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Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator
Gynecology / Aug 31st, 2019 12:03 pm     A+ | a-

 

Uterine manipulation is essential for laparoscopic hysterectomy procedures involving dissection of the female pelvis. Several uterine manipulators are available to help maneuver the uterus facilitation proper dissection in the pelvis.

At our World Laparoscopy Hospital, we routinely in female where cervical manipulation is not possible we use the myoma screw for uterine manipulation during total laparoscopic hysterectomy or surgery for cervical, bladder, and rectal cancers.

However, its use is avoided in two situations. First, in endometrial cancer, where the peritoneal spread of tumor cells is feared. Second, in patients with pyometra in cervical cancer, where insertion of the screw would lead to spillage of pus into the abdominal cavity.

With the use of myoma screw, there were no intraoperative complications. In conclusion, this method has the advantages of not requiring any vaginal manipulator, reducing the number of people required during operation, permitting a near-maximum manipulation of the uterus in all three dimensions, and giving the control of these manipulations directly to the surgeon. On the other hand, the technique also has some inadequacies of recognizing vaginal edge which should be discussed and improved on in the future.

Various vaginal manipulators are used in laparoscopic surgery to manipulate the uterus. When these enter through the cancer tissue, like the cervical canal or the endometrial cavity, manipulation can sometimes result in tissue breakup and bleeding. This can theoretically lead to cancer cells entering into the circulation and systemic spread. Some vaginal manipulators are comparatively expensive and require an additional assistant at the vaginal end.

The uterus is often manipulated using a grasping forceps, but this entails the use of one port for uterine manipulation or insertion of an additional port. Moreover, graspers often slip leading to tissue break up. This is especially common at the uterine cornua, which bleed during repeated manipulation with graspers. In all these situations using myoma scew is a good option.

10 COMMENTS
Dr. Monica
#1
Apr 24th, 2020 9:54 am
Sir, I know that you are very helpful to others. Your teaching style is stimulating and Case studies classes very interesting. Thanks for sharing the Laparoscopy Hysterectomy video.
Manish
#2
Apr 24th, 2020 9:59 am
Your lecture is very informative and well presented, which helped to learn quickly. Thanks for sharing the Hysterectomy video.
Dilara
#3
May 11th, 2020 8:35 am
Dr. Mishra thank you sir, Your lecture is very informative and well presented, with perfect explanations. This is very interesting to learn Laparoscopy Hysterectomy surgery with out Uterine manipulation. Thank you ! this was amazing! it will improve my technique.
Dr. Noora Sajawani
#4
May 18th, 2020 8:16 am
This is the best explanation i have ever seen for the Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator. You're an amazing Teacher !!!! God bless you. Thank you sooo much for this video.
AMIT KUMAR
#5
May 21st, 2020 10:20 am
Thanks..very interesting video. A very interesting and motivating topic on otal Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator. Thanks for sharing.
Dr. Shubham Verma
#6
May 22nd, 2020 11:27 am
This video is excellent in presentation. Excellent surgery technic and also safe. Thanks for uploading the video of Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator
Dr. Deepak Jaiswal
#7
Jun 10th, 2020 7:40 am
Such an excellent presentation. Excellent surgery techniques. Thanks for uploading this video of Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator.
Dr Nitish Kumar Yadav
#8
Jun 12th, 2020 12:27 pm
Thank you for the great presentation with perfect explanations very informative and well presented video of Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator. You explained it really wonderfully. Thank you so much!. This is really helpful for Gynaecologist's! You are the best teacher.
Dr. Tom Hollandeenee
#9
Jun 12th, 2020 12:50 pm
I found prof. Dr. R. K. Mishra is an wonderful Teacher. The things that he taught me helped me a great deal in my Practice as well as presentation. Because of his explanations i am doing very well in practice. Because of the help and attention. Dr. Mishra provided me I have understand and enjoy his explanation wonderful demonstration. Thanks World Laparoscopy Hospital for sharing this great video presentation of Total Laparoscopic Hysterectomy by Myoma Screw Without Uterine Manipulator on Internet.
Dr. Mahedee Youknowdah Whale
#10
Jun 12th, 2020 1:09 pm
Dr. Mishra is great in that he didn’t just give the answers away – he made you how to do Laparoscopy surgery THINK. My prof he taught me This was sort of frustrating, but sir your video and lecture it helped me understand the material much better. The best this is sir your Explanation, Demonstration and your wonderful presentation.
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