Practical Endoscopy - Tips by Experts

About the Book

• A concise reference book for beginners and busy surgeons in need of precise practical tips during endoscopic surgery.
• It starts with basic principles of endoscopic surgery, instrumentations and set-up.
• Each chapter describes in-depth preoperative preparation, steps of surgery, tips and tricks by surgeons.
• Encompasses variety of minimally invasive gynecology techniques, such as vaginal surgery, laparoscopy and hysteroscopy.
• Includes latest advances like use of laparoscopy with robotic assistance, single incision laparoscopy and transvaginal sling procedures for stress incontinence.
• Practical tips and footnotes given at the end of chapters.
• Enriched with colourful surgical photographs that facilitates understanding of the surgical techniques.
• An important add-on resource for medical libraries, trainees and practical gynaecologists.

About the Author

Sunita R Tandulwadkar MD FICS Dip Endo (USA and Germany) Nirzari Mangeshikar MBBS DNB (OBGY)

Table of Contents:
Section 1 BASIC ENDOSCOPY CHAPTER 1. How to Set-up an Ideal Endoscopic Operation Theater 3 PG Paul, Sunita R Tandulwadkar, Renuka Borisa, P Biju, Kannan K, Fiadjoe P CHAPTER 2. Equipment and Instruments in Endoscopic Surgery 5 Sunita R Tandulwadkar Anesthesia Work Station 5 CHAPTER 3. Energy Sources in Endoscopic Surgery 11 Wachyu Hadisaputra, Leonita TA Sutrisna Aim 11 Fundamentals and Biophysics of Electrosurgery 11 Types of Energy Source 12 Use of the Thermal Effect 12 General Safety Aspects 13 Prevention of Electrosurgical Injuries 14 Other Energy Sources 15 CHAPTER 4. Medicolegal Issues in Endoscopic Surgeries 17 Sanjay Gupte Medicolegal Aspects in Endoscopic Surgeries 17 CHAPTER 5. Prevention of Complications in Endoscopic Surgeries 20 PG Paul, Renuka Borisa, P Biju, Kannan K, Fiadjoe P Prevention of Preoperative Complication 20 Prevention of Postoperative Complications 22 Prevention of Complications During Hysteroscopy 23 CHAPTER 6. Port Placement 24 Sunita R Tandulwadkar Routine Port Placements 24 In Difficult Situations, Like 24 CHAPTER 7. Laparoscopic Suturing 27 Alessandro Loddo, Vito Cofelice, Gian Benedetto Melis Making the Ideal Stitch 28 Suturing Techniques 28 Contentsxvi Practical Endoscopy: Tips by Experts Section 2 HYSTEROSCOPY CHAPTER 8. Diagnostic Hysteroscopy 37 Sunita R Tandulwadkar, Pooja Lodha Preoperative Preparation 37 Anesthesia 37 Important Equipment 37 Technique 37 CHAPTER 9. Office Hysteroscopy 42 Sunita R Tandulwadkar, Pooja Lodha Preoperative Evaluation 42 Preoperative Preparation 42 Important Equipment 42 Technique 42 CHAPTER 10. Classification of Microhysteroscopic Images 44 Jorge E Dotto, Paola Da Graca Mila, Miguel A Bigozzi Jr, Jorge E Dotto Jr, Jacques Hamou Hysteroscopy Techniques 44 Classification of Hysteroscopic Images 44 CHAPTER 11. Hysteroscopic Myomectomy 56 Sunita R Tandulwadkar, Nirzari Mangeshikar Preoperative Evaluation 56 Preoperative Preparation 56 Important Equipment 56 Classification of Submucosal Fibroid 56 Technique 56 CHAPTER 12. Hysteroscopic Management of Intrauterine Adhesions 62 Sunita R Tandulwadkar, Pooja Lodha Preoperative Evaluation 62 Preoperative Preparation 62 Instrumentation 62 Technique 62 Postoperative Care 62 CHAPTER 13. Hysteroscopic Cannulation for Proximal Tubal Block 66 Sunita R Tandulwadkar Preoperative Evaluation 66 Preoperative Preparation 66 Important Equipment 66 Technique 66Contents xvii CHAPTER 14. Hysteroscopic Resection of Septum 68 Sunita R Tandulwadkar, Sejal Naik Preoperative Evaluation 68 Preoperative Preparation 68 Special Instruments 68 Technique 68 Section 3 LAPAROSCOPY CHAPTER 15. Laparoscopic Hysterectomy 75 Sunita R Tandulwadkar Preoperative Evaluation 75 Preoperative Preparation 75 Important Equipment 75 Technique 75 Steps of Laparoscopic Hysterectomy 76 CHAPTER 16. Laparoscopic Subtotal and Total Hysterectomy for Multiple Fibroids 84 Liselotte Mettler, Anupama Deenadayal, Ibrahim Alkatout Microscopic Facts and Fibroid Viability 86 Costs of Fibroids 86 Will the Ovaries be Removed or Left in Place? 86 Laparoscopic Subtotal Hysterectomy 87 Prerequisites 87 Steps of Surgery 88 Laparoscopic Total Hysterectomy (LTH) 91 CHAPTER 17. Laparoscopic Hysterectomy in Case of Large Uteri 111 Bruno J van Herendael, Lisbeth Jochems Preparation of the Surgery 111 The Ten Step Laparoscopic Hysterectomy 113 CHAPTER 18. Laparoscopic Hysterectomy for Previous Cesarean Sections 118 Ornella Sizzi, Giuseppe Florio Preoperative Evaluation 118 Preoperative Preparation 118 Equipment 118 Technique 118 Changing of Technique for Previous Cesarean Sections 121 Steps in Case of Adhesions and Uterus Ventrofixation 121 CHAPTER 19. Laparoscopic Hysterectomy in Endometriosis 126 Sanjay Patel, Yogendra Jhala Hysterectomy in Endometriosis with Frozen Pelvis 126xviii Practical Endoscopy: Tips by Experts CHAPTER 20. Laparoscopic Radical Hysterectomy 135 Shailesh Puntambekar Preoperative Preparation 135 Instruments and Equipment 135 Technique 135 Procedure 135 CHAPTER 21. Laparoscopic Myomectomy 143 Sunita R Tandulwadkar, Nirzari Mangeshikar Preoperative Evaluation of the Patient 143 Preoperative Preparations 143 Instruments and Equipment 143 Bowel Preparation 143 Prerequisites 143 Procedure 143 Closure of Uterine Flap 144 Extraction of Myoma 144 Myomectomy in Difficult Situations 144 CHAPTER 22. Laparoscopic Myomectomy for Intramural Fibroids 153 Rafique Parkar Indications 153 Contraindications 153 Advantages 153 Principles for a Good Laparoscopic Myomectomy 154 Preoperative Evaluation/Preparation 154 Surgical Procedure 154 CHAPTER 23. Laparoscopic Management of Benign Ovarian Mass 160 Prakash Trivedi Preoperative Evaluation 160 Preoperative Preparation 160 Laparoscopic Ovarian Cystectomy 160 Polycystic Ovarian Drilling 160 Benign Cystic Teratomas 168 CHAPTER 24. Laparoscopic Management of Tubal Ectopic 171 Sunita R Tandulwadkar, Sejal Naik Unruptured Ectopic 171 Salpingostomy 171 Salpingectomy 172 Ruptured Ectopic 172 CHAPTER 25. Laparoscopic Salpingectomy 176 Sunita R Tandulwadkar Preoperative Evaluation 176 Preoperative Preparation 176Contents xix Criteria for Salpingectomy in an Infertile Patient 176 Instruments 176 Procedure 176 CHAPTER 26. Conservation Laparoscopic Management of Hydrosalpinx 180 Sunita R Tandulwadkar Preoperative Evaluation 180 Preoperative Preparation 180 Important Equipment 180 Surgical Steps 180 CHAPTER 27. Laparoscopic Tubotubal Anastomosis 183 Sanjay Patel Preoperative Evaluation 183 Indications 183 Contraindications 183 Equipment and Instruments 183 Sutures, Needles and Energy 183 Selection of Cases 184 Intra-operative Evaluation 184 Surgical Technique 184 Procedure 187 Types of Anastomosis 187 CHAPTER 28. Laparoscopic Management of Endometrioma 193 Sunita R Tandulwadkar Preoperative Evaluation 193 Preoperative Preparation 193 Important Equipment 193 Ablation of Cyst Wall 193 Cystectomy 194 CHAPTER 29. Salpingoscopy 198 Sanjay Patel Instruments and Procedure of Salpingoscopy 198 CHAPTER 30. Laparoscopic Management of Adenomyoma 205 Sanjay Patel, Yogendra Jhala Transvaginal Ultrasonography 205 Adenoma on Laparoscopy 206 Adenoma on Hysteroscopy 206 Coexisting Pathologies 208 Preoperative Adenoma Mapping 208 AIM of the Adenoma Resection 209 Technique of Adenomyoma Resection 209 Technique of Endosuturing: Intra-corporeal Slip Knot Technique 212 Our Experience 213xx Practical Endoscopy: Tips by Experts CHAPTER 31. Anatomy of Pelvic Floor and Laparoscopic Prolapse Repair 215 Revaz Botchorishvili, Sara Campos Preoperative Evaluation 215 Preoperative Preparation 215 Specific Instruments and Equipment 215 Prerequisites 216 Port Placements 216 Anatomical Landmarks in Port Placement 216 Key steps of the Procedure 216 CHAPTER 32. Laparoscopic Sling Surgery 224 Sunita R Tandulwadkar, Nirzari Mangeshikar Laparoscopic Sacro-spinous Fixation for Uterine Prolapse 224 CHAPTER 33. Laparoscopic Cervical Cerclage 228 Sunita R Tandulwadkar, Nirzari Mangeshikar When to Perform? 228 Advantages 228 Disadvantages 228 Preoperative Evaluation 228 Preoperative Preparation 228 Instruments and Materials 228 Steps of Laparoscopic Cerclage Procedure 228 CHAPTER 34. Single Incision Laparoscopic Surgery using Common Laparoscopic Instruments 231 Sevellaraja Supermaniam Preoperative Evaluation 231 Preoperative Preparation 231 Important Equipment 231 Technique 231 Steps for Performing Single Incision Laparoscopic Hysterectomy 234 Postoperative Management 238 Other Procedures that can be Performed by this Technique 238 CHAPTER 35. Robotic Surgery in Gynecology 241 Charles Miller, Kirsten Sasaki Selection of Cases 241 Preparation for Surgery 241 Section 4 VAGINAL SURGERY CHAPTER 36. Vaginal Surgery: Surgical Principles 249 Andri Nieuwoudt Anatomical Considerations 251 Perivaginal Organization 251 The Role of Surgical Auditing in Defect Specific Surgery 254Contents xxi CHAPTER 37. Nondescent Vaginal Hysterectomy 258 Sunita R Tandulwadkar Preoperative Evaluation 258 Preoperative Preparation 258 Anesthesia 258 Position 258 Technique 258 Modifications 258 Postoperative 259 CHAPTER 38. Newer Concepts of Anterior and Posterior Vaginal Prolapse Repair 260 Ajay Rane Pelvic Organ Supports 260 Diagnosis 261 POP-Q System 261 Investigations 261 Urodynamics 261 Imaging 261 Ultrasound 261 Surgical Management 261 Transobturator Mesh (PERIGEE) 262 Transobturator Sling (MONARC) 262 CHAPTER 39. Apical and Posterior Vaginal Wall Repair 265 Andri Nieuwoudt Apical and Posterior Vaginal Wall Repair 265 I. Bilateral Uterosacral Cervicopexy (BUSCer) 268 II. Bilateral Uterosacral Colpopexy (BUSCol) 273 CHAPTER 40. Transvaginal Tape Obturator (TVTO) for Stress Urinary Incontinence 276 Prakash Trivedi, Sunita R Tandulwadkar Preoperative Evaluation 276 Preoperative Preparation 276 Important Equipment 276 Procedure 276 Tvt AbbrevoTM 285 Section 5 UNUSUAL CASES CHAPTER 41. Uterus Didelphys with Abnormally Placed Ovaries 289 Sunita R Tandulwadkarxxii Practical Endoscopy: Tips by Experts CHAPTER 42. Case of Chronic Twisted Adnexa 293 Sunita R Tandulwadkar CHAPTER 43. 27-year-old Female with Bad Obstetric History with Unicornuate Uterus 295 Sunita R Tandulwadkar, Pooja Lodha CHAPTER 44. Case of Ovarian Fibroma 297 Prakash Trivedi, Sunita R Tandulwadkar CHAPTER 45. Laparoscopy for Benign Uterine, Tubal and Ovarian Pathologies in Adolescent Age Group 300 Sunita R Tandulwadkar, Nirzari Mangeshikar Pre-operative Preparations 300 Intra-operative considerations 300 Post-operative considerations 300 CHAPTER 46. Hysteroscopic Resection of a Large Type 0 Submucous Myoma 312 Sunita R Tandulwadkar, Nirzari Mangeshikar CHAPTER 47. Anti-NMDA Receptor Antibody Encephalitis—A Rare Condition Associated with Ovarian Teratoma 314 Sunita R Tandulwadkar, Devika Chopra Investigations 314 Diagnosis 314 Histopathology 314 Patient Recovery 315 Index 317