Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-27T14:11:19.548Z Has data issue: false hasContentIssue false

Chapter 45 - Basic Laparoscopic Gynaecological Procedures

from Section 10 - Operative Gynaecology

Published online by Cambridge University Press:  24 November 2021

By
Gabriele Centini ,
Simone Bruni  and
Karolina Afors
Edited by
Tahir Mahmood ,
Charles Savona-Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
Get access

Summary

In the last decade, laparoscopic surgery had become popular in gynaecological surgery. Advantages of the minimally invasive approach are reduced postoperative morbidity, less postoperative pain and, consequently, less analgesic requirement, early resumption of intestinal activity and reduced length of hospital stay. Ectopic pregnancy occurs in approximately 1–2% of pregnancies and the incidence is increasing. The most common site of ectopic pregnancy is the ampullary tubal portion and less frequently other parts of the tube and uterus (cornual and caesarean scar pregnancy), the cervix, the ovary and the abdominal cavity are affected. All variants of extrauterine pregnancy can be treated by a minimally invasive approach in the majority of cases. Moreover, minimally invasive surgery can be considered the standard therapeutic option for adnexal masses which represent one of the most common gynaecological diseases. In this chapter, we describe the main surgical techniques concerning these two pathologies, which are of great interest for daily gynaecological practice.

Keywords

laparoscopyectopic pregnancysalpingotomysalpingectomyovarian cysts
Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 397 - 406
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Sowter, MC, Farquhar, CM, Petrie, KJ, Gudex, G. A randomised trial comparing single dose systemic methotrexate and laparoscopic surgery for the treatment of unruptured tubal pregnancy. BJOG 2001;108:192–203.Google ScholarPubMed
Graczykowski, JW, Mishell, DR Jr. Methotrexate prophylaxis for persistent ectopic pregnancy after conservative treatment by salpingostomy. Obstet Gynecol 1997;89:118–122.CrossRefGoogle ScholarPubMed
Vermesh, M, Silva, PD, Rosen, GF, et al. Management of unruptured ectopic gestation by linear salpingostomy: a prospective, randomized clinical trial of laparoscopy versus laparotomy. Obstet Gynecol 1989;73:400–404.Google Scholar
Lundorff, P, Thorburn, J, Hahlin, M, Kallfelt, B, Lindblom, B. Laparoscopic surgery in ectopic pregnancy: a randomized trial versus laparotomy. Acta Obstet Gynecol Scand 1991;70:343–348.CrossRefGoogle ScholarPubMed
Gray, DT, Thorburn, J, Lundorff, P, Strandell, A, Lindblom, B. A cost-effectiveness study of a randomised trial of laparoscopy versus laparotomy for ectopic pregnancy. Lancet 1995;345:1139–1143.CrossRefGoogle ScholarPubMed
Mol, F, van Mello, NM, Strandell, A, Jurkovic, D, Ross, J. Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label, multicentre, randomised controlled trial. Lancet 2014;383:1483–1489.CrossRefGoogle ScholarPubMed
Becker, S, Solomayer, E, Hornung, R, et al. Optimal treatment for patients with ectopic pregnancies and a history of fertility-reducing factors. Arch Gynecol Obstet 2011;283:41–45.Google Scholar
Lee, DH. Recurrent ectopic pregnancy after ipsilateral partial salpingectomy: a case report. Clin Exp Obstet Gynecol 2015;42:540–542.CrossRefGoogle ScholarPubMed
Lee, MH, Im, SY, Kim, MK, Shin, SY, Park, WI. Comparison of laparoscopic cornual resection and cornuotomy for interstitial pregnancy. J Minim Invasive Gynecol 2017;24:397–401.CrossRefGoogle ScholarPubMed
Kaur, N, Reid, F, Ma, K. Ovarian ectopic pregnancy: laparoscopic excision and ovarian conservation. J Minim Invasive Gynecol 2019;26:1006.Google Scholar
Kaijser, J, Bourne, T, Valentin, L, et al. Improving strategies for diagnosing ovarian cancer: a summary of the International Ovarian Tumor Analysis (IOTA) studies. Ultrasound Obstet Gynecol 2013;41:9–20.Google Scholar
Royal College of Obstetricians and Gynaecologists. Management of suspected ovarian masses in premenopausal women. Green-top Guideline No. 62. 2011.Google Scholar
Royal College of Obstetricians and Gynaecologists. The management of ovarian cysts in postmenopausal women. Green-top Guideline No. 34. 2016.Google Scholar
Canis, M, Rabischong, B, Houlle, C, et al. Laparoscopic management of adnexal masses: a gold standard? Curr Opin Obstet Gynecol 2002;14:423–428.Google Scholar
Canis, M, Botchorishvili, R, Manhes, H, et al. Management of adnexal masses: role and risk of laparoscopy. Semin Surg Oncol 2000;19:28–35.3.0.CO;2-C>CrossRefGoogle ScholarPubMed
Canis, M, Mage, G, Pouly, JL, et al. Laparoscopic management of suspicious adnexal masses. J Am Assoc Gynecol Laparosc 1994;1:S6.Google Scholar
Canis, M, Mage, G, Pouly, JL, et al. Laparoscopic diagnosis of adnexal cystic masses: a 12-year experience with long-term follow-up. Obstet Gynecol 1994;83:707–712.Google Scholar
Wiskind, AK, Toledo, AA, Dudley, AG, Zusmanis, K. Adhesion formation after ovarian wound repair in New Zealand white rabbits: a comparison of ovarian microsurgical closure with ovarian nonclosure. Am J Obstet Gynecol 1990;163:1674–1678.CrossRefGoogle ScholarPubMed
Exacoustos, C, De Felice, G, Pizzo, A, et al. Isolated ovarian endometrioma: a history between myth and reality. J Minim Invasive Gynecol 2018;25:884–891.Google Scholar
Jadoul, P, Kitajima, M, Donnez, O, Squifflet, J, Donnez, J. Surgical treatment of ovarian endometriomas: state of the art? Fertil Steril 2012;98:556–563.CrossRefGoogle ScholarPubMed
López de la Torre, MA, Abrao, HM, Fernandes, LF, Kho, RM, Abrao, MS. Ten principles for safe surgical treatment of ovarian endometriosis. J Minim Invasive Gynecol 2017;24:203–204.Google Scholar
Muzii, L, Luciano, AA, Zupi, E, Panici, PB. Effect of surgery for endometrioma on ovarian function: a different point of view. J Minim Invasive Gynecol 2014;21:531–533.Google Scholar
Bourdel, N, Roman, H, Mage, G, Canis, M. Surgery for the management of ovarian endometriomas: from the physiopathology to the pre-, peri- and postoperative treatment. Gynécol Obstét Fertil 2011;39:709–721.Google Scholar
Muzii, L, Achilli, C, Bergamini, V, et al. Comparison between the stripping technique and the combined excisional/ablative technique for the treatment of bilateral ovarian endometriomas: a multicentre RCT. Hum Reprod 2016;31:339–344.Google ScholarPubMed
Working group of ESGE, ESHRE and WES. Recommendations for the surgical treatment of endometriosis – part 1: ovarian endometrioma. Gynecolog Surg 2017;14:27.Google Scholar
Eltabbakh, GH, Charboneau, AM, Eltabbakh, NG. Laparoscopic surgery for large benign ovarian cysts. Gynecol Oncol 2008;108:72–76.Google Scholar
Mecke, H, Savvas, V. Laparoscopic surgery of dermoid cysts: intraoperative spillage and complications. Eur J Obstet Gynecol Reprod Biol 2001;96:80–84.CrossRefGoogle ScholarPubMed
Sinha, A, Ewies, AA. Ovarian mature cystic teratoma: challenges of surgical management. Obstet Gynecol Int 2016;2016:2390178.Google Scholar
Vaudoyer, F, Golfier, F, Raudrant, D. Operative technique for assumed benign ovarian cysts. J Gynecol Obstet Biol Reprod 2001;30:S68–S77.Google Scholar
Borghese, B, Marzouk, P, Santulli, P, de Ziegler, D, Chapron, C. Surgical treatments of presumed benign ovarian tumors. J Gynecol Obstet Biol Reprod 2013;42:786–793.CrossRefGoogle ScholarPubMed
Audebert, AJ, Gomel, V. Role of microlaparoscopy in the diagnosis of peritoneal and visceral adhesions and in the prevention of bowel injury associated with blind trocar insertion. Fertil Steril 2000;73:631–635.Google Scholar
Ahmad, G, O’Flynn, H, Duffy, JM, Phillips, K, Watson, A. Laparoscopic entry techniques. Cochrane Database Syst Rev 2012;2:CD006583.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×