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
P-09 
Our gynecologic robotic surgery experiences in a state hospital
Berrin Göktuğ Kadıoğlu
1
, Yakup Kumtepe
2
, Firdevs Şekerci Baran
3
1
Department of Obstetric and Gynecolgy, Sağlık Bilimleri University, Training and Research 
Hospital, Erzurum, Turkey
2
Department of Obstetric and Gynecolgy, Atatürk University,Erzurum,Turkey
3
Department of Obstetric and Gynecolgy, Sağlık Bilimleri University,Training and Research 
Hospital, Erzurum, Turkey
AIM: In recent years, rapid development of minimally invasive surgical methods has led to less 
preferred gynecology of traditional methods. Robotic surgery is one of these new methods in 
the direction of these developments. This study aims to share the first experiences of a robotic 
surgeon in a state hospital.
 
METHOD: In the study, 40 patients, who went through robotic gynecological surgery (GS) during 
January 2014- May 2017 in Erzurum Nenehatun Maternity Hospital, were analyzed. Age, BMI, 
previous abdominal operations (PAO), operation indications (OI), operation time (OT), pathological 
evaluation, uterus weight (UW), amount of blood loss during operation (BL), complications and 
duration of the hospitalization (DoH) were the recorded parameters. Except from one, all the 
patients that were operated had benign pathology and total hysterectomy was performed on all.  
Da Vinci XI was used in operations. Same number of ports were placed on all patients. Pieces of 
operation were exerted through the vagina.
 
RESULTS: In this study, data of 40 patients were analyzed. The mean values for the data were 
age 48 years, BMI 28, rate of PAO 12 %, the most common OI uterine fibroids 52 % and abnormal 
uterine bleeding 45 %.
The mean OT was 166 min, mean docking time was 15 min, console time 123 min. Mean BL 
was 93 ml. Mean UW was 256 gr, Peroperative complication was observed in 4 patients. In 10% 
of cases, perioperative complications such as non-functioning of the robotic arm, hemorrhage, 
needle drop, hematuria; in 20% of cases, postoperative complications such as bleeding, intestinal 
obstruction, nonspecific cardiopulmonary disorder were observed.
 
CONCLUSION: As a conclusion, robot assistance in GS has significance especially in endometriosis, 
cases with advanced adhesion and some oncological cases due to more clear display and high 
maneuver ability. For adaptation to such cases, utilization of robot in benign cases is important 
to complete the learning curve and gain speed.
 
Keywords: robotic surgery, gynecology, benign disease
 
 

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 www.minimalinvazivjinekolojikcerrahi.org
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
Figure 1: Correlation between BMI and Operating time
 
 
Figure-2: Correlation between Uterine weight and Operating time
 
 

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21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
 www.minimalinvazivjinekolojikcerrahi.org
Table-1: Parameters
parameter
Mean
SD
n
%
Age (Year)
47,78
4,27
40
BMI (kg/m2)
28,18
4,27
Previous abdominal operation
6
15
Skin-skin operation time (min.)
166,00
33,40
‘docking’ time (min.)
15,06
5,54
‘console’ time (min.)
122,25
29,46
Complication
peroperative
4
10
postoperative
8
20
Uterine weight (g)
255.98
86.41
Hospitalization time (days)
4,25
1,33
Peroperative bleeding volume (ml)
92,75
122,25
Parameters
 
Table 2: Indications
Indication
n
%
Explanation (Accompanying pathology) 
Operations
Myoma uteri
9
22.5
Myoma uteri+ other
12 30
Bilateral ovarian mass, adenomyosis, HSIL,level 
1 uterinesupportloss,sub-serosal myoma,pelvic 
pain, endometrioma
Abnormal uterine bleeding
5
12.5
Abnormal uterine bleeding + 
endometrial pathology
13 32.5
Kr.endometrit,end. Polip,endometrial 
hyperplasia(with atypia or not),tubalmetaplasia
Endometrium Ca
1
2.5
Good differential endometrioid adeno Ca
 
 

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 www.minimalinvazivjinekolojikcerrahi.org
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
P-10 
Minimally Invasive Surgery for the Treatment Of Uterin Leiomyoma in an Adolescent 
Patient
Cihat Murat Alınca
1
, Gülşan Karabay
1
, Sinan Serdar Ay
2
1
Department of Obstetrics and Gynecology, Sağlık Bilimleri University Şişli Hamidiye Etfal 
Education and Research Hospital, İstanbul, Turkey
2
Department of Obstetrics and Gynecology, Saray Government Hospital, Tekirdağ, Turkey
Uterine leiomyomas are the most common gynecological tumors affecting 20% to 30% 
of adult women. However, it is infrequent in adolescence (<1%) and there are only a few 
cases that have been reported in the literature. We aimed to present a case of uterine 
leiomyoma in adolescence treated by minilaparotomy as minimal invazive surgery. 
A 16-year-old nulligravid girl was referred to our department with a progressively expanding 
lower pelvic mass for the previous 6 months. On physical examination revealed relatively 
smooth pelvic mass which extends uterus completely. Her complete blood account, 
beta HCG and biochemical profile levels were within normal limits. She suffered from 
hypermenoreic menstrual cycles. The patient had no additional significant gynecological, 
medical, surgical or family history. Pelvic ultrasound (US) revealed a hypoechoic solid 
intramural lesion. Magnetic resonance imaging (MRI) of the pelvis showed that the lesion 
is 106 x 103x 98 mm sized uterine leiomyoma. Bilateral ovary was normal in appearance. The 
patient underwent transvers minilaparotomy under general anesthesia with the incisition 
length of 7 cm. The laparotomy results confirmed the diagnosis of an intramural leiomyoma 
originating from the uterus. There was no free fluid or lymphadenopathy. The leiomyoma 
was then progressively morcellated after placement of abdominal pads around the incision.  
In conclusion, little is known about the natural course of myomas in adolescents since cases are 
rare. Minimally invasive methods seem to have equivalent recurrence and fertility consequences 
for abdominal myomectomy for these cases. We hope to learn more about the pathogenesis and 
fertility implications of leiomyomas in adolescents with long term follow up.
 
Keywords: leiomyoma, adolescent, minilaparotomy, minimal invasive surgery
 
 

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