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1.
Prog. obstet. ginecol. (Ed. impr.) ; 62(2): 119-121, mar.-abr. 2019. ilus
Article in English | IBECS | ID: ibc-184905

ABSTRACT

Objective: The objective of the study was to analyze cases of endometrial vascular dystrophy in the Hysteroscopy Unit of Hospital Clínico San Carlos, Madrid, Spain. Review: We reviewed a total of 7,658 hysteroscopies carried out in the unit during 2011-May 2017. We identified a total of 8 cases and analyzed both the hysteroscopy and the histopathology data. Conclusion: The condition known as endometrial vascular dystrophy does not comprise vascular disorders, but rather involves tortuous secretory glands (normal) filled with retained blood. We can find no explanation for this phenomenon


Objetivo: el objetivo del trabajo es analizar los casos de "Distrofia Vascular Endometrial" encontrados en la unidad de histeroscopias del Hospital Clínico de San Carlos (UCM). Material y métodos: se revisan un total de 7.658 histeroscopias, practicadas en la unidad durante el periodo de tiempo comprendido entre 2011- mayo de 2017. Se analizan las histeroscopias, así como el estudio histopatológico e histoquimico de los 8 casos de DVE encontrados. Resultados: se encuentran un total de 8 casos de DVE, totalmente documentados con videos, desechándose otros casos que no están documentados. Conclusión: los autores llegan a la conclusión de que la llamada Distrofia Vascular Endometrial, no está constituida por alteraciones vasculares, sino que se trata de glándulas secretoras tortuosas (normales) pero llenas de sangre retenida y material de secreción. No encuentran explicación a este fenómeno


Subject(s)
Humans , Female , Hysteroscopy/statistics & numerical data , Endometrial Hyperplasia/diagnostic imaging , Vasculitis/diagnostic imaging , Endometrial Hyperplasia/epidemiology , Histocytochemistry/methods , Retrospective Studies
2.
Cir. Esp. (Ed. impr.) ; 87(2): 95-100, feb. 2010. tab, ilus
Article in Spanish | IBECS | ID: ibc-80055

ABSTRACT

Introducción El sistema Da Vinci (Intuitive Surgical®) es un telemanipulador quirúrgico que proporciona numerosas ventajas técnicas al abordaje laparoscópico convencional (visión tridimensional, posición ergonómica, precisión en los movimientos, instrumental multiarticular, etc.) y que se viene utilizando en diversas especialidades en todo el mundo desde el año 2000. El primer hospital público español que incorporó esta tecnología robótica fue el Hospital Clínico San Carlos (HCSC) de Madrid en julio de 2006.IntroducciónPresentamos la organización multidisciplinaria y los resultados asistenciales, docentes e investigadores del programa de cirugía robótica (PCR) desarrollado en el HCSC. Material y método Con una dirección común y un equipo común de instrumentistas, se incorporaron progresivamente al PCR los servicios de Cirugía General, Urología y Ginecología, con procedimientos variados y de complejidad creciente. Se programaron numerosas actividades docentes y de difusión tanto intrahospitalarias como extrahospitalarias para dar a conocer el PCR. Resultados Entre julio de 2006 y julio de 2008 se intervinieron 306 pacientes en el ámbito del PCR-HCSC: 169 en Cirugía General, 107 en Urología y 30 en Ginecología. Los resultados demostraron la factibilidad de los procedimientos y su corta curva de aprendizaje. La actividad docente realizada incluyó a residentes y especialistas interesados en la tecnología robótica. Conclusión La incorporación estructurada y gradual de la cirugía robótica mediante el PCR-HCSC ha permitido facilitar el aprendizaje, compartir la infraestructura diseñada, coordinar las actividades de difusión y la colaboración multidisciplinaria. Esta experiencia inicial ha demostrado la eficacia de una organización adecuada y un equipo motivado (AU)


Background Da Vinci system (Intuitive Surgical®) is a surgical telemanipulator providing many technical advantages over conventional laparoscopic approach (3-D vision, ergonomics, highly precise movements, endowrist instrumentation…) and it is currently applied to several specialties throughout the world since 2000. The first Spanish public hospital incorporating this robotic technology was Hospital Clinico San Carlos (HCSC) in Madrid, in July 2006.BackgroundWe present the multidisciplinary organization and clinical, research and training outcomes of the Robotic Surgery Plan developed in the HCSC. Material and methods Starting from joint management and joint scrub nurses team, General and Digestive Surgery, Urology and Gynaecology Departments were progressively incorporated into the Robotic Surgery Plan, with several procedures increasing in complexity. A number of intra and extra-hospital teaching and information activities were planned to report on the Robotic Surgery Plan. Results Between July 2006 and July 2008, 306 patients were operated on: 169 by General Surgery, 107 by Urology and 30 by Gynaecology teams. The outcomes showed feasibility and a short learning curve. The educational plan included residents and staff interested in robotic technology application. Conclusion The structured and gradual incorporation of robotic surgery throughout the PCR-HCSC has made it easier to learn, to share designed infrastructure, to coordinate information activities and multidisciplinary collaboration. This preliminary experience has shown the efficiency of an adequate organization and motivated team (AU)


Subject(s)
Humans , Outcome Assessment, Health Care , Surgery Department, Hospital/organization & administration , Hospitals, University/organization & administration , Robotics
3.
Cir Esp ; 87(2): 95-100, 2010 Feb.
Article in Spanish | MEDLINE | ID: mdl-20060964

ABSTRACT

BACKGROUND: Da Vinci system (Intuitive Surgical) is a surgical telemanipulator providing many technical advantages over conventional laparoscopic approach (3-D vision, ergonomics, highly precise movements, endowrist instrumentation...) and it is currently applied to several specialties throughout the world since 2000. The first Spanish public hospital incorporating this robotic technology was Hospital Clinico San Carlos (HCSC) in Madrid, in July 2006. We present the multidisciplinary organization and clinical, research and training outcomes of the Robotic Surgery Plan developed in the HCSC. MATERIAL AND METHODS: Starting from joint management and joint scrub nurses team, General and Digestive Surgery, Urology and Gynaecology Departments were progressively incorporated into the Robotic Surgery Plan, with several procedures increasing in complexity. A number of intra and extra-hospital teaching and information activities were planned to report on the Robotic Surgery Plan. RESULTS: Between July 2006 and July 2008, 306 patients were operated on: 169 by General Surgery, 107 by Urology and 30 by Gynaecology teams. The outcomes showed feasibility and a short learning curve. The educational plan included residents and staff interested in robotic technology application. CONCLUSION: The structured and gradual incorporation of robotic surgery throughout the PCR-HCSC has made it easier to learn, to share designed infrastructure, to coordinate information activities and multidisciplinary collaboration. This preliminary experience has shown the efficiency of an adequate organization and motivated team.


Subject(s)
Hospitals, University/organization & administration , Outcome Assessment, Health Care , Robotics , Surgery Department, Hospital/organization & administration , Humans
4.
Prog. obstet. ginecol. (Ed. impr.) ; 49(11): 621-629, nov. 2006. tab, graf
Article in Es | IBECS | ID: ibc-050200

ABSTRACT

Objetivo: Analizar la eficacia y la seguridad de la endometrectomía histeroscópica en pacientes con hemorragia uterina disfuncional. Material y métodos: Estudio retrospectivo de 119 pacientes con menometrorragias. Se evaluó la histología prequirúrgica y posquirúrgica, las complicaciones inmediatas y tardías, la recidiva de la sintomatología y la necesidad de reintervención. Resultados: La edad media de las pacientes fue de 45 años (rango, 25-72). Tras una mediana de seguimiento de 14 meses (rango, 9-54), el 92,8% de las mujeres mejoró de su metropatía. En el 30,9% persistió la amenorrea; en el 26,3%, la hipomenorrea; y en el 35,4%, la eumenorrea. Las complicaciones globales fueron del 5,9% (7 casos), 6 casos a corto plazo (3 perforaciones y 3 hemorragias intraoperatorias) y un caso de hematometra a largo plazo. Un 7,2% (8 casos) mantuvo menometrorragias tras la ablación. El fallo del tratamiento se asoció con la resección incompleta del endometrio y la presencia de complicaciones intraoperatorias. La tasa de respuesta se redujo con el tiempo: el 96% a los 6 meses y el 87% a los 3 años. Se realizó un 7,3% (8 casos) de reintervenciones, 3 de ellas histerectomías. Conclusiones: La ablación/resección endometrial o endometrectomía histeroscópica es un tratamiento seguro y efectivo en el manejo quirúrgico de la menometrorragia


Objective: To analyze the safety and efficacy of hysteroscopic endometrectomy in patients with menometrorrhagia. Material and methods: We performed a retrospective study of 119 patients with menometrorrhagia. Histology, early and late complications, symptom recurrence, and reinterventions were evaluated. Results: The mean age of the patients was 45 years (range, 25-72). With a median follow-up of 14 months (range, 9-54), menometrorrhagia was improved in 92.8%. A total of 30.9% showed amenorrhea, 26.3% hypomenorrhea, and 35.4% eumenorrhea. Complications occurred in seven patients (5.9%), early complications in six (three uterine perforations and three intraoperative hemorrhages), and there was one late complication (hematometra). Symptom recurrence was observed at the end of follow-up in eight patients (7.2%). Treatment failure was associated with incomplete endometrial resection and the presence of intraoperative complications. Treatment efficacy decreased during follow-up and was 96% at 6 months and 87% at 3 years. Reinterventions were performed in 7.3% (eight patients); of these, hysterectomy was performed in three patients. Conclusions: Hysteroscopic endometrectomy is a safe and effective surgical treatment for menometrorrhagia


Subject(s)
Female , Adult , Middle Aged , Aged , Humans , Endometrial Hyperplasia/surgery , Menorrhagia/surgery , Metrorrhagia/surgery , Endometrium/surgery , Hysteroscopy/methods , Retrospective Studies , Postoperative Complications
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