Total laparoscopic hysterectomy for non-puerperal uterine inversion: anatomical and operative considerations

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• 作者：Vasileios Minas ; Antonios Anagnostopoulos ; Nahid Gul
• 关键词：Total laparoscopic hysterectomy ; Uterine inversion ; Uterine myoma ; Laparoscopy
• 刊名：Gynecological Surgery
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：12
• 期：4
• 页码：287-289
• 全文大小：199 KB
• 参考文献：1.Auber M, Darwish B, Lefebure A, Ness J, Roman H (2011) Management of nonpuerperal uterine inversion using a combined laparoscopic and vaginal approach. Am J Obstet Gynecol 204:e7鈥揺9CrossRef PubMed
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• 作者单位：Vasileios Minas (1)
  Antonios Anagnostopoulos (1)
  Nahid Gul (1)
  
  1. Minimal Access Centre, Department of Obstetrics & Gynaecology, Wirral University Teaching Hospital, Upton, UK
  
• 刊物主题：Gynecology; Minimally Invasive Surgery; Surgical Oncology; Obstetrics/Perinatology; Reproductive Medicine; Interventional Radiology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1613-2084

文摘

The diagnosis and management of non-puerperal uterine inversion can be challenging. The majority of cases are caused by benign leiomyomas, but 15 % are related to a malignant mass. Published case reports can guide gynaecologists who encounter this rare condition and provide valuable insight in its management. We present a case of non-puerperal uterine inversion in a pre-menopausal woman treated by total laparoscopic hysterectomy. We discuss the challenges we encountered due to the distorted pelvic anatomy and conclusions drawn from a literature review. The article is accompanied by relevant video material. A high level of suspicion is required for the diagnosis of non-puerperal uterine inversion. Morcellation techniques should be avoided due to the potential for malignancy. Where myomectomy is performed vaginally, the possibility of uterine rupture should be taken into account. Management by total laparoscopic hysterectomy has not been reported previously, but appears to be feasible. The technique should be meticulous and aim to identify by dissection important structures. Keywords Total laparoscopic hysterectomy Uterine inversion Uterine myoma Laparoscopy