Laparoendoscopic Single-Site Surgery for Management of Heterotopic Pregnancy: A Case Report and Review of Literature
Shadi Rezai,Richard Giovane,Heather Minton,Elise Bardawil,Yiming Zhang,Ninad M Patil,Cassandra E. Henderson,Xiaoming Guan +7 more
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TLDR
Although LESS for benign OB/GYN cases is feasible, safe, and equally effective compared to the conventional laparoscopic techniques, studies have suggested no clinically relevant advantages in the frequency of perioperative complications between LESS and conventional methods.Abstract:
Background. Heterotopic pregnancy occurs when two pregnancies occur simultaneously in the uterus and an ectopic location. Treatment includes removal of the ectopic pregnancy with preservation of the intrauterine pregnancy. Treatment is done laparoscopically with either a Laparoendoscopic Single-Site Surgery (LESS) or a multiport laparoscopic surgery. Case. We present a case of a first trimester heterotopic pregnancy in a 42-year-old gravida 5, para 0-1-3-1 female with previous history of left salpingectomy, who underwent laparoscopic right salpingectomy and lysis of adhesions (LOA) via Single-Incision Laparoscopic Surgery (SILS). Conclusion. Although LESS for benign OB/GYN cases is feasible, safe, and equally effective compared to the conventional laparoscopic techniques, studies have suggested no clinically relevant advantages in the frequency of perioperative complications between LESS and conventional methods. No data on the cost effectiveness of LESS versus conventional methods are available. LESS utilizes only one surgical incision which may lead to decreased pain and better cosmetic outcome when compared to multiport procedure. One significant undesirable aspect of LESS is the crowding of the surgical area as only one incision is made. Therefore, all instruments go through one port, which can lead to obstruction of the surgeon’s vision and in some cases higher rate of procedure failure resulting in conversion to multiport procedure.read more
Citations
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Pregnancy-preserving Laparoendoscopic Single-site Surgery for Gynecologic Disease: A Case Series.
TL;DR: LESS may be performed by experienced surgeons on gravid patients in any trimester for adnexal masses, fibroids, heterotopic pregnancy, and cervical incompetence in pregnant women and future multiple-center studies may provide further evidence that LESS is a feasible and safe option for gynecological surgery during pregnancy.
Journal ArticleDOI
Spontaneous Heterotopic Pregnancy with Unaffected Intrauterine Pregnancy: Systematic Review of Clinical Outcomes.
Mihaela Oancea,Răzvan Ciortea,Doru Diculescu,Alexandra-Andreea Poienar,Mihaela Grigore,Roxana-Adelina Lupean,Renata Nicula,Diana Chira,Stefan Strilciuc,Dan Mihu +9 more
TL;DR: Normal follow-up and evolution of intrauterine pregnancy have been observed regardless of surgical approach (open or laparoscopic), and early diagnosis and treatment are advised, as they impact maternal and fetal outcomes.
References
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Journal ArticleDOI
Combined intrauterine and extrauterine gestations: a review.
E.Albert Reece,E.Albert Reece,Roy H. Petrie,Roy H. Petrie,Meredith F. Sirmans,Meredith F. Sirmans,Mieczyslaw Finster,Mieczyslaw Finster,W. Duane Todd,W. Duane Todd +9 more
TL;DR: A combination of signs and symptoms, including abdominal pain, adnexal mass, peritoneal irritation, and an enlarged uterus, was the most significant finding in support of a presumptive diagnosis of combined gestations.
Journal ArticleDOI
Consensus statement of the consortium for laparoendoscopic single-site surgery
Inderbir S. Gill,Arnold P. Advincula,Monish Aron,Jeffrey Caddedu,David Canes,Paul G. Curcillo,Mihir M. Desai,John C. Evanko,Tommaso Falcone,Victor W. Fazio,Matthew T. Gettman,Andrew A. Gumbs,Georges-Pascal Haber,Jihad H. Kaouk,Fernando J. Kim,Stephanie King,Jeffrey L. Ponsky,Feza H. Remzi,Homero Rivas,Alexander S. Rosemurgy,Sharona Ross,Philip R. Schauer,Rene Sotelo,Jose Speranza,John F. Sweeney,Julio Teixeira +25 more
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Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy.
Jeffrey M. Marks,Melissa S. Phillips,RM Tacchino,Kurt E. Roberts,Raymond P. Onders,George DeNoto,Gary Gecelter,Eugene Rubach,Homero Rivas,Arsalla Islam,Nathaniel J. Soper,Paraskevas Paraskeva,Alexander S. Rosemurgy,Sharona Ross,Sajani Shah +14 more
TL;DR: Results of this trial show SILC to be a safe and feasible procedure when compared with 4PLC, with similar total adverse events but with an identified significant increase in hernia formation.
Journal ArticleDOI
Cornual heterotopic pregnancy: contemporary management options.
TL;DR: There is insufficient evidence to recommend any single treatment modality and the decision should be based on such factors as clinical presentation, surgeon's expertise, side effects, overall cost, and the patient's preference.
Journal ArticleDOI
Robotic-assisted laparoendoscopic single-site surgery in gynecology: initial report and technique
TL;DR: The initial clinical experience and technique with robotic-assisted single-port surgery in gynecology and an attempt to further enhance cosmetic benefits and reduce morbidity of minimally invasive surgery is presented.