Robotic or laparoscopic treatment of cesarean scar defects or cesarean scar pregnancies with a uterine sound guidance

Wang, Hsiao-Fen; Chen, Huihua; Ting, Wan-Hua; Lu, Hsin-Fen; Lin, Ho‐Hsiung; Hsiao, Sheng‐Mou

doi:10.1016/j.tjog.2021.07.007

Cited by 6 publications

(3 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 Particularly, some researchers have demonstrated the effectiveness of laparoscopic CSD excision and repair, [4][5][6] while others have reported on the usefulness of robotic surgery for CSDi. 7,8 The latter reports suggest that needle handling procedures are easier to perform than laparoscopic surgery because of the challenges associated with laparoscopic suturing of the resected isthmus.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of an articulating laparoscopic needle holder for cesarean scar defect repair

Nobuta,

Tsuji,

Nakamura

et al. 2024

J of Obstet and Gynaecol

View full text Add to dashboard Cite

AimTo evaluate the efficacy of an articulating laparoscopic needle holder in laparoscopic surgery for cesarean scar defect.MethodsWe performed a retrospective case–control study at the Shiga University of Medical Science. Patients who underwent laparoscopic uterine scar repair were divided into an articulating laparoscopic needle holder (ArtiSential®) group and a rigid needle holder (conventional) group to compare the suture and total operative times. Uterine myometrial suturing involves a double‐layer interrupted suture, including a modified Gambee suture for the first layer. We measured the residual myometrial thickness using magnetic resonance imaging preoperatively and at 3 months postoperatively.ResultsBoth groups comprised 10 patients each. The time per stitch for the first and second layers was significantly shorter in the ArtiSential group than in the conventional group (median 208 s vs. 403 s, p < 0.0001 and median 17 s vs. 29 s; p < 0.0001, respectively). The total operating time was significantly shorter in the ArtiSential group (mean 188 min vs. 240 min, p = 0.0015). The postoperative residual myometrial thickness (mean 9.1 mm in the ArtiSential group and 9.6 mm in the conventional group) was significantly higher than the preoperative residual myometrial thickness (mean 1.6 mm in the ArtiSential group and 1.6 mm in the conventional group) (p < 0.0001 in both groups).ConclusionsAn articulating needle holder is useful in laparoscopic surgery for cesarean scar defect, especially when a modified Gambee suture is required.

show abstract

Section: Introductionmentioning

confidence: 99%

Effectiveness of an articulating laparoscopic needle holder for cesarean scar defect repair

Nobuta,

Tsuji,

Nakamura

et al. 2024

J of Obstet and Gynaecol

View full text Add to dashboard Cite

show abstract

“…Yuan et al [ 15 ] proposed a focused ultrasound ablation method combined with ultrasound-guided suction curettage for the treatment of CSP. Other methods include laparoscopic management [ 16 , 17 ], sometimes with robotic assistance [ 18 , 19 ], ligation/clamping of uterine arteries [ 20 ], lesion resection [ 21 ], and transvaginal hysterotomy [ 22 ]. Some protocols propose vacuum aspiration under ultrasound guidance [ 23 , 24 ], due to the low blood loss while other authors recommend administration of multidose regimen of methotrexate [ 25 , 26 , 27 ] combined with curettage [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Uterine Artery Embolization Combined with Subsequent Suction Evacuation as Low-Risk Treatment for Cesarean Scar Pregnancy

Bohîlțea

Ducu

Mihai³

et al. 2021

Diagnostics

View full text Add to dashboard Cite

Objective: The aim of this study is to propose a standardized management of care for patients diagnosed with cesarean scar pregnancy (CSP). There are two types of CSP: Type 1 (on the scar) vs. type 2 (in the niche). To date there is no international standard to predict the extent of invasion or the optimal management of CSP. Materials and methods: We used intramuscular methotrexate injection followed by uterine artery embolization combined with suction evacuation as a conservative approach for the treatment of seven patients diagnosed with CSP. Our inclusion criteria, to be satisfied simultaneously, were established as follows: (1) patients with CSP; (2) early gestational age ≤ 9 weeks, and (3) written consent of the proposed treatment of the patient. Results: This course of treatment produced a positive outcome in all cases. We did not have any complications (e.g., emergency hysterectomy, perforation of the uterine cavity, severe hemorrhage, or endometritis) during the procedures or in the follow-up. The most important predictors of successful management are early diagnosis of CSP and orientation of the invasive trophoblast opposite to the scar. Conclusions: The main finding from this series of cases is that associating systemic methotrexate and uterine artery embolization provides efficient and low-risk management of CSP. This treatment regime is adequate for both types of CSPs. We consider that early localization diagnosis of pregnancy following a cesarean delivery is mandatory for CSP morbidity prevention.

show abstract

“…1 Besides conservative treatment, surgical lysing procedures, called as adhesiolysis sometimes cannot be totally avoided in these subjects with adhesion, since either emergency, such as intestinal obstruction complicated by adhesions or the other indications for further surgery, such as recurrent uterine myomas, adenomyosis, chocolate cysts, or others may occur. Minimally invasive procedures, such as hysteroscopic, laparoscopic, and robotic approaches, are very popular in the management of subjects with various indications for surgeries, 5,8,9 and additionally, these approaches are also reported as the preferred options for adhesiolysis. 1,10 However, it is believed in long term that history of any of myomectomy, cystectomy, electrofulguration for endometriosis, appendectomy, or bowel surgery is considered as a “contraindication” for laparoscopic surgeries, 11 although this hypothesis is worthy of being tested.…”

mentioning

confidence: 99%

Pelvic adhesion: A challenge of all gynecologic surgeries

Liu

Wang

2022

Journal of the Chinese Medical Association

View full text Add to dashboard Cite

Robotic or laparoscopic treatment of cesarean scar defects or cesarean scar pregnancies with a uterine sound guidance

Cited by 6 publications

References 27 publications

Effectiveness of an articulating laparoscopic needle holder for cesarean scar defect repair

Effectiveness of an articulating laparoscopic needle holder for cesarean scar defect repair

Uterine Artery Embolization Combined with Subsequent Suction Evacuation as Low-Risk Treatment for Cesarean Scar Pregnancy

Pelvic adhesion: A challenge of all gynecologic surgeries

Contact Info

Product

Resources

About