abdominal hysterectomy with bilateral adnexectomy
, and total omentectomy
Suspension of the vagina to the presacral region is an effective treatment for uterovaginal prolapse. The abdominal approach was considered if the patient had uterine or ovarian pathology that needs to manage with hysterectomy or adnexectomy
and also have anterior vaginal defect or urinary incontinence that needs to perform paravaginal defect repair or Burch colposuspension. Total recurrence rate was 13.7% with transvaginal approach. Moreover, the recurrence rate was 5% by abdominal approach. About 92% of success rate by the robotic surgery that there was no significant difference with vaginal approach. Robotic surgery could be done with uterosacral suspension concomitant total or subtotal hysterectomy.
BSO is crucial in perimenopausal and postmenopausal women because the removal of prophylactic adnexectomy
precludes adnexal torsion, ovarian cancer, benign ovarian pathologies, and prolapsed salpinx (7.91%) (25, 26).
In the second case, total laparoscopic hysterectomy and bilateral adnexectomy
was performed and GTM was applied to control the bleeding from the left pelvic side wall after adhesiolysis.
Surgical procedures "a priori"-assumed Number Number of pain (VRS-11) of cases cases with malignancy Abdominal hysterectomy 6 3 1 Abdominal hysterectomy 7 1 1 with adhesiolysis Colposuspension 5 1 0 Diagnostic laparoscopy 4 4 0 Laparoscopy-assisted 6 1 0 vaginal hysterectomy Laparoscopic supracervical 6 5 0 hysterectomy Laparoscopic adhesiolysis 4 4 0 Laparoscopic adnexectomy
4 5 0 Laparoscopic ovariectomy 4 22 1 Laparoscopic myomectomy 5 5 1 Laparotomy with 8 3 0 adhesiolysis Vaginal hysterectomy 5 9 0 Total 4.8 (1.1) 63 4 Data are presented as the number of patients and as mean (SD); expected surgery-related "a priori"-assumed pain was taken using VRS-11, where 0 = no pain at all and 10 = worst pain which could be imagined according to .
Therefore, medical hormone suppression should be considered as an adjuvant therapy to surgery and as preventive therapy for relapses when total hysterectomy with bilateral adnexectomy
is not performed or when residual disease is left following surgery [55-57].
Abdominal hysterectomy, bilateral adnexectomy
, and pelvic lymphadenectomy were initially performed, followed by a skin incision to the right lower abdomen.
Considering this finding and inability to place sutures along with the oxidized cellulose strip just placed on the vein, which was fragile and breakable, left-sided adnexectomy
In both conventional and robot-assisted laparoscopy simulation pathways, complete procedural curriculums (for example, hysterectomy with adnexectomy
) are available.
The bleeding caused by the adhesiolysis at the level of right adnexa caused us to perform total hysterectomy and bilateral adnexectomy
. The patient did not receive any blood transfusion.
Laparoscopic hysterectomy and adnexectomy
were performed as a part of prophylactic surgery.