis
1 Introduction
2 Synopsis of Pelvic Anatomy
3 The Lower Anterolateral Abdominal Wall
3.1 Vascular Supply to the Lower Anterolateral Abdominal Wall
4 The Umbilicus
5 The Three Pelvic Compartments, their Borders and Contents
5.1 Posterior Compartment
5.2 Anterior Compartment
5.2.1 The Female Urethra (Fig. 1)
5.3 Middle Compartment, Only in Female
5.3.1 Uterus
5.3.2 Ovary
5.3.3 Ovarian Blood and Lymphatics
6 Surgical Anatomy of the Ureter
7 Uterine and Cervical Ligaments of Importance in Female Pelvis
7.1 Cervical Ligaments
8 Vagina
9 Female Avascular Pelvic Spaces (Figs. 9 and 10)
10 Anatomic Surgical Areas of the Pelvis
11 Conclusion
References
Further Readings
Ergonomics and Patient Safety in Gynaecological Endoscopic Surgery
1 Introduction
2 Ergonomics in Endoscopic Surgery
3 Patient Selection
3.1 Patient
3.2 The Disease
3.3 Team and Centre
4 Communication and Leadership
4.1 Safe Surgery Checklists
5 Theatre Set-up (Optimising the Environment)
5.1 Display Screen: Height and Position
5.2 Instrument Handles
5.3 Instrument Length
5.4 Articulated Instruments
5.5 The Fulcrum Effects
5.6 Fulcrum Effect in Morbidly Obese Women
6 Surgical Skills
6.1 Surgical Strategy
6.2 Surgical Tactics
6.3 Surgical Sequence
6.4 Time Management (Surgical Speed)
6.5 Robotic-Assisted Endoscopic Surgery
7 Conclusion
References
Gynaecological Endoscopy in a Low−/Middle-Income Country: Challenges and Prospects
1 Introduction
2 Challenges
2.1 Financial Constraints
2.2 Technical Support
2.3 Energy Supply
2.4 First-Party Collaborator in Endoscopic Machine and Instrument Supply
2.5 Institutional Policies
2.6 Socio-Cultural Influences
3 Prospects
4 Conclusion
References
Part II: Laparoscopy
Anaesthesia for Laparoscopic Surgery
1 Introduction
2 Physiological Changes during Laparoscopy
2.1 Physiological Effects of Pneumoperitoneum
2.1.1 Cardiovascular Effects
2.1.2 Respiratory Effects
2.1.3 Neurologic Effects
2.1.4 Renal Effects
2.1.5 Gastrointestinal Effects
2.2 Physiological Effects of Positioning
3 Anaesthetic Management
3.1 Preoperative Assessment
3.2 Premedication
3.3 Monitoring
3.4 Anaesthesia Technique
3.5 Post-Operative Management
4 Laparoscopy Surgery in Pregnant Women
5 Conclusion
References
Laparoscopic Port Position, Placement and Closure
1 Port Position and Placement
1.1 Introduction
1.2 Primary Port
1.3 Secondary Port
1.3.1 Removal of Cannula
1.4 Single Port
2 Laparoscopic Port Closure
2.1 Predisposing Factors to Port Hernia
2.2 Safe Approaches to Port Closure
2.2.1 The Standard Open Closure
2.2.2 Laparoscopic Direct Visualization
References
Laparoscopic Entry/Access Techniques
1 Introduction
2 Types of Trocar
3 Types of Laparoscopic Access/Entry Techniques
4 Closed Access Techniques
4.1 Closed Non-Visual Access Technique with Veress Needle
4.2 Sites of Veress Needle Entry
4.3 Steps of Veress Needle Insertion
4.4 Veress Needle Safety Tests or Checks
4.5 Veress Needle Modifications
4.6 Steps of Primary Trocar Insertion
4.6.1 Disposable Shielded Trocar
4.6.2 Radially Expanding Access System
5 Closed Access with Direct Trocar Entry (with Pneumoperitoneum or Gasless)
5.1 Closed Access with Direct Sharp Trocar (with Pneumoperitoneum)
5.2 Closed Access with Trocar (Gasless)
6 Visual Access Techniques
6.1 Disposable Optical Trocar
6.2 Trocarless Reusable Visual Access Cannula (EndoTIP Visual Cannula)
7 Open-Access Technique
7.1 Hasson Technique
8 Conclusion
References
Techniques for Laparoscopic Tissue Retrieval
1 Introduction
2 Tissue Retrieval Techniques
2.1 Tissue Retrieval Through the Port
2.1.1 Technique
2.2 Tissue Retrieval Through the Port Site
2.2.1 Technique
2.3 Retrieval Bags
2.3.1 Commercial Endobags
Technique
2.3.2 Improvised Endobags
2.4 Gloves
2.4.1 Technique
2.5 Condom
3 Removal and Fragmentation of Tissues from the Endobag outside the Abdomen
3.1 Morcellation
3.2 Colpotomy
3.3 Hand-Assisted Laparoscopic Surgery
3.4 Natural Orifices, Transluminal Endoscopic Surgery (Notes)
4 Conclusion
References
Diagnostic Laparoscopy and Dye Test
1 Introduction
2 Preoperative Procedures
2.1 Informed Consent
2.2 COVID-19 Era and Testing
2.3 Wrong Person, Site, Procedure Prevention
2.4 Piercings and Tattoos
2.5 Preoperative Skin Preparation
3 Operative Procedure
3.1 Instruments
3.2 Instruments for Single-Incision Laparoscopy
3.3 Instruments for Mini-Laparoscopy
3.4 Insufflation Needle
3.5 Suction and Irrigation
3.6 Grasping Instruments
4 Technique of Methylene Blue Dye Test
5 Procedure-Related Complications
5.1 Conversion to an Open Procedure
5.2 Bleeding
5.3 Bladder Puncture
5.4 Port-Site Hernia
6 Conclusion
References
Laparoscopic Suturing Techniques
1 Background
2 Extracorporeal Suturing
2.1 The Roeder Knot
2.2 Instruments for Extracorporeal Suturing
3 Intracorporeal Suturing
3.1 Instruments for Laparoscopic (Intracorporeal) Suturing
3.1.1 Needle Holder/Driver
3.1.2 Needle Receiver/Assisting Instrument
3.1.3 Suture Material
3.2 Steps in Laparoscopic Suturing
3.2.1 Introducing the Suture into the Abdomen
3.2.2 Loading the Needle on the Driver
3.2.3 Going through Tissue (Fig. 8)
3.2.4 Preparing for Knot Tying
3.2.5 Subsequent Knots
3.3 Removal of Needle from the Abdomen
3.3.1 Through a 10-Mm-Sized Port
3.3.2 Through a 5-Mm-Sized Port
References
Laparoscopic Management of Benign Ovarian Tumours
1 Introduction
2 Types of Benign Ovarian Tumour
3 Clinical Evaluation
4 Investigations
4.1 Investigation of the Premenopausal Patient
4.2 Investigation of the Postmenopausal Patient
5 Laparoscopic Surgical Treatment
5.1 Options of Laparoscopic Procedures
5.1.1 Aspiration
5.1.2 Cystectomy
5.1.3 Oophorectomy
5.1.4 Salpingo-Oophorectomy
6 Conclusion
References
Laparoscopic Ovarian Drilling
1 Introduction
2 Mechanism of Action of LOD
3 Patient Selection and Predictors of Success
4 Operative Technique
5 Dose Response
6 Choice of Electrocautery
7 Unilateral (ULOD) or Bilateral Ovarian Drilling (BLOD)
8 To re-Drill or Not?
9 Laparoscopic Ovarian Drilling Prior to IVF Treatment
10 Complications of LOD
11 Conclusion
References
Laparoscopic Tubal Surgery and Laparoscopic Management of Ectopic Pregnancy
1 Introduction
2 Advances in Laparoscopic Tubal Surgery
3 Brief Anatomy of the Adnexa and the Laparoscopic Perspective
4 Types of Laparoscopic Tubal Surgery
4.1 Laparoscopic Bilateral Tubal Ligation
4.1.1 Contraindications
4.2 Laparoscopic Tubal Ligation Procedures
4.2.1 Procedures
4.2.2 Complications
5 Laparoscopic Tubal Ligation Reversal
5.1 Procedure
5.2 Types of Tubal Reversal or Anastomosis
5.2.1 Procedure
6 Tubal Blockage Operations
6.1 Fimbrioplasty
6.1.1 Procedure Is As Described Above
6.2 Neosalpingostomy/Salpingostomy
6.2.1 Procedure
6.2.2 Contraindications
6.2.3 Prognosis
6.3 Salpingectomy
6.3.1 Procedure
6.4 Laparoscopically Guided Hysteroscopic Tubal Recanalization
6.4.1 Procedure
6.4.2 Contraindications
6.4.3 Complications
7 Advances in Laparoscopy Tubal Surgery
7.1 Robotic Tubal Recanalization
8 Laparoscopic Management of Ectopic Pregnancy (Conservative and Radical, Prognosis and Complications)
8.1 Introduction
8.2 Evidence-Based Treatment Approach
8.2.1 Tubal (Ampullary/Infundibulum/Isthmic)
8.2.2 Cornual/Interstitial Pregnancy
8.2.3 Caesarean Scar Pregnancy
8.2.4 Ovarian Pregnancy
8.2.5 Abdominal Pregnancy (Early)
8.2.6 Cervical Pregnancy
8.2.7 Other Treatment Adjuncts/Postoperative Counselling Options
8.2.8 Evidence to Support Minimal Invasive Surgery Over Open Surgery (Cochrane Database)
8.3 Laparoscopic Operations for Ectopic Pregnancy
8.3.1 Salpingectomy
Procedure
8.3.2 Salpingotomy/Salpingostomy
Procedure
8.3.3 Fimbrial Milking/Evacuation of Tubal Pregnancy
Procedure
8.3.4 Cornual Excision/Cornuostomy
The Procedure of Cornual Excision/Cornuostomy
8.3.5 Hysteroscopic Removal Procedures Under Laparoscopic or Ultrasound Guidance
8.3.6 Enucleation of Ovarian Pregnancy/Ovarian Wedge Resection, or Ovariectomy
Procedure
8.3.7 Removal of Abdominal Ectopic Pregnancy
8.4 Advances in the Management of Ectopic Pregnancy
8.4.1 Single-Incision Laparoscopic Surgery (SILS)
8.4.2 Da Vinci Robotic Platform/System
8.5 Conclusion
References
Laparoscopy-Guided Hysteroscopic Proximal Tubal Cannulation (Endoscopic Tubal Cannulation)
1 Introduction
2 Preoperative Considerations and Requirements
3 Step-by-Step Procedure for Endoscopic Tubal Cannulation
4 Outcome of Tubal Cannulation
5 Complications
6 Contraindications
7 Conclusion
References
Laparoscopy in Pregnancy
1 Introduction
2 Current Perspectives on Laparoscopy in Pregnancy
3 Indications for Laparoscopy During Pregnancy
4 Some Contraindications for Laparoscopy During Pregnancy
5 Relevant Investigations (Abdominal Pain in Pregnancy)
6 Valid Consent for Laparoscopy in Pregnancy
7 Procedure for Laparoscopy in Pregnancy
8 Postoperative Considerations
9 Conclusion
References
Laparoscopic Abdominal Cerclage
1 Introduction
2 Historical Aspects
3 Laparoscopic Approach
4 Indications for Laparoscopic Abdominal Cerclage
5 Timing of the Procedure: Prenatal or Antenatal
5.1 Laparoscopic Abdominal Cerclage on a Non-pregnant Uterus
5.2 Laparoscopic Abdominal Cerclage During Pregnancy
6 Preoperative Counseling of Patients
7 Instruments and Sutures Needed
7.1 Stepwise Procedure in Non-pregnant Uterus
7.2 The Following Modifications Can Be Done to the Above Procedure
8 Laparoscopic Abdominal Cerclage During Pregnancy
9 Special Precautions with Advanced Gestational Age
10 Placement of Suture Lateral to Uterine Vessels
11 Postoperative Care After Laparoscopic Abdominal Cerclage
11.1 Non-pregnant Uterus Cerclage
11.2 Cerclage During Pregnancy
12 Complications of the Procedure
12.1 Non-pregnant Cerclage
12.2 Cerclage During Pregnancy
13 Laparoscopic Abdominal Cerclage in Challenging Conditions
13.1 Previous Lower Segment Caesarean Section (LSCS)
13.2 Laparoscopic Abdominal Cerclage for Bicornuate Uterus
13.3 Removal of the Cerclage Stitch
14 Caesarean Section After Laparoscopic Abdominal Cerclage
References
Minimal Access Urogynaecology
1 Introduction
2 Preoperative Management
2.1 Bowel Preparation
2.2 Operating Room Set-Up
2.3 Trocar Placement (Using the Ipsilateral Port Placement)
2.4 Uterine Manipulation
2.5 Energy Sources
3 Surgical Procedures
3.1 Laparoscopic Y-Mesh Sacrohysteropexy
3.2 Laparoscopic Sacrocolpopexy
3.3 Laparoscopic Uterosacral Suture Sacrohysteropexy
3.4 Sacrospinous Ligament Fixation
3.5 Laparoscopic Burch Colposuspension
3.6 Transurethroscopic Bulkamid® Injection
3.7 Cystoscopic Botox Injection
3.8 Laparoscopic Vesicovaginal Fistula Repair
4 Conclusion
References
Laparoscopic Myomectomy
1 Introduction
2 Advantages of Laparoscopic Myomectomy Over Open Abdominal Myomectomy
3 Patient Selection for Laparoscopic Myomectomy
4 Preoperative Considerations
5 Instruments Required
6 Technique
6.1 Patient Positioning
6.2 Preparation of the Operating Field
6.3 Port Position
6.4 Vasopressin Injection
6.5 Making the Uterine Incision
6.6 Enucleation of the Fibroid
6.7 Suturing the Defect
6.8 Removal of Fibroids
7 Special Situations
7.1 Hand-Assisted Laparoscopic Myomectomy (HALM)
8 Postoperative Considerations
References
Laparoscopic Management of Endometriosis
1 Definition
2 Prevalence
3 Pathogenesis
4 Clinical Features
5 Histological Phenotypes of Endometriosis
6 Diagnosis
6.1 Preoperative Diagnosis
6.2 Intraoperative Diagnosis
6.3 Visual vs. Histological Diagnosis of Endometriosis
7 Classification of Endometriosis
7.1 Preoperative Classification
7.1.1 Ultrasound-Based Endometriosis Staging System (UBESS)
7.2 Intraoperative Classification
8 Surgical Treatment
8.1 Systematic Evaluation of the Pelvis at Laparoscopy for the Diagnosis of Endometriosis
8.2 Conservative, Semi-conservative and Radical Surgical Treatment for Endometriosis
8.3 Ablation vs. Excision
8.4 See and Treat vs. Two-Stage Approach
9 Outcomes from Surgical Treatment
10 Complications from Laparoscopic Surgery for Endometriosis
11 Medical Treatment of Endometriosis
12 Multidisciplinary Team Care Approach
13 Challenges of Managing Endometriosis in Resource-Restricted Countries
14 Conclusion
References
Laparoscopic Hysterectomy
1 Introduction
2 Advantages of Laparoscopic Approach to Hysterectomy
3 Perioperative Considerations
3.1 Indications for Laparoscopic Surgery: Patient Selection
4 Laparoscopic Hysterectomy and Modifications
5 Operative Setup
6 Surgical Anatomy
6.1 Abdomen and Pelvis
6.1.1 Pelvic Viscera and Blood Supply
6.2 Important Anatomic Relationships
6.2.1 Internal Iliac Artery Ligation
6.3 The Avascular Spaces of the Pelvic Retroperitoneum [13, 14]
7 Surgical Goals
8 Laparoscopic Hysterectomy
8.1 Surgical Technique [15]
9 Major Complications
10 Conclusion
10.1 A Note on Robotic-Assisted Laparoscopic Hysterectomy
References
Laparoscopic Radical Hysterectomy
1 Historical Perspective
2 Classification of Radical Hysterectomy
3 Indications and Contraindications to Laparoscopic Radical Hysterectomy
4 Advantages and Limitations of Laparoscopic Radical Hysterectomy
5 The Procedure for Laparoscopic Radical Hysterectomy
5.1 Bowel Preparation
5.2 Operating Room Setup
5.3 Trocar Placement (Using the Ipsilateral Port Placement)
5.4 Uterine Manipulation
6 Procedure
6.1 Diagnostic Exploration
6.2 Dissection of Lateral Peritoneum and Pararectal Space
6.3 Dissection of the Rectovaginal Space
6.4 Dissection of the Vesicovaginal Space
6.5 Dissection of the Paravesical Space
6.6 Dissection of the Ureter and Hysterectomy
6.7 Pelvic Lymphadenectomy
7 Complications of Laparoscopic Radical Hysterectomy
8 Conclusion
References
Complications of Laparoscopy
1 Introduction
2 Classification of Complications
2.1 Clavien-Dindo Classification of Surgical Complications
2.2 Classification Based on Type and Site of Injury
2.2.1 Anaesthesia
Pneumoperitoneum
Positioning
Extraperitoneal Gas Insufflation
CO2 Embolism
2.2.2 Entry-Related Injury
Abdominal Wall Vascular Injury
Hernia at Trocar Site
2.2.3 Electrosurgical Injuries
Capacitive Coupling
Return Electrode or Alternate Site Burns
2.2.4 Haemorrhagic (Major Vascular) Injury
2.2.5 Intestinal Injury
2.2.6 Urologic Injuries
Bladder Injuries
Ureteral Injury
2.2.7 Neurologic Injuries
2.2.8 Infections
2.2.9 Port-Site Metastasis
3 Conclusion
References
Part III: Hysteroscopy
Tips and Tricks to Facilitate the Art of Intrauterine Surgery
1 Introduction
2 Set-Up and General Considerations
2.1 Patient Position and  Operating Room Table Manipulation
2.2 Eyes on the Screen
2.3 Avoid Multiple Entries
2.4 Vaginal Distention
2.5 Cervical Canal
3 Diagnostic Procedures
4 Shawki Bubble Test and Methylene Blue Test
5 Endometrial and Endocervical Polyp
6 Septal Metroplasty
7 Submucous Fibroid
8 Transcervical Resection of the Endometrium (TCRE)
9 Intrauterine Adhesions
10 Conclusion
References
Anaesthesia for Operative Hysteroscopy
1 Introduction
2 Anaesthetic Considerations
3 Position
4 Distension Fluid
5 Day Case Anaesthesia
6 Preoperative Preparations for Operative Hysteroscopy
7 Anaesthetic Options
8 Monitoring
9 Complications of Operative Hysteroscopy
10 Conclusion
References
Distension Media in Hysteroscopy
1 Introduction
2 Brief Historical Background
3 Principles of Maintaining Adequate Intrauterine Pressure (IUP) During Hysteroscopy
4 Distending Media Delivery Systems in Hysteroscopy
4.1 Gravity Delivery Systems
4.2 Modified Gravity Fluid Delivery System
4.3 Continuous Flow Infusion Pumps
4.4 Automated Pressure-Sensitive Fluid Delivery Systems
5 Types of Distension Media
5.1 Gaseous Distension Media
5.2 Fluid Distension Media
5.2.1 Types of Fluid Distension Media
High Viscosity Fluids
Low Viscosity Fluids
Electrolyte-Rich Solutions (Normal Saline, Ringer’s Lactate)
Electrolyte-Free Solutions
6 Fluid Monitoring in Hysteroscopy
7 Intravasation, Fluid Deficit and Circulatory Overload
8 Fluid Management in Hysteroscopy
References
Untitled
Hysteroscopic Management of Uterine Synechiae
1 Introduction
2 Aetiology
3 Classification
4 Presentation
5 Diagnosis
5.1 Hysteroscopy
5.2 Hysterosalpingography
5.3 Saline Infusion Sonography
5.4 Transvaginal Ultrasound Scan
5.5 Magnetic Resonance Imaging
5.6 3D Ultrasonography
6 Treatment
7 Prevention of Adhesion Reformation
7.1 Intrauterine Device (IUD)
7.2 Intrauterine Foley Catheter
7.3 Intrauterine Balloon Stent
7.4 Re-absorbable Agents: Intrauterine Gel
8 Endometrial Preparation
9 Follow-Up
References
Hysteroscopic Myomectomy
1 Introduction
2 Classification of Submucosal Fibroids
3 Patient Selection and Indications for Hysteroscopic Myomectomy
3.1 Indications for Hysteroscopic Myomectomy
3.2 Contraindications
4 Consenting and Preoperative Evaluation
5 Operating Tools and Distension Media
6 Preoperative Preparation Medications
7 The Procedure
8 Further Consideration and Post-operative Care
9 Newer Techniques: Morcellation and Vaporization of Submucosal Fibroids
9.1 Morcellation
9.2 Vaporization Techniques
10 Second-Stage Procedure
11 Advantages of Hysteroscopic Myomectomy Over Laparotomy for Myomectomy in Cases of Submucosal Fibroid
12 Complications of Hysteroscopic Myomectomy
References
Complications Associated with Hysteroscopic Surgery
1 Introduction
2 Prevalence
3 Anaesthetic Complications
3.1 Prevention
4 Neurological Complications Associated with Suboptimum Patient Positioning
4.1 Prevention
5 Cervical Injury
5.1 Prevention
6 Uterine Perforation
6.1 Prevention
6.2 Identification and Management
7 Occult Visceral Thermal Injuries
7.1 Prevention
8 Complications Associated with the Distension Media
8.1 Gas Media
8.2 Fluid Distension Media
8.3 Prevention, Recognition and Management of Excessive Fluid Absorption
9 Air Embolism
9.1 Prevention
10 Intraoperative and Post-operative Bleeding
10.1 Prevention and Management
11 Infection
12 Uterine Synechia Following Hysteroscopic Surgery
12.1 Prevention and Management
13 Risk of Morbidly Adherent Placenta Following Reproductive Hysteroscopic Surgery
14 Other Complications
References