Journal of minimally invasive gynecology
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J Minim Invasive Gynecol · Jul 2012
Case ReportsA case of retained placenta increta successfully treated via uterine arterial embolization using N-butyl 2-cyanoacrylate.
A 29-year-old woman with placenta increta with hemorrhage underwent uterine artery embolization using 12.5% NBCA (N-butyl 2-cyanoacrylate) diluted with iodized oil (Lipiodol). Complete resolution of placenta increta without performing curettage was obtained. ⋯ Menstruation resumed after 3 months. In cases of retained placenta due to placenta accreta, and even those with placenta increta, uterine artery embolization using NBCA is a useful treatment.
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To estimate the necessity of routine patient positioning in steep Trendelenburg in robotic-assisted gynecologic surgery performed for benign indications. ⋯ Robotic-assisted benign gynecologic surgery can be effectively performed without use of the steep Trendelenburg position. The practice of routine adherence to steep Trendelenburg positioning in benign gynecologic robotic surgery should be questioned.
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J Minim Invasive Gynecol · Jul 2012
Abdominal wall nerve injury during laparoscopic gynecologic surgery: incidence, risk factors, and treatment outcomes.
To determine the incidence and clinical significance of iliohypogastric-ilioinguinal neuropathy from lower abdominal lateral port placement and fascial closure during laparoscopic gynecologic surgery. ⋯ There is an estimated 5% risk of clinically significant postoperative neuropathic pain due to injury of the iliohypogastric-ilioinguinal nerve with fascial closure of laparoscopic incisions in the lower abdomen. Pain seems to be due to suture entrapment of sensory fibers because it is usually resolved by removal of the suture. Prompt recognition and treatment may prevent subsequent development of chronic abdominopelvic pain.