Article: Left upper quadrant approach in gynecologic laparoscopic surgery

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TitleLeft upper quadrant approach in gynecologic laparoscopic surgery
AuthorsNgu, SF1
Cheung, VYT1
Pun, TC1
KeywordsLaparoscopy
neoplastic
pneumoperitoneum
pregnancy complications
surgical procedures - minimally invasive
tissue adhesions
Issue Date2011
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1600-0412
CitationActa Obstetricia Et Gynecologica Scandinavica, 2011, v. 90 n. 12, p. 1406-1409 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1600-0412.2011.01257.x
AbstractObjective. To review the use of the left upper quadrant approach in benign gynecologic laparoscopic surgery over a nine-year period. Design. Retrospective review. Setting. University-affiliated hospital. Population. Women who underwent laparoscopic gynecologic surgery the upper quadrant approach between January 2002 and December 2010. Methods. Medical records were reviewed. Main outcome measures. Demographic data, past surgical histories, indications for surgery and the use of the left upper quadrant approach, intraoperative findings, diagnosis and any complications. Results. 143 patients were identified, accounting for 4.9% of all gynecologic laparoscopic surgery. The indications for using the left upper quadrant approach were: previous open abdominal surgery (113, 79.0%), surgery in the second trimester of pregnancy (16, 11.1%), presence of large pelvic mass (9, 6.2%), previous transverse rectus abdominis myocutaneous flap for breast reconstruction (3, 2.0%), previous periumbilical hernia repair (1, 0.6%) and previous laparoscopic umbilical wound dehiscence (1, 0.6%). In women with previous abdominal surgery, the overall incidence of adhesions between omentum and/or bowel to the anterior abdominal wall in the umbilical region was 58.4%. Twelve (8.3%) patients required conversion to laparotomy. One patient had subcutaneous surgical emphysema over the left upper quadrant entry site. Conclusions. The left upper quadrant approach is an effective, safe and easy technique for peritoneal cavity access in women undergoing laparoscopic gynecologic surgery and should be considered in women with risk factors of periumbilical adhesions and in the presence of a large pelvic mass. © 2011 Nordic Federation of Societies of Obstetrics and Gynecology.
ISSN0001-6349
2011 Impact Factor: 1.771
2011 SCImago Journal Rankings: 0.138
DOIhttp://dx.doi.org/10.1111/j.1600-0412.2011.01257.x
ISI Accession Number IDWOS:000297054800017
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorNgu, SF
dc.contributor.authorCheung, VYT
dc.contributor.authorPun, TC
dc.date.accessioned2011-09-23T05:59:54Z
dc.date.available2011-09-23T05:59:54Z
dc.date.issued2011
dc.description.abstractObjective. To review the use of the left upper quadrant approach in benign gynecologic laparoscopic surgery over a nine-year period. Design. Retrospective review. Setting. University-affiliated hospital. Population. Women who underwent laparoscopic gynecologic surgery the upper quadrant approach between January 2002 and December 2010. Methods. Medical records were reviewed. Main outcome measures. Demographic data, past surgical histories, indications for surgery and the use of the left upper quadrant approach, intraoperative findings, diagnosis and any complications. Results. 143 patients were identified, accounting for 4.9% of all gynecologic laparoscopic surgery. The indications for using the left upper quadrant approach were: previous open abdominal surgery (113, 79.0%), surgery in the second trimester of pregnancy (16, 11.1%), presence of large pelvic mass (9, 6.2%), previous transverse rectus abdominis myocutaneous flap for breast reconstruction (3, 2.0%), previous periumbilical hernia repair (1, 0.6%) and previous laparoscopic umbilical wound dehiscence (1, 0.6%). In women with previous abdominal surgery, the overall incidence of adhesions between omentum and/or bowel to the anterior abdominal wall in the umbilical region was 58.4%. Twelve (8.3%) patients required conversion to laparotomy. One patient had subcutaneous surgical emphysema over the left upper quadrant entry site. Conclusions. The left upper quadrant approach is an effective, safe and easy technique for peritoneal cavity access in women undergoing laparoscopic gynecologic surgery and should be considered in women with risk factors of periumbilical adhesions and in the presence of a large pelvic mass. © 2011 Nordic Federation of Societies of Obstetrics and Gynecology.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationActa Obstetricia Et Gynecologica Scandinavica, 2011, v. 90 n. 12, p. 1406-1409 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1600-0412.2011.01257.x
dc.identifier.doihttp://dx.doi.org/10.1111/j.1600-0412.2011.01257.x
dc.identifier.epage1409
dc.identifier.hkuros195980
dc.identifier.isiWOS:000297054800017
dc.identifier.issn0001-6349
2011 Impact Factor: 1.771
2011 SCImago Journal Rankings: 0.138
dc.identifier.issue12
dc.identifier.pmid21854368
dc.identifier.scopuseid_2-s2.0-81355129111
dc.identifier.spage1406
dc.identifier.urihttp://hdl.handle.net/10722/139902
dc.identifier.volume90
dc.languageeng
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1600-0412
dc.publisher.placeUnited Kingdom
dc.relation.ispartofActa Obstetricia et Gynecologica Scandinavica
dc.relation.referencesReferences in Scopus
dc.subjectLaparoscopy
dc.subjectneoplastic
dc.subjectpneumoperitoneum
dc.subjectpregnancy complications
dc.subjectsurgical procedures - minimally invasive
dc.subjecttissue adhesions
dc.titleLeft upper quadrant approach in gynecologic laparoscopic surgery
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong