Extending the limits of vaginal hysterectomy under local anesthesia and conscious sedation
Introduction and hypothesis In this video we present the surgical management of a 58-year-old woman presenting with a large prolapsed myomatous uterus treated with vaginal hysterectomy (VH) and pelvic floor repair (PFR) (uterosacral ligament suspension and posterior colporraphy) under local anesthes...
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| Veröffentlicht in: | International Urogynecology Journal 2021-08, Vol.32 (8), p.2287-2289 |
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| container_title | International Urogynecology Journal |
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| creator | Grigoriadis, Themos Zacharakis, Dimitrios Kypriotis, Konstantinos Protopapas, Athanasios Hadzillia, Sofia Athanasiou, Stavros |
| description | Introduction and hypothesis
In this video we present the surgical management of a 58-year-old woman presenting with a large prolapsed myomatous uterus treated with vaginal hysterectomy (VH) and pelvic floor repair (PFR) (uterosacral ligament suspension and posterior colporraphy) under local anesthesia and conscious sedation.
Methods
The patient underwent VH and PFR by using an infiltration of a local anesthetic solution of lidocaine, ropivacaine and adrenaline in combination with intravenous (iv) conscious sedation. Debulking techniques, such as intramyometrial coring, uterine bisection, myomectomy and wedge resection, were used to facilitate VH. The final weight of the removed uterus was 870 g.
Results
This video demonstrates that performing a surgically challenging VH under local anesthesia is feasible.
Conclusions
Vaginal uterine morcellation can be performed to debulk the enlarged uterus so that hysterectomy can be accomplished under local anesthesia. The use of local anesthesia may safely be offered as an alternative to patients undergoing a complex vaginal hysterectomy and reconstructive surgery. |
| doi_str_mv | 10.1007/s00192-021-04721-1 |
| format | Article |
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In this video we present the surgical management of a 58-year-old woman presenting with a large prolapsed myomatous uterus treated with vaginal hysterectomy (VH) and pelvic floor repair (PFR) (uterosacral ligament suspension and posterior colporraphy) under local anesthesia and conscious sedation.
Methods
The patient underwent VH and PFR by using an infiltration of a local anesthetic solution of lidocaine, ropivacaine and adrenaline in combination with intravenous (iv) conscious sedation. Debulking techniques, such as intramyometrial coring, uterine bisection, myomectomy and wedge resection, were used to facilitate VH. The final weight of the removed uterus was 870 g.
Results
This video demonstrates that performing a surgically challenging VH under local anesthesia is feasible.
Conclusions
Vaginal uterine morcellation can be performed to debulk the enlarged uterus so that hysterectomy can be accomplished under local anesthesia. The use of local anesthesia may safely be offered as an alternative to patients undergoing a complex vaginal hysterectomy and reconstructive surgery.</description><identifier>ISSN: 0937-3462</identifier><identifier>EISSN: 1433-3023</identifier><identifier>DOI: 10.1007/s00192-021-04721-1</identifier><identifier>PMID: 33704537</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Gynecology ; Hysterectomy ; IUJ Video ; Local anesthesia ; Medicine ; Medicine & Public Health ; Urology ; Uterus ; Vagina</subject><ispartof>International Urogynecology Journal, 2021-08, Vol.32 (8), p.2287-2289</ispartof><rights>The International Urogynecological Association 2021</rights><rights>The International Urogynecological Association 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-c1aeb939f539303606bcffdd6c0443a0e6f576f597955cdee135fad784af1bc53</citedby><cites>FETCH-LOGICAL-c375t-c1aeb939f539303606bcffdd6c0443a0e6f576f597955cdee135fad784af1bc53</cites><orcidid>0000-0002-5099-9452</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00192-021-04721-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00192-021-04721-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33704537$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grigoriadis, Themos</creatorcontrib><creatorcontrib>Zacharakis, Dimitrios</creatorcontrib><creatorcontrib>Kypriotis, Konstantinos</creatorcontrib><creatorcontrib>Protopapas, Athanasios</creatorcontrib><creatorcontrib>Hadzillia, Sofia</creatorcontrib><creatorcontrib>Athanasiou, Stavros</creatorcontrib><title>Extending the limits of vaginal hysterectomy under local anesthesia and conscious sedation</title><title>International Urogynecology Journal</title><addtitle>Int Urogynecol J</addtitle><addtitle>Int Urogynecol J</addtitle><description>Introduction and hypothesis
In this video we present the surgical management of a 58-year-old woman presenting with a large prolapsed myomatous uterus treated with vaginal hysterectomy (VH) and pelvic floor repair (PFR) (uterosacral ligament suspension and posterior colporraphy) under local anesthesia and conscious sedation.
Methods
The patient underwent VH and PFR by using an infiltration of a local anesthetic solution of lidocaine, ropivacaine and adrenaline in combination with intravenous (iv) conscious sedation. Debulking techniques, such as intramyometrial coring, uterine bisection, myomectomy and wedge resection, were used to facilitate VH. The final weight of the removed uterus was 870 g.
Results
This video demonstrates that performing a surgically challenging VH under local anesthesia is feasible.
Conclusions
Vaginal uterine morcellation can be performed to debulk the enlarged uterus so that hysterectomy can be accomplished under local anesthesia. The use of local anesthesia may safely be offered as an alternative to patients undergoing a complex vaginal hysterectomy and reconstructive surgery.</description><subject>Gynecology</subject><subject>Hysterectomy</subject><subject>IUJ Video</subject><subject>Local anesthesia</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Urology</subject><subject>Uterus</subject><subject>Vagina</subject><issn>0937-3462</issn><issn>1433-3023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kEtPGzEUha2qqIS0f6CLylI33Qxcz7XHmSWKaEGKxAY2bCzHj8TRzBjsmar59zgNBYlFF35I9zvHx4eQrwzOGYC8yACsrSuoWQVclp19IDPGESuEGj-SGbQoK-RNfUrOct4BAAcBn8gpogQuUM7Iw9Wf0Q02DBs6bh3tQh_GTKOnv_UmDLqj230eXXJmjP2eToN1iXbRlIEeXC6SHHS5WmrikE2IU6bZWT2GOHwmJ1532X15Oefk_ufV3fK6Wt3-ulleriqDUoyVYdqtW2y9wBYBG2jWxntrGwOcowbXeCHLamUrhLHOMRReW7ng2rO1ETgnP46-jyk-TSWU6kM2rutKwpJH1QIAZSNqXtDv79BdnFL55oESiwWXfNEWqj5SJsWck_PqMYVep71ioA7Nq2PzqjSv_javWBF9e7Ge1r2zr5J_VRcAj0Auo2Hj0tvb_7F9Bu_ujw0</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Grigoriadis, Themos</creator><creator>Zacharakis, Dimitrios</creator><creator>Kypriotis, Konstantinos</creator><creator>Protopapas, Athanasios</creator><creator>Hadzillia, Sofia</creator><creator>Athanasiou, Stavros</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5099-9452</orcidid></search><sort><creationdate>20210801</creationdate><title>Extending the limits of vaginal hysterectomy under local anesthesia and conscious sedation</title><author>Grigoriadis, Themos ; Zacharakis, Dimitrios ; Kypriotis, Konstantinos ; Protopapas, Athanasios ; Hadzillia, Sofia ; Athanasiou, Stavros</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-c1aeb939f539303606bcffdd6c0443a0e6f576f597955cdee135fad784af1bc53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Gynecology</topic><topic>Hysterectomy</topic><topic>IUJ Video</topic><topic>Local anesthesia</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Urology</topic><topic>Uterus</topic><topic>Vagina</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grigoriadis, Themos</creatorcontrib><creatorcontrib>Zacharakis, Dimitrios</creatorcontrib><creatorcontrib>Kypriotis, Konstantinos</creatorcontrib><creatorcontrib>Protopapas, Athanasios</creatorcontrib><creatorcontrib>Hadzillia, Sofia</creatorcontrib><creatorcontrib>Athanasiou, Stavros</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International Urogynecology Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grigoriadis, Themos</au><au>Zacharakis, Dimitrios</au><au>Kypriotis, Konstantinos</au><au>Protopapas, Athanasios</au><au>Hadzillia, Sofia</au><au>Athanasiou, Stavros</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extending the limits of vaginal hysterectomy under local anesthesia and conscious sedation</atitle><jtitle>International Urogynecology Journal</jtitle><stitle>Int Urogynecol J</stitle><addtitle>Int Urogynecol J</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>32</volume><issue>8</issue><spage>2287</spage><epage>2289</epage><pages>2287-2289</pages><issn>0937-3462</issn><eissn>1433-3023</eissn><abstract>Introduction and hypothesis
In this video we present the surgical management of a 58-year-old woman presenting with a large prolapsed myomatous uterus treated with vaginal hysterectomy (VH) and pelvic floor repair (PFR) (uterosacral ligament suspension and posterior colporraphy) under local anesthesia and conscious sedation.
Methods
The patient underwent VH and PFR by using an infiltration of a local anesthetic solution of lidocaine, ropivacaine and adrenaline in combination with intravenous (iv) conscious sedation. Debulking techniques, such as intramyometrial coring, uterine bisection, myomectomy and wedge resection, were used to facilitate VH. The final weight of the removed uterus was 870 g.
Results
This video demonstrates that performing a surgically challenging VH under local anesthesia is feasible.
Conclusions
Vaginal uterine morcellation can be performed to debulk the enlarged uterus so that hysterectomy can be accomplished under local anesthesia. The use of local anesthesia may safely be offered as an alternative to patients undergoing a complex vaginal hysterectomy and reconstructive surgery.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>33704537</pmid><doi>10.1007/s00192-021-04721-1</doi><tpages>3</tpages><orcidid>https://orcid.org/0000-0002-5099-9452</orcidid></addata></record> |
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| subjects | Gynecology Hysterectomy IUJ Video Local anesthesia Medicine Medicine & Public Health Urology Uterus Vagina |
| title | Extending the limits of vaginal hysterectomy under local anesthesia and conscious sedation |
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