Cerrahi kongresi kongre biLİmsel programi ve biLDİRİ Özetleri

21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
 www.minimalinvazivjinekolojikcerrahi.org
Figure 1
 
 
Steps of ureter repair
 
 
 

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 www.minimalinvazivjinekolojikcerrahi.org
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
P-03 
Laparoscopic treatment modalities for pelvic floor muscle dysfunction
Yigit Akin
1
, Isil Basara Akin
2
1
Department of Urology, Izmir Katip Celebi University, Izmir, Turkey 
2
Department of Radiology, Dokuz Eylul University, Izmir, Turkey
OBJECTIVE: Pelvic floor dysfunction (PFD) is collection of complicated clinical findings, and occurs 
as a result of the weakness of the pelvic floor muscles. Pelvic floor consist of pelvic bone, muscles, 
and connective tissues. The PFD include clinical outcomes such as stress urinary incontinence 
(SUI), pelvic organ prolapse (POP), sensory and bladder empting abnormalities, several chronic 
pelvic pain, defecatory, and sexual dysfunction. SUI and POP are the most common clinical 
manifestations of PFD. The major risk factors for PFD consist of obesity, menopause, pregnancy, 
and giving birth. In this study we evaluated our results on laparoscopic sacrocolpopexy of single 
surgeon.
 
MATERIAL METHODS: All Patients data were recorded on computer and was evaluated 
retrospectively. All incontinence patients underwent videourodynamics and radiological 
evaluations. All patients underwent laparoscopic sacrocolpopexy. Prolen mesh greats were 
used and were stabilized with laparoscopic tucker and proven stitches. Demographic data, 
operational and post operative data were evaluated. Exclusion criterion was unregular follow-
up. Complications were classified according to Clavien classification. 
 
RESULTS: We have 18 patients with full data. Mean age was 53±4.4. Mean birth was 3±0.6. Mean 
hospital stay was 3.2 days. Mean follow-up was 22.3 months. The urinary catheter was removed 
postoperative first day. We did not experience any early postoperative complication. However, 
one patient had recurrence (vault prolapsus) 4 months after the surgery (She did not want any 
additional intervention). 2 Patients had mesh erosion 6 months after the surgery. We removed 
mesh from these patients. Nevertheless, the success rate was 83.3%. 
 
DISCUSSION: Laparoscopic sacrocolpopexy is one of the minimally invasive surgical treatment 
modality of vault prolapsus. However, complications should be considered and should be 
explained to patients.
 
Keywords: incontinence, laparoscopy, vault prolapsus, sacrocolpopexy
 
 

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21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
 www.minimalinvazivjinekolojikcerrahi.org
P-04
The effect of simple clinical manoeuver on shoulder and abdominal pain a laparascopic 
gynecologic oncology surgery:a prospective randomised trial
Kemal Güngördük
1
, Osman Aşıcıoğlu
2
, Isa Aykut Özdemir
3
1
Department of Gynecologic Oncology, Muğla Sıtkı Koçman University,Muğla,Turkey
2
Department of Gynecologic Oncology, Kanuni Sultan Süleyman Education and Research 
Hospital,İstanbul,Turkey
3
Department of Gynecologic Oncology, Bakırköy Sadi Konuk Education and Research Hospital, 
İstanbul,Turkey
OBJECTIVE: To evaluate the effectiveness of the pulmonary clinical manoeuver (PCM) in 
removing postlaparoscopic carbon dioxide from the abdominal cavity to decrease laparoscopy-
induced abdominal or shoulder pain after gynecologic oncology surgery.
 
MATHERIAL-METHOD: A prospective, randomized, controlled trial was conducted at four 
education and research hospital in Turkey, from October 1, 2013, through September 1, 2014. 
One hundred ten women undergoing laparoscopic surgery for malign or premalign gynecologic 
lesions were randomly assigned to 2 groups: the manoeuver group (n=55), and the control group 
(n=55). Postoperative maneuvers included PCM. Postoperative shoulder and abdominal pain 
was assessed 12, 24 and 48 hours later using a visual analog scale (VAS, 0–10). In addition, the 
incidence of postdischarge nausea and vomiting were recorded until 48 hours after discharge. 
Trial Registration: clinicaltrials.gov Identifier: NCT01940042
 
RESULTS: The severity of postoperative shoulder pain at 12 and 24 hours was significantly 
decreased in the manoeuver group compared with control group (2.2±0.5 and 2.0±0.4 in the 
maneuver group vs 4.0±0.6 and 3.9±0.4 in the control group [p:<0.001 and <0.001, respectively]. 
PCM significantly reduced the severity of upper abdominal pain at 12 and 24 hours compared 
with the control group (3.1±0.4 and 2.9±0.4 in the manoeuver group vs 5.9±0.5 and 4.9±0.5 in 
the control group [p:<0.001 and <0.001, respectively]. The incidence of postoperative nausea 
and vomiting was similar between groups ( 23.6 % in manoeuver group vs 29.3% in control 
group) [p:<.516]. Furthermore the rate of analgesic requirements during postoperative period 
was similar between groups ( 78.2% in control group vs 74.5 % in manoeuver group) [ p:0.654]. 
 
CONCLUSIONS: PCM was found to be an effective and safe method to reduce postoperative 
shoulder and upper abdomen pain levels in patients undergoing laparoscopic gynecologic 
oncology surgery.
 
Keywords:  Laparoscopy, pulmonary clinical manoeuvre, shoulder pain, abdominal pain 
 

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