AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program
AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program
AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program
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<strong>AGES</strong> <strong>XXIII</strong> <strong>Annual</strong> <strong>Scientific</strong> <strong>Meeting</strong> <strong>2013</strong><br />
Free Communications Chairmen’s Choice - Friday 8 March<br />
All patients had post-operative ultrasound between 6 to<br />
10 weeks, which show intact uterine wall with no evidence<br />
of scar defect and resolution of hydrometra. Six patients<br />
underwent IVF cycle with a mean of 2.17 cycles (1-3 cycles).<br />
There were 5 clinical pregnany and 4 live births recorded. The<br />
time interval from repair of scar defect to delivery was 15<br />
months (12-19 months). 1 patient was lost to follow-up.<br />
CONCLUSION: Caesarean scar defect is an underrecognized<br />
contributing factor to secondary infertility 1 .<br />
Repair of caesarean scar defect laparoscopically may improve<br />
pregnancy outcome in these patients 2 . Laparoscopic repair of<br />
caesarean scar defect has the advantage of being minimally<br />
invasive while allowing optimal view during dissection of<br />
vesico-vaginal space and restoring of integrity of the uterine<br />
wall, without major cormobidty to the patients 3 .<br />
REFERENCES:<br />
1. Gubbini G, Centini G, Nascetti D, Marra E, Moncini<br />
I, Bruni L, Petraglia F, Florio P. Surgical hysteroscopic<br />
treatment of cesarean-induced isthmocele in restoring<br />
fertility: prospective study. J Minim Invasive Gynecol.<br />
2011 Mar-Apr;18(2):234-7<br />
2. Donnez O, Jadoul P, Squifflet J, Donnez J. Laparoscopic<br />
repair of wide and deep uterine scar dehiscence after cesarean<br />
section. Fertil Steril. 2008 Apr;89(4):974-80. Epub 2007 Jul 10<br />
3. Klemm P, Koehler C, Mangler M, Schneider U, Schneider<br />
A. Laparoscopic and vaginal repair of uterine scar<br />
dehiscence following cesarean section as detected by<br />
ultrasound. J Perinat Med. 2005;33(4):324-31<br />
AUTHOR AFFILIATION: K. Y. Kong 1 , D. Angstetra 2 ,<br />
G. Reid 3 ; 1. Women’s & Children’s Health, St George<br />
Hospital, Sydney, Australia. 2. Department of Obstetrics &<br />
Gynaecology, Gold Coast Hospital, Southport, Queensland,<br />
Australia. 3. Department of Obstetrics & Gynaecology,<br />
Liverpool Hospital, Sydney, Australia.<br />
SESSION 7 - Free COMMUNICATIONS<br />
Chairmen’s Choice / 1320-1330<br />
Establishment of robotic surgical programme for<br />
benign gynaecology in an advanced laparoscopic<br />
centre – proctorship and beyond<br />
Choi S, Rosen D, Chou D, Reyftmann L, De Rosnay<br />
P, Greg Cario G<br />
BACKGROUND: In this oral presentation, we share our<br />
experience in establishing a robotic surgery programme<br />
dedicated to treatment of benign gynaecological conditions<br />
in an advanced laparoscopic centre. Our early data, including<br />
those in the proctorship period, are discussed.<br />
METHODS: Prospective data were collected from July 2012<br />
to January <strong>2013</strong> for all women undergoing robot-assisted<br />
procedures performed by the three advanced laparoscopic<br />
surgeons within Sydney Women’s Endosurgery Centre<br />
(SWEC). Patient demographic, intraoperative, perioperative<br />
and postoperative data were collected.<br />
RESULTS: Twenty robot-assisted cases were performed within<br />
SWEC. Seven cases of total robot-assisted hysterectomy were<br />
performed during proctorship. Only one patient required<br />
conversion to conventional laparoscopic procedure. No major<br />
complications were recorded. The mean hospital stay was 1.3<br />
+/- 0.2 days. A trend of reduction in docking time, surgeon<br />
console time, total operation time and anaesthetic time was<br />
observed with gaining experience and technical refinement.<br />
CONCLUSION: Our experience with robotic-assisted<br />
hysterectomy appears promising even during the initial<br />
learning curve. The technique, docking time and operative<br />
time gradually improved with experience.<br />
AUTHOR AFFILIATION: S. Choi, D. Rosen, D. Chou,<br />
L. Reyftmann, P. De Rosnay, G. Cario; Sydney Women’s<br />
Endosurgery Centre (SWEC), St. George Private Hospital,<br />
Kogarah, New South Wales, Australia.<br />
SESSION 7 - Free COMMUNICATIONS<br />
Chairmen’s Choice / 1330-1340<br />
Laparoscopic myomectomy of an 1.8kg<br />
pedunculated fibroid causing uterine torsion<br />
Cebola M, Cario G, Rosen D, Reyftmann L, De<br />
Rosnay P, Choi S, D<br />
This is a surgical video presentation of a laparoscopic<br />
myomectomy of a 17cm pedunculated fibroid in a 47 years old<br />
nulliparous lady. The patient primarily had pressure symptoms<br />
including urinary frequency, bloating and pelvic discomfort.<br />
Preoperative MRI confirmed pedunculated nature of the<br />
fibroid. Intraoperatively, the uterus was noted to be in 270 deg<br />
torsion in clockwise direction, such that the left cornua was<br />
located posteriorly. Left adnexal vasculatures were congested<br />
but blood supply to the fibroid was unaffected. Following<br />
detortion of the uterus and injection of dilute Vasopressin, the<br />
thick pedicle was suture ligated with Roeder, extracorporeal<br />
slip knot. The long arm of the sutures were not cut so that the<br />
knot could be easily tightened further with knot pusher as they<br />
inevitable loosen as one works towards dividing the fibroid<br />
from it’s pedicle. The pedicle was further coagulated and<br />
sutured for additional haemostatic measure. The fibroid was<br />
extracted with a 15mm electrical morcellator.<br />
AUTHOR AFFIILIATION: M. Cebola, G. Cario, D. Rosen, L.<br />
Reyftmann, P. De Rosnay, S. Choi, D. Chou; Sydney Women’s<br />
Endosurgery Centre (SWEC), St. George Private Hospital,<br />
Kogarah, New South Wales, Australia.<br />
SESSION 7 - Free COMMUNICATIONS-<br />
Chairmen’s Choice / 1340-1350<br />
To excise or ablate endometriosis A prospective<br />
randomized double blinded trial after 5 years<br />
follow-up<br />
Healey M, Kaur H, Cheng C<br />
BACKGROUND: At present, gynaecologists performing<br />
laparoscopic treatment of endometriosis choose to excise<br />
or to ablate lesions. The current medical literature does not<br />
provide evidence to support one method over the other (1).<br />
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