Pelvic Adhesive Disease: Current Approaches to Management

Lue, John R; Boyd, Louise S; Diamond, Michael P.

doi:10.4172/2325-9795.1000150

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…When the mesothelial cells on the serous membrane of the peritoneal surfaces become injured, fibroblasts invade the area and deposit extracellular matrix material, including collagen, which contributes to the adhesion development. [ 4 ] Adhesions that are associated with endometriosis can attach to nearby pelvic structures or cause deep tissue scarring. Subsequently, these lesions often cause immobilization of pelvic structures and manifest as pain when external forces are applied to the adherent structures.…”

Section: Discussionmentioning

confidence: 99%

Improving accuracy of intraoperative diagnosis of endometriosis: Role of firefly in minimal access robotic surgery

2016

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Endometriosis continues to be a major primary gynecologic etiology of chronic pelvic pain. The symptom profile, which includes cyclic pelvic pain, dysmenorrhea, and dyspareunia or dyschezia, is nonspecific and does not correlate with the extent or severity of disease. Trans-vaginal or trans-rectal ultrasound, as well as magnetic resonance imaging, can help visualize endometriomas and deeply infiltrating endometriosis. Additionally, there have been no serum marker tests available so far. However, even intraoperatively, the diagnosis may be missed, leading to under diagnosis and delayed or noninitiation of treatment. There are thought to be three distinct endometriotic lesions of the pelvis that are seen laparoscopically. The first is that which is visible on the pelvic peritoneal surface or the surface of the ovary, which is commonly termed peritoneal endometriosis. Second, endometriotic lesions that occur within the ovary and form cysts that are often lined with endometrioid mucosa are termed endometriomas. Lastly, rectovaginal endometriomas are endometriotic lesions that contain a mixture of adipose and fibrous tissue located between the rectum and vagina. All of these lesions can be singular or multiple and the pelvis may contain one or all three types of lesions. The shared histologic feature with all three lesions is the presence of endometrial epithelial cells or endometrial stroma. During a diagnostic procedure, the da-Vinci robot and its firefly mode allow for three dimensional visualization and seven degrees of instrument articulation for meticulous dissection of fibrotic areas of peritoneum that may contain deep infiltrating lesions of endometriosis. This case report describes a relatively new and innovative technique for effectively diagnosing and successfully treating endometriosis when other less invasive methods have failed.

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Section: Discussionmentioning

confidence: 99%

Improving accuracy of intraoperative diagnosis of endometriosis: Role of firefly in minimal access robotic surgery

2016

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“…Icodextrin 4% solution, acts as an osmotic agent that retains fuid within the peritoneal cavity for 3 to 4 days and prevents contact between organs using hydro floatation. 45 Modified oxidised regenerated cellulose (Interceed) is the first barrier to demonstrate efficacy in humans which forms a gel and physically separates tissue layers during tissue healing. Hyaluronan and carboxymethyl cellulose-based bioresorbable membrane (Seprafilm) are used as a barrier to keep the intestines separated until the mesothelial lining is restored.…”

Section: Pharmacological Agentsmentioning

confidence: 99%

Adhesive Small Bowel Obstruction: A Review

Ghimire

Maharjan

2023

J Nepal Med Assoc

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Adhesion is a leading cause of small bowel obstruction. Adhesive small bowel obstruction has significant challenges in diagnosis, treatment and prevention with considerable impact on morbidity and socioeconomic burden. Small bowel obstruction caused by adhesion or any other aetiology is clinically indistinguishable due to similar clinical presentation. Computed Tomography scans and water-soluble contrast studies are more specific in diagnosis and possess value in predicting the need for surgery. Surgical management is indicated only in complicated cases or failed conservative treatments with the majority resolving with non-operative management. However, there is no clear-cut consensus about the timing of operative intervention. Meticulous surgical practice is the keystone in preventing adhesion formation despite the availability of numerous pharmacological and surgical strategies. This review aims to update the current knowledge of the pathophysiology of adhesion formation, treatment options and various prevention modalities of adhesive small bowel obstruction.

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Pelvic Adhesive Disease: Current Approaches to Management

Cited by 2 publications

References 17 publications

Improving accuracy of intraoperative diagnosis of endometriosis: Role of firefly in minimal access robotic surgery

Improving accuracy of intraoperative diagnosis of endometriosis: Role of firefly in minimal access robotic surgery

Adhesive Small Bowel Obstruction: A Review

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