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
V-25 
Laparoscopic Secondary Cytoreduction Followed by HIPEC (Hyperthermic Intraperitoneal 
Chemotherapy) for a Patient with Recurrent Ovarian Cancer
Emine Karabuk
1
, Fatema Alkhan
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
STUDY OBJECTIVE: To perform laparoscopic HIPEC after the laparoscopic cytoreduction on a 
patient with recurrent ovarian cancer 
 
DESIGN: Step by step video explanation of the surgery 
 
SETTING AND INTERVENTION: 41 year old woman who had maximal debulking surgery 
for ovarian serous adenocarcinoma 13 months ago. After that standard chemotherapy was 
completed. Local recurrence was detected in PET CT and MRI; there were two nodules (15x10 
mm and 10x8 mm) on the meso of sigmoid colon at routine control. Secondary cytoreductive 
surgery with HIPEC was planned and laparoscopic approach was preferred for surgery. 
Secondary cytoreductive surgery with HIPEC was recommended in an attempt to improve the 
prognosis of the patients and incorporates surgical removal of all visible disease followed by 
chemical destruction of microscopic disease through chemo-perfusion. Minimally invasive 
approach is increasing in popularity recently but performing HIPEC by closed technique is 
rarely in gynecologic oncology. So we aimed to demonstrate the way of application, suitability, 
feasibility and safety of this method.
 
CONCLUSION: Laparoscopic cytoreductive surgery combined with HIPEC is feasible and safe 
for curative treatment of strictly selected patients with ovarian malignancy and might reduce 
postoperative complications and length of hospital stay.
 
Keywords: Laparoscopy, HIPEC, Ovarian Cancer
 
 
 

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 www.minimalinvazivjinekolojikcerrahi.org
21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
V-26 
Laparoscopic nerve sparing rectal shaving for rectocervical endometriositic nodule
Hüseyin Altuntaş
Özel IMC Hastanesi, Mersin
32 yaşında g0p0 şiddetli dismenore, disparoni, diskezya ve ağrılı defekasyon şikayetleri olan 
hastanın pelvik muayenesinde vajen doğal, uterus fikse adneksler serbest, tvusg: douglas oblitere, 
uterus posteriorunda isthmus hizasında rektumda 18 mm uzunluğunda 0,6 mm infiltrasyon 
yapan endometriozis nodulu izlendi, CA 125: normal. 2 günlük diyet sonrası gerçekleştirilen 
operasyonda laparoskopik bilateral ureterolizis, bilateral hipogastrik sinir disseksiyonu, 
pararektal fossa diseksiyonu sonrası rektal nodulun uterustan serbestleştirilip rektal shaving ile 
nodulun eksiyonu. rektum metilen blue test ile kontrol edildi. intraoperatif komplikasyon yok. 
Final patoloji: endometriozis nodulu. sonuc olarak 3 cm den küçük rektal endometriozis nodulleri 
laparoskopik nerve sparing shaving yöntemi ile güvenli şekilde tedavi edilebilir.
 
Anahtar Kelimeler: sinir koruyucu, rektal endometriozis, üreterolizis, shaving
 
 
 

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21 - 25 Şubat 2018
Wyndham Grand İstanbul Levent • İstanbul
MİNİMAL İNVAZİV JİNEKOLOJİK
CERRAHİ KONGRESİ
 www.minimalinvazivjinekolojikcerrahi.org
V-27 
What laparoscopic techniques can be used to prevent retorsion of the ovary ?
Nilüfer Akgün
1
, Engin Türkgeldi
1
, Alper Eraslan
1
, Barış Ata
2
1
Vkv Koc Üniversitesi Hastanesi
2
Vkv Amerikan Hastanesi
BACKGROUND: Ovarian torsion accounts for 2.7% of acute abdominal pain in women and it is 
rare, 1/5000, during pregnancy. Detorsion, rather than oophorectomy, is the preferred treatment. 
However, retorsion of the ovary is possible if necessary measures are not taken. Our aim was to 
describe the laparoscopic techniques that can help to prevent retorsion of the ovary.
 
CASE: We report of two cases who had acute right pelvic pain. First case a 22-year-old 
patient with acute onset right adnexeal tenderness with a palpable mass. Ultrasonographic 
examination revealed two simple cysts measuring 45 * 28 mm and 32 * 31 mm at the right 
ovary and some free peritoneal fluid. Laparoscopy was performed and detorsioned. The 
cyst was aspirated and its size was reduced. Further, oopheropexy was performed to prevent 
retorsion. Postoperative course was uneventful and the patient was discharged the next day. 
Second case was a 27-year-old woman at 8th gestational week presenting with pelvic pain, 
nausea and vomiting. The ultrasound examination revealed an ovarian mass with a diameter of 
approximately 80 mm in the right adnexal region and showed no blood flow in color and power 
Doppler mode. Ovarian detorsion and right salpingectomy was performed. Corpus luteum 
content was aspirated and the right ovary was placed in the pouch of Douglas to reduce the 
risk for retorsion. Patient was supplemented with progesterone until the 12th gestational week. 
 
CONCLUSION: The usual current treatment for ovarian torsion is the detorsion and ovarian 
preservation, while simple detorsion may predispose to recurrent torsion. Aspiration of the 
ovarian cyst can decrease the cyst size and reduce risk for retorsion. Oophoropexy can be 
considered to prevent retorsion of enlarged ovaries. Laparoscopy can be safely performed during 
pregnancy and enlarged uterus can help prevent recurrence in pregnant women by reducing the 
mobility of the torsioned adnexa.
 
Keywords: ovarian torsion, laparoscopic management, recurrence, abdominal pain
 
 
 

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