Abstract:Heterotopic pregnancy is the simultaneous coexistence of both intrauterine and extrauterine pregnancies. Cornual heterotopic pregnancies can cause catastrophic haemorrhage because of their location. Available evidence suggests that they have usually been managed surgically by laparotomy and cornual resection, few were managed medically and two expectantly. Of the surgical group, only three underwent laparoscopic management. We report the first case of successful management of cornual heterotpic pregnancy by Ha… Show more
“…There are various reports of successful laparoscopic procedures using ultrasonic energy devices. This includes gynecological [45–48], laparoscopic cholecystectomy [49–51], laparoscopic appendectomy [52], laparoscopic myomectomy [53, 54], laparoscopic colorectal [55], laparoscopic salpingo-oophorectomy [56] and laparoscopic management of cornual heterotopic pregnancy [57]. Ultrasonic scalpel (Harmonic ACE) was also successfully used in division of pulmonary vessels in video assisted lung resection [58].…”
Background
Instruments that apply energy to cut, coagulate and dissect tissue with minimal bleeding facilitate surgery. The improper use of energy devices may increase patient morbidity and mortality. The current article reviews various energy sources in terms of their common uses and safe practices.
Methods
For the purpose of this review, a general search was conducted through NCBI, SpringerLink and Google. Articles describing laparoscopic or minimally invasive surgeries using a single or multiple energy sources are considered, as are the articles comparing various commercial energy devices in laboratory settings. Keywords such as ‘laparoscopy’, ‘energy’, ‘laser’, ‘electrosurgery’, ‘monopolar’, ‘bipolar’, ‘harmonic’, ‘ultrasonic’, ‘cryosurgery’, ‘argon beam’, ‘laser’, ‘complications’, and ‘death’ were used in the search.
Results and Conclusion
A review of the literature shows that the performance of the energy devices depends upon the type of procedure. There is no consensus as to which device is optimal for a given procedure. The technical skill level of the surgeon and the knowledge about the devices are both important factors in deciding safe outcomes. As new energy devices enter the market increases, surgeons should be aware of their indicated use in laparoscopic, endoscopic and open surgery.
“…There are various reports of successful laparoscopic procedures using ultrasonic energy devices. This includes gynecological [45–48], laparoscopic cholecystectomy [49–51], laparoscopic appendectomy [52], laparoscopic myomectomy [53, 54], laparoscopic colorectal [55], laparoscopic salpingo-oophorectomy [56] and laparoscopic management of cornual heterotopic pregnancy [57]. Ultrasonic scalpel (Harmonic ACE) was also successfully used in division of pulmonary vessels in video assisted lung resection [58].…”
Background
Instruments that apply energy to cut, coagulate and dissect tissue with minimal bleeding facilitate surgery. The improper use of energy devices may increase patient morbidity and mortality. The current article reviews various energy sources in terms of their common uses and safe practices.
Methods
For the purpose of this review, a general search was conducted through NCBI, SpringerLink and Google. Articles describing laparoscopic or minimally invasive surgeries using a single or multiple energy sources are considered, as are the articles comparing various commercial energy devices in laboratory settings. Keywords such as ‘laparoscopy’, ‘energy’, ‘laser’, ‘electrosurgery’, ‘monopolar’, ‘bipolar’, ‘harmonic’, ‘ultrasonic’, ‘cryosurgery’, ‘argon beam’, ‘laser’, ‘complications’, and ‘death’ were used in the search.
Results and Conclusion
A review of the literature shows that the performance of the energy devices depends upon the type of procedure. There is no consensus as to which device is optimal for a given procedure. The technical skill level of the surgeon and the knowledge about the devices are both important factors in deciding safe outcomes. As new energy devices enter the market increases, surgeons should be aware of their indicated use in laparoscopic, endoscopic and open surgery.
An electronic search concerning the surgical approach in cases of interstitial pregnancy from January 2000 to May 2013 has been carried out. Fifty three studies have been retrieved and included for statistical analysis. Conservative and radical surgical treatments in 354 cases of interstitial pregnancy are extensively described. Hemostatic techniques have been reported as well as clinical criteria for the medical approach. Surgical outcome in conservative versus radical treatment were similar. When hemostatic techniques were used, lower blood losses and lower operative times were recorded. Conversion to laparotomy involved difficulties in hemostasis and the presence of persistent or multiple adhesions. Laparoscopic injection of vasopressin into the myometrium below the cornual mass was the preferred approach.
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