21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
www.minimalinvazivjinekolojikcerrahi.org
VS-72
Step by step OR Preparation and Patient Positioning for Robotic Surgery- video
presentation
Ozguc Takmaz
1
, Savas Gundogan
1
, Esra Ozbasli
1
, Mete Gungor
1
, Mehmet Murat Naki
2
, Faruk Köse
2
1
Acibadem MAA University, Department of Obstetrics and Gynecology
2
Acibadem University Atakent Hospital, Istanbul, Turkey
OBJECTIVE: To describe patient positioning and operation room formation for gynecologic
robotic surgery
BACKGROUND: Endowrist manipulation, 3-dimensional visualization and short learning curve
make robotic surgery progressively adopted in gynecologic operations. However, use of robotic
platform is more complicated and needs an educated team for optimal performance. Well-
designed operation room, proper patient positioning and optimal port placement are the initials
for a successful robotic surgery. Operation room for robotic surgery has to be both enough
spacious for placing the components of the platform and height for the docking procedure.
Further, patient positioning and port placement have to be more careful to avoid to harm the
patient from remote controlling instruments.
SETTING: Acibadem MAA University Maslak Hospital Operation Room
DESIGN: Step-by-step description video of the preparation of operation room and the patient
positioning for robotic gynecologic surgeries.
CONCLUSION: Optimal placing the platform components and organizing the operating room
and positioning the patient also with proper port placements enable robotic surgeries less
complicated and more successful.
Keywords: robotic surgery, operation room, patient positioning
www.minimalinvazivjinekolojikcerrahi.org
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
VS-73
Laparoscopic Management of a Giant Ovarian Cyst in an Adolescent patient
Ahmet Bariş Güzel, Ümran Küçükgöz Güleç, Ghanim Khatib, Mehmet Ali Vardar, Mete Sucu
Çukurova Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum AD.ADANA
Ovarian cysts are the most common cause of pelvic masses in women, and in the majority
of the cases, women are in their fertile age but giant intraabdominal cysts are very rare, and
conventional treatment is full midline laparotomy. The use of the laparoscopic approach versus
open approach for the management of huge ovarian cysts is controversial. Laparoscopy is
considered as the gold standard approach to manage benign ovarian cysts. The advantages of a
laparoscopic approach over a laparotomy include better cosmetic results, less blood loss, less pain
and analgesic requirement, faster recovery, and shorter hospitalization time. The laparoscopic
approach to large ovarian cysts extending to the umbilicus may be difficult because of the risk of
cyst rupture and the small working space. The laparoscopic management of very large ovarian
cysts has been described, but most patients are managed by laparotomy. We present a case of
complete laparoscopic extirpation of a giant ovarian cyst.
CASE: A 17-year-old female presented with progressive abdominal distension for 1-year along
with abdominaly distantion and pelvic pain.
Sonographic scan showed a giant uniloculer cystic mass in the abdomen measuring 18x25x30
cm. A laparoscopic left cystectomy and partial ovarian excision was performed. The postoperative
course was uneventful, and the patient was discharged home on postoperative day 1 with minimal
pain and tolerating a regular diet. Pathology examination revealed a serous cystadenoma..
CONCLUSION: Giant ovarian cysts can be managed laparoscopically when a normal tumor
marker profile and benign imaging appearance exclude the possibility of malignancy.
Keywords: Giant ovarian cyst, cystadenoma, Laparoscopy, Adolescent
Keywords: Giant ovarian cyst, cystadenoma, Laparoscopy, Adolescent
SÖZLÜ
BİLDİRİLER
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
www.minimalinvazivjinekolojikcerrahi.org
SS-01
Pelvik organ prolapsusu etyopatogenezinde kollajen tip-1 ve kollajen metabolizması
düzenleyicilerinin araştırılması
Esra Nur Tola
Esra Nur Tola
GİRİŞ: Pelvik organ prolapsusu (POP) yaygın ve major bir sağlık sorunudur. POP’la ilişkili olarak
pek çok risk faktörü tanımlansa da etken genelde multifaktörieldir. Uterosakral ligament (USL)
uterusu yerinde tutan en güçlü bağlardan biridir ve konnektif dokusunda bol miktarda kollajen
tip-1 içerir. POP’lu kadınlarda USL’de kollajen içeriğinde azalma, kollajen tipleri ve morfolojik
özelliklerinde değişiklikler tespit edilmiştir. ‘A disintegrin-like and metalloproteinase with
thrombospondin type motifs (ADAMTS)-2’ prokollajenin kollajene dönüşmesinde etkili bir
metalloproteinazdır.
AMAÇ: POP’lu kadınların USL’inde ADAMTS-2 ve kollajen tip-1 düzeylerini araştırmaktır.
MATERYAL-METHOD: Çalışmamıza POP skorlama (POP-Q) sistemine göre Evre 3/4 POP tanısı
konulup vajinal histerektomi planlanan 22 ve benign jinekolojik nedenlerle histerektomi
planlanan 23 kadın alındı. Kollajen metabolizması yaş, menopoz ve sigarayla etkilenebileceğinden
çalışmamızda sadece postmenopozal ve sigara içmeyen hastalar alındı. Hormon replasman
tedavisi, kollajen metabolizmasıyla ilişkili durum, kronik hastalık, malignansi, pelvik cerrahi öyküsü
olan hastalar çalışmadan dışlandı. Histerektomi sırasında sol USL’den 5-10 mm’lik doku alındı ve
homojenizasyondan sonra dokuların ADAMTS-2 ve kollajen tip-1 düzeyleri ELISA yöntemiyle ölçüldü.
SONUÇLAR: Gruplar arasında demografik veriler homojen dağılmıştı. POP grubu USL’deki
ADAMTS-1 ve kollajen tip-1 seviyesi kontrol grubuna göre daha düşüktü (Tablo 1).Yaş, vücut
kitle indeksi, gravida ve doğum şeklinin etkisi çıkarıldıktan sonra ADAMTS-2’nin POP gelişiminde
etkisi izlenmezken, kollajen tip-1’in POP gelişimi üzerine negatif prediktif etkisi bulundu (Tablo
2). ADAMTS-2 ve kollajen tip-1 birbiriyle pozitif korele iken, yaş, menopoz süresi, parite ve POP-Q
skoru ile korele değildi (Tablo 3).
SONUÇ: USL’deki kollajen tip-1 ve ADAMTS-2 seviyeleri POP etyopatogenezinde önemli olabilir.
Özellikle USL’deki azalmış kollajen tip1 POP gelişimiyle ilişkilidir.
Anahtar Kelimeler: Pelvik organ prolapsusu, ADAMTS-2, kollajen tip-1, uterosakral ligament
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