Perioperative comparisons of the laparoscopic myomectomy and laparoscopically assisted myomectomy in women with symptomatic uterine myoma / 대한산부인과내시경학회지

OBJECTIVE: This study was conducted to compare the perioperative outcomes in patients with symptomatic uterine myoma who underwent laparoscopic (LM) or laparoscopically assisted myomectomy (LAM). METHODS: A total of 207 patients with myoma underwent LM or LAM in Samsung Medical Center between October 2006 and March 2010. Of them, 121 patients with LM and 50 with LAM met the inclusion criteria and were compared for the perioperative outcomes. RESULTS: The operation time was significantly shorter in the LAM group than in the LM group (111 min versus 139 min; p<.001, respectively). Estimated blood loss was significantly higher in the LAM group (p<.001). Intraoperative, early postoperative complications, hospitalization days and postoperative analgesics use were similar between the 2 study groups. CONCLUSION: LM and LAM is comparable in the perioperative outcomes in patients with symptomatic uterine myoma.

Differentiation in the Management of Osteoporosis between Premenopausal and Menopausal Women / 대한폐경학회지

OBJECTIVES: To evaluate the management and awareness of osteoporosis based on general characteristics, problems, and menopausal status. METHODS: Two hundred twenty women were recruited from the Department of Obstetrics and Gynecology of a university hospital between January 2010 and December 2010. The participants completed self-questionnaires about the management of osteoporosis. We determined the correlation of the management of osteoporosis between pre- and post-menopausal women using ANOVA with SPSS version 12.0K (SPSS Inc., Chicago, IL, USA). RESULTS: The mean age was 52.5 +/- 9.4 years (range, 43~83 years). One hundred twenty-four women were postmenopausal (56.1%). Postmenopausal women were statistically more likely to have examinations for osteoporosis, and take calcium and engage in exercise to prevent osteoporosis. CONCLUSION: It is necessary to educate and counsel premenopausal women and patients at high-risk for fracture about the management of osteoporosis.

Differentiation in the Management of Osteoporosis between Premenopausal and Menopausal Women / 대한폐경학회지

OBJECTIVES: To evaluate the management and awareness of osteoporosis based on general characteristics, problems, and menopausal status. METHODS: Two hundred twenty women were recruited from the Department of Obstetrics and Gynecology of a university hospital between January 2010 and December 2010. The participants completed self-questionnaires about the management of osteoporosis. We determined the correlation of the management of osteoporosis between pre- and post-menopausal women using ANOVA with SPSS version 12.0K (SPSS Inc., Chicago, IL, USA). RESULTS: The mean age was 52.5 +/- 9.4 years (range, 43~83 years). One hundred twenty-four women were postmenopausal (56.1%). Postmenopausal women were statistically more likely to have examinations for osteoporosis, and take calcium and engage in exercise to prevent osteoporosis. CONCLUSION: It is necessary to educate and counsel premenopausal women and patients at high-risk for fracture about the management of osteoporosis.

Brachial Plexus Injury During Laparoscopic Gynecologic Surgery in Postmenopausal Women / 대한폐경학회지

Neurologic complications are rarely associated with laparoscopic procedures. The probable etiology of an axonal injury to the musculocutaneous nerve (motor branch) of the biceps brachii during a laparoscopic procedure is the position in which the patient is maintained. Restraining arms during general anesthesia with an unintentional change in the angle of the arm in the Trendelenburg position, may lead to hyperextension of the arm, resulting in pressure on and stretching of the brachial plexus nerve and neurologic damage. We present a case of a patient undergoing gynecologic surgery who had a brachial plexus injury.

Brachial Plexus Injury During Laparoscopic Gynecologic Surgery in Postmenopausal Women / 대한폐경학회지

Neurologic complications are rarely associated with laparoscopic procedures. The probable etiology of an axonal injury to the musculocutaneous nerve (motor branch) of the biceps brachii during a laparoscopic procedure is the position in which the patient is maintained. Restraining arms during general anesthesia with an unintentional change in the angle of the arm in the Trendelenburg position, may lead to hyperextension of the arm, resulting in pressure on and stretching of the brachial plexus nerve and neurologic damage. We present a case of a patient undergoing gynecologic surgery who had a brachial plexus injury.

Adhesion formation after applying adhesion barrier in laparoscopic gynecologic surgery: Experience of 7 patients / 대한산부인과내시경학회지

OBJECTIVE: Adhesion barrier has been commonly used in gynecologic surgery. The objective of this study is to evaluate the outcome of applying adhesion barrier in preventing adhesion formation after laparoscopic surgery. METHODS: Between March 2000 and March 2010, we retrospectively reviewed the medical records of patients who performed laparoscopic surgery twice at Samsung Medical Center. The patients to whom adhesion barrier was applied at the end of the first laparoscopic surgery and had imaging files of pelvic cavity at second laparoscopic surgery were included. The patients with recurrent endometriosis and pelvic inflammatory disease which can make postoperative adhesion by itself due to the nature of the disease were excluded. RESULTS: Ten patients were eligible to be analyzed. Only 3 among 10 showed adhesion free and we could find de novo adhesion formation in 7 patients at second laparoscopic surgery. Eight patients used Intercede(R) (oxidized regenerated cellulose mesh; Johnson & Johnson, New Brunswick, NJ, USA) and two patients used Guardix(R) (sodium hyaluronic acid solution and carboxymethylcellulose: Hanmi, Seoul, Korea). In six patients, adhesion formation was found at the operation site and one patient showed postoperative adhesion distant from operation site between omentum and anterior peritoneum of pelvic wall. CONCLUSION: We observed adhesion formation despite of prior use of adhesion barrier after laparoscopic gynecological surgery. These results suggest that the use of adhesion barrier alone after gynecologic laparoscopic surgery may not guarantee adhesion prevention.

Endometriosis Detected in Postmenopausal Women Not Receiving Menopausal Hormone Therapy: Two Case Reports / 대한폐경학회지

Endometriosis is an estrogen dependent disease in reproductive age. Endometriosis is a chronic inflammatory gynecologic disease. Problems associated with endometriosis include dysmenorrhea, dyspareunia, and infertility. Postmenopausal endometriosis is rare; however, postmenopausal endometriosis is infrequently associated with cancer, thus management is most important for gynecologists. We present two cases of endometriosis associated with postmenopausal women who were not receiving menopausal hormone therapy with a retrospective review of the medical records and a brief review of the literature.

A case of robotic laparoscopic radical trachelectomy / 대한산부인과학회지

To present a case of successful robotic assisted radical trachelectomy. A nulliparous woman with early cervical cancer underwent a laparoscopic radical trachelectomy and pelvic lymphadenectomy with the da Vinci robot (Intuitive Surgical Inc., Sunnyvale, CA). After the pelvic lymph nodes were found negative on frozen section, the parametria, paracolpia and uterosacral ligaments were dissected transabdominally sparing the ascending branches of the uterine arteries. Cervical transection and vaginal closure were performed transvaginally. Surgical time was 450 min. No perioperative complications were noted. Robotic laparoscopic radical trachelectomy may bridge the gap between laparotomy and laparoscopy for radical trachelectomy.

Case Report: A new surgical technique for Transverse Vaginal Septum / 대한산부인과학회지

Transverse vaginal septum, especially completely imperforate condition, is a rare congenital anomaly of female genital tract. The patient was 26 years old and visited for primary amenorrhea and low abdominal pain. Secondary sexual characteristics were all normal, but the depth of the vagina was only about 1cm. Hematometra was suspected and two large cystic structures were detected in the pelvis on ultrasonography. Intravenous pyelography and other laboratory results were normal. Vaginoplasty was needed to drain out the hematometra. We tried a new surgical technique using radial incisions of the closed vaginal end. To prevent postoperative contracture, we used a sterile pen case. and educated the patient to dilatate the vagina with that, daily. Here, we report a case of complete imperforate transverse septum with reviews of literatures.