www.minimalinvazivjinekolojikcerrahi.org
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
VS-59
PlasmaJet: an Energy Device Modality in Gynecology Surgery
Fatema Alkhan
1
, Emine Karabuk
1
, Mehmet Murat Naki
1
, Mete Gungor
2
, Mehmet Faruk Kose
1
1
Acibadem University Atakent Hospital,
Istanbul, Turkey
2
Acibadem Maslak Hospital, Istanbul, Turkey
OBJECTIVE: To demonstrate the usage of Plasmajet in laparoscopic ovarian cystectomy
INTRODUCTION: The PlasmaJet System uses a low DC voltage applied between internal bipolar
electrodes to produce highly energetic pure argon plasma that is electrically neutral. When the
plasma comes into contact with tissue, it rapidly gives up its energy in three useful forms; first as
light that is useful for illuminating the surgical field in laparoscopic procedures, secondly as heat
that results in coagulation
of bleeding surfaces, and thirdly as kinetic energy, which is harnessed
to cut and ablate tissue. The kinetic energy produced by the device first removes blood and
liquids from the tissue surface. This is followed by the transfer of thermal energy to the tissue
resulting in the formation of a thin and flexible yet complete sealing layer.
METHOD: The PlasmaJet system is not strictly an electrosurgical device either, but use of direct
current electrical energy is necessary to eventually create the heat needed to treat tissue. The
PlasmaJet system releases its energy in 3 ways: light, heat, and kinetic energy. The effect at the
tissue level is influenced by how close the jet of
ionized gas is to the tissue, which handpiece is
chosen, and which button is pushed on the handpiece. The maximum depth of tissue penetration
effect is only 2 mm, reached after 5 seconds of continuous application. This video will show the
ovarian cystectomy by PlasmaJet.
CONCLUSION: Plasmajet can be used as a modality of electrosurgery in laparoscopic procedure,
depending on the surgeon’s preference and its availability in the institute. Studies are needed to
compare this modality with others in term of feasibility and the outcome on the follicles.
Keywords: Laparoscopy, Ovarian, Cyst
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
www.minimalinvazivjinekolojikcerrahi.org
VS-60
Risk-reducing salpingo-oophorectomy plus hysterectomy in a BRCA mutation carrier:
surgical techinique based on ocological point of view
Tayfun Toptas
1
, Isin Ureyen
1
,
Aysel Uysal
2
1
Department of Gynecologic Oncology, SBU Antalya Research and Training Hospital, Antalya,
Turkey
2
Department of Gynecologic Surgery, SBU Antalya Research and Training Hospital, Antalya,
Turkey
OBJECTIVE: Women with mutations of BRCA1 or BRCA2 genes have up to a 54% lifetime risk
of developing ovarian cancer. A risk-reducing bilateral salpingo-oophorectomy (RRSO) lowers
their chances of developing ovarian and fallopian tube cancer by up to 80%. In this video
demonstration, we aimed to show oncological aspects of a much
performed but less known
surgical technique.
SURGICAL TECHNIQUE: A gravidity and parity 2, 36-year of woman with breast cancer and
BRCA1 mutation was referred to our clinic by her clinical oncologist. Her breast disease was
under complet clinical remission. She has regularly taking tamoxiphene 20mg/d. An endometrial
biopsy revealed benign endometrial polyp. After counselling with genetician, a RRSO was
offerred. Addition of hysterectomy to the RRSO was left to patient’s discretion. The procedure
was performed according to a surgical protocol, which was defined firstly by Powell et al. in
2011, and later, proposed by NCCN guidelines. The protocol inculdes following steps:
operative
laparoscopy; carefull inspection of upper abdomen, bowel surfaces, omentum, appendix (if
present), and pelvic organs; biopsy of any abnormal peritoneal findings; obtaining pelvic washing
for cytology (50 cc normal saline instilled and aspirated immediately); performance of total BSO,
removing 2 cm of proximal ovarian vasculature,
all tube up to the cornua, and all peritoneum
surrounding the ovaries and tubes, especially peritoneum underlying areas of adhesion between
tube and/or ovary and the pelvic sidewall. To avoid traumatic exfoliation of cells, handling of the
tubes and ovaries during surgery was minimized.
CONCLUSION: In this video presentation, we demonstrated the steps of proposed surgical
protocol for RRSO. The use of standardized surgical and pathologic
algorhythms is essential in
detecting occult malignancies in BRCA carriers.
Keywords: BRCA mutation, laparoscopy, salpingo-oophorectomy, ovarian cancer
www.minimalinvazivjinekolojikcerrahi.org
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
VS-61
Laparoskopik Vena Kava Onarımı
Seda Yüksel Şimşek, Hüsnü Çelik, Songül Alemdaroğlu, Şafak Yılmaz Baran,
Erhan Şimşek
Başkent Üniversitesi Adana t noyan Arastirma Hastanesi
laparoskopik lenfadenektomi yapılan bir endometrium kanseri vakamızda oluşan vena kava
defektinin laparoskopik olarak onarılmasını gösteren bir olgu sunumudur
Anahtar Kelimeler: laparoskopi, vena kava, intraabdominal kanama