A Combined Strategy of Vaginal Hysterectomy by Electrosurgery with Post Hysterectomy Check Laparoscopy in Benign Indications Associated with Known or Suspected Concomitant Pelvic Disease: A Retrospective Study

Purohit, Ramkrishna; Sharma, Jay Gopal; Meher, Devajani; Samy, Mohammed; Sarkar, Rupam

doi:10.26502/ogr065

Cited by 1 publication

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“…The laparoscopy was performed adopting the strategy of post-hysterectomy check laparoscopy (PHCL) 15 ( Supplementary Video 8 ). Both vaginal stump margins were clamped vaginally by Allis forceps to restore pneumoperitoneum.…”

Section: Methodsmentioning

confidence: 99%

“…Both vaginal stump margins were clamped vaginally by Allis forceps to restore pneumoperitoneum. 15 Remnant visible endometriotic lesions above the level of the ovary, in the regions anterior to the bladder, anterolateral wall of the pelvis, the upper part of the rectum, recto-sigmoid, and other organs were treated surgically via laparoscopy using coagulation, excision of nodules and adhesiolysis. The adhered upper part of the rectum to the pararectal fascia, pelvic side wall and infundibulopelvic ligament was lysed.…”

Section: Methodsmentioning

confidence: 99%

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Vagino-Laparoscopic Conservative Strategy of Hysterectomy in Indicated Cases of Severe Pelvic Endometriosis Followed by 24 Months of Depot-Medroxyprogesterone Acetate Therapy— A Symptom-Solving Treatment Model to Ease Surgical Challenges

Purohit,

Sharma,

Meher

et al. 2023

IJWH

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Purpose To demonstrate the long-term outcome of a symptom-solving treatment model (SSTM). Patients and Methods An observational study was carried out between June 2016 and December 2022 in our private setup on consecutive candidates of hysterectomy for severe pelvic endometriosis. Candidates were treated by the SSTM, which constitutes a systematic vagino-laparoscopic conservative strategy of hysterectomy with preservation of the ovary or ovaries followed by 24 months of postoperative depot-medroxyprogesterone acetate (DMPA) therapy. Cases were followed up to December 2022, 2.5 years beyond the last hysterectomy in May 2020. Main Outcome Measures Relief of endometriosis-associated symptoms and prevention of recurrence in the long term. Results Symptomatic relief of endometriosis-related pain, such as cyclical dysmenorrhoea, pelvic pain, dyschezia, and vaginal pain, occurred in all 68 (100%) cases from the next expected date of menstruation. None of the cases showed a recurrence of endometriosis-related pelvic pain; overall, 37 (54.41%) cases crossed 4–6 years, and 31 (45.58%) cases crossed 2.5–4.0 years following the hysterectomy operation. Four (5.88%) cases had non-endometriotic pelvic pain. None of the cases required repeat surgery or had any major side effects or complications due to DMPA. No major perioperative complications were observed. The results were achieved without the requirement of challenging extensive retroperitoneal laparoscopic dissection, ureterolysis, and rectum surgeries. Conclusion This SSTM can be an option in indicated cases of severe pelvic endometriosis to provide symptom relief and prevent the recurrence of endometriosis-associated pelvic pain in the long term.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%