1. Intraoperative Techniques for Evaluation of Minor Ureteral Injuries.
- Author
-
King, NR and Lee, TTM
- Abstract
To demonstrate intraoperative surgical techniques used to evaluate ureteral integrity following gynecologic laparoscopy. N/A. The patients underwent surgery at a tertiary care center. They were placed in dorsal lithotomy position in steep Trendelenburg to aid in performance of pelvic laparoscopy. Insufflation was carried out to 15mmHg. A primary 10mm umbilical trocar was used for the camera and three additional 5mm assist ports were placed. The first patient is a 35-year-old G0 who underwent laparoscopic excision of severe bilateral deep infiltrating endometriosis. The second patient is a 51-year-old G3P2103 who underwent total laparoscopy hysterectomy for pain caused by post-ablation tubal sterilization syndrome. Indocyanine Green dye given intravenously followed by infrared imaging via laparoscopy. Retrograde instillation of methylene blue into the ureter under laparoscopic visualization. The first patient had a small area of devascularization along the right ureter and the second patient had a small luminal defect in the distal left ureter. Both were treated with indwelling stents and recovered without complication. The techniques outlined in this video can aid gynecologic surgeons in identifying minor ureteral injuries intraoperatively, allowing for prompt treatment and avoidance of severe morbidity and long-term sequelae. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF