ENDOSCOPIC SLIDE Flyer - AGES

PROGRAM ABSTRACTS
>>>>>>>>>>> THE LIMITS OF ENDOSCOPIC SURGERY
Laparoscopy in pregnancy
Saturday 19 August / Session 9 / 1100 - 1120
Yuen PM
complications. The prevention, recognition and management of
these problems are essential for this surgery to be acceptable.
Methods include the broad use of minimally invasive reinvestigation
as indicated, and that delay in recognising and managing
complications can result in significant morbidity and mortality.
Background: Pregnancy, especially in more advanced gestation,
was considered as an absolute contraindication for laparoscopy. With
the advance in technology and improvement in surgical skill,
laparoscopy has also been employed in advanced pregnancy, mostly
for removal of persistent adnexal mass. We evaluated our 10 years
experience in the performance of laparoscopy for removal of
persistent adnexal mass in the second trimester of pregnancy.
Methods: Between April 1994 and December 2005, 75
consecutive women underwent laparoscopic removal of adnexal
masses that had persisted into the second trimester of pregnancy
in an academic tertiary referral centre. Operative complications,
pregnancy and labor outcomes were evaluated.
Results: The median gestation was 10.5 weeks (range 5-25) at
diagnosis and 16 weeks (range 12-25) at the time of operation.
Only two women required conversion to laparotomy. Cystectomy
was performed in 62 women, oophorectomy in 10 and fenestration
in 3. The median operating time was 50 minutes (range 30-120).
There were no intra-operative complications or major
postoperative complications. No women were given tocolytic
therapy and none developed uterine contractions. There was one
spontaneous abortion 6 weeks after the operation and one woman
was lost to follow up. Of the remaining 73 women, the median
gestation at delivery was 39 weeks (range 33-42) and the median
birthweight was 3155 gms (range 2220 – 4200). Conclusions:
Laparosocpic surgery for persistent adnexal masses in the second
trimester of pregnancy is safe with low maternal and perinatal
morbidity and mortality when performed by experienced surgeons.
Author address: Professor Pong Mo Yuen President of Asia-Pacific
Association of Gynecologic Endoscopy and Minimally Invasive Therapy
(APAGE). Consultant and Honorary Clinical Associate Professor,
Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The
Chinese University of Hong Kong, Hong Kong
The unwell patient after laparoscopy
Saturday 19 August / Session 9 / 1140 - 1200
Stening F
Laparoscopy has revolutionised abdominal surgery and, as a
result, has been associated with some unique post operative
Case presentation: Adhesiolysis for chronic
pain – a medico-legal dilemma
Saturday 19 August / Session 10 / 1200 - 1300
Karthigasu K
Adhesions:- Adhesions are a difficult dilemma for all
gynaecologists. Do they cause symptoms Do they cause pain
How can we distinguish which adhesions cause pain Will operating
on them provide relief of symptoms Will operating make the
patients worse Do the risks of surgery outweigh benefits All
these questions we ask ourselves when faced with patients with
possible adhesions. In this session we present a number of cases
and ask an expert panel their opinions on management.
Vecchietti procedure
Saturday 19 August / Session 12 / 1545 - 1600
Cooper M
Mayer-Von Rokitansky-Kuster-Hauser (MRKH) Syndrome is a
rare congenital abnormality characterised by normal secondary
sexual characteristics, vaginal aplasia, normal ovaries and a
rudimentary uterus. The prevalence of this anomaly is one case
per 4-5,000 live female births. To produce a functioning
neovagina in affected subjects, management relies on one of
several approaches; non-surgical i.e. Frank technique (1), a
split-thickness skin graft i.e. McIndoes technique (2), sigmoid
colon grafts (3,4) or a combination of surgical and non-surgical
(Vecchietti technique). Numerous variations of these techniques
have also been described.
Giuseppe Vecchietti first described his technique for creating a
neovagina in subjects with Mayer-Von Rokitansky-Kuster-Hauser
Syndrome (MRKH) in 1965 (5). The initial description was of an
open abdominal procedure involving a Pfannenstiel incision,
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>>>>>>>> THE LIMITS OF
ENDOSCOPIC SURGERY