Intraoperative Injury in Reconstructive Pelvic Surgery

Khan, Fareesa; Kenton, Kim

doi:10.1097/01.spv.0000240146.33176.96

Cited by 3 publications

(2 citation statements)

References 59 publications

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“…With the increasing application of laparoscopy in gynecological surgery since the late 1980s, the number of IUI has increased markedly during the past two decades, partly because of the introduction of laparoscopy and the overall increase in surgical procedures (2)(3)15). Additionally, the incidence of ureteral injury is related to the types of operations performed at different periods and the surgeons' experience (16). The probability of ureteral injury in laparoscopic operations increases by 0.2-6.0% (2,17).…”

Section: Discussionmentioning

confidence: 99%

Does prophylactic ureteral catheter placement offer any advantage for laparoscopic gynecological surgery? A urologist’ perspective from a systematic review and meta-analysis

et al. 2020

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Our aim is to assess the efficacy of prophylactic ureteral catheter placement on patients undergoing laparoscopic gynecological surgery. We searched the electronic database including PubMed, Cochrane Library, Embase, Web of Science, WANFANG and CNKI in January 2020 to identify possible studies without languages limitations. A manual search was also conducted. The trials that compared catheterized group (CG) to non-catheterized group (NCG) were included. This meta-analysis was accomplished by RevMan5 (version 5.3). Initial search yield 997 studies and 5 randomized control trials were included in the final meta-analysis. Pooling data of five studies showed that patients in the CG had a lower risk of ureteral injury than those in NCG (RR: 0.44, 95% CI: 0.20-0.97, P=0.04) without significant between-study heterogeneity (P=0.23, I 2 =29%). The pooled data analysis showed a statistically significant difference in favor of prophylactic ureter catheter placement (MD: −40.51, 95% CI: −58.65 to −22.36, P<0.0001). Random-effects model meta-analysis found that patients in the CG experienced higher EBL compared to NCG (SMD: −5.78, 95% CI: −10.51 to −1.04, P=0.02). There was no statistically significant difference between CG group and NCG group (P=0.23) with regard to LOS. Current evidence indicates that prophylactic ureteral catheter placement has the advantages of reducing ureteral injury, shortening the operative time, and reducing the amount of bleeding. It might serve as a routine preoperative preparation choice for laparoscopic gynecological surgery, especially with pelvic adhesion. Further large volume, multicenter well-designed trials are warranted before making the final clinical guidelines.

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Section: Discussionmentioning

confidence: 99%

Does prophylactic ureteral catheter placement offer any advantage for laparoscopic gynecological surgery? A urologist’ perspective from a systematic review and meta-analysis

et al. 2020

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“…The female pelvis, for example, is a complex region containing a network of autonomic and somatic nerves (Mauroy et al, 2007; Montoya et al, 2011) that interact with bony and soft tissue structures (Bertrand et al, 2013), which are oriented in a small physical space (Sergovich et al, 2010). Significantly, recent literature has discussed the possibility of iatrogenic surgical injury to innervation of the female pelvis following various procedures (Giovannetti et al, 2021; Haylen et al, 2011; Khan & Kenton, 2006). There is literature which has described complex pathways of innervation in this region using various approaches, including microdissection and immunohistochemistry (IHC), allowing for interpretation of the relevant clinical anatomy of innervation of the female pelvis and relationships with surrounding structures (Kraima et al, 2016; Moszkowicz, Alsaid, Bessede, Penna, et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Three‐dimensional reconstruction of the innervation of the female pelvis: A review of current methods

et al. 2023

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The three‐dimensional (3D) reconstruction of tissues is a valuable approach for elucidating the anatomy of nerves and plexuses, which are often microscopic in nature and therefore difficult to fully appreciate using gross dissection approaches alone. A common workflow which can be used to generate such 3D models has yet to be comprehensively described. This study aimed to review 3D reconstruction methodologies and findings related to human female pelvic innervation to determine whether there is an optimal methodology and identify the limitations of these approaches. A comprehensive literature review was conducted using keywords including 3D reconstruction, human female pelvic nerves, and innervation. Twenty relevant articles published between 2003 and 2019 were selected for review. The 3D reconstruction of female pelvic innervation generally follows two workflows involving either immunohistochemistry (IHC) (n = 16) or magnetic resonance imaging (MRI) (n = 4). There were commonalities among the general steps reported for 3D tissue reconstruction across these two imaging methodologies. Notably, there was some variability in study methodology across the studies reviewed, suggesting there is not a clear best practice for the reconstruction of these tissues. Information that generates 3D mapping of innervation has important clinical applications, such as informing and optimizing surgical approaches to avoid damage to local innervation. IHC and MRI‐based approaches are both feasible for the reconstruction of pelvic innervation, though there are advantages and disadvantages to both. Information from this review can be used to help inform the development of 3D models of female pelvic innervation in the future.

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Effect of Additional Reconstructive Surgery on Perioperative and Postoperative Morbidity in Women Undergoing Vaginal Hysterectomy

Heisler¹,

Weaver

Melton

et al. 2009

Obstetrics &Amp; Gynecology

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Intraoperative Injury in Reconstructive Pelvic Surgery

Cited by 3 publications

References 59 publications

Does prophylactic ureteral catheter placement offer any advantage for laparoscopic gynecological surgery? A urologist’ perspective from a systematic review and meta-analysis

Does prophylactic ureteral catheter placement offer any advantage for laparoscopic gynecological surgery? A urologist’ perspective from a systematic review and meta-analysis

Three‐dimensional reconstruction of the innervation of the female pelvis: A review of current methods

Effect of Additional Reconstructive Surgery on Perioperative and Postoperative Morbidity in Women Undergoing Vaginal Hysterectomy

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