Transvaginal Extraction: Feasible

Slides:

Advertisements

Similar presentations

Crohn’s colitis patients can be offerred an ileoanal pouch

Advertisements

Current Teaching in United States Feza H. Remzi,M.D. F.A.C.S., F.A.S.C.R.S., F.T.S.S. ( Hon) Department of Colorectal Surgery Digestive Disease Institute.

Update on management of colonic diverticulitis Dr. Nerissa Mak Oi Sze Department of Surgery North District Hospital/ Alice Ho Miu Ling Nethersole Hospital.

Morcellation of specimen : Fact or fiction? Gustavo Plasencia MD, FACS, FASCRS.

Dr Lam Shek Ming Sherman Kwong Wah Hospital.  Introduction  Review of literature  Conclusion.

Challenges in Surgery for Severe, Refractory Ulcerative Colitis: Case Studies Phillip R. Fleshner,M.D. Shierley,Jesslyne,and Emmeline Widjaja Chair in.

No (Visible) Scar Colectomy Michael J Stamos, MD Professor and Chair Department of Surgery Univ. of California, Irvine.

How do we manage perforated Crohn’s Disease? Daniel von Allmen, MD Cincinnati Children’s Hospital Medical Center Cincinnati, Ohio.

Laparoscopic Colon Surgery

INSTRUMENTS AND Pneumoperitoneum. Dr. Anmar Nassir, FRCS(C) Fellowship in Andrology (U of Ottawa) Fellowship in EndoUrology and Laparoscopy (McMaster.

TECHNIQUE OF LAPAROSCOPIC NEPHRECTOMY Dr. Anmar Nassir, FRCS(C) Fellowship in Andrology (U of Ottawa) Fellowship in EndoUrology and Laparoscopy (McMaster.

Robotic Surgery… The Future is Here

Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA.

EBM: LAPAROSCOPIC COLON SURGERY - results and data + a single center experience (120 patients ) Zdravko Perko University Department of Surgery, Clinical.

Crohn’s disease - A Review of Symptoms and Treatment

Mr D Light ST5 Mr S Subramonia Consultant Laparoscopic Colorectal Surgeon Consultant Laparoscopic Colorectal Surgeon Mr A Krishna Consultant Laparoscopic.

Cedars-Sinai Medical Center Los Angeles, California

Patient Selection for IAP Nigel A. Scott MD FRCS Manchester UK.

Slawomir Marecik, MD, FACS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA.

Diseases of Large Bowel. Diverticulosis of the Colon I. Diverticula of the colon are acquired herniations of colonic mucosa protruding through the.

Complications During and After Restoration of Intestinal Continuity After Colostomy. Is it Worth it? Gustavo Plasencia, MD, FACS, FASCRS.

High risk population in GI field how we can find them? Ahmad Shavakhi MD Associate professor of gastroenterology.

Robotic LAR with Transanal Extraction Alessio Pigazzi City of Hope Duarte, CA.

SurgerySurgery Abdominal Wall Reconstruction: Patch the tire or rebuild the car? Michael J. Rosen MD, FACS Associate Professor of Surgery Chief, Division.

PERISTOMAL HERNIA: THE CASE FOR EXTRAPERITONEAL COLOSTOMY Garnet Blatchford, M.D.

SNDA : CELEBREX TM INDICATION Reduction and Regression of Adenomatous Colorectal Polyps in Familial Adenomatous Polyposis Patients FDA ODAC Presentation.

Hand Assisted Surgery Bradley R. Davis, MD, FACS, FASCRS Associate Professor of Surgery Director Surgical Education/Surgical Skills Lab Program Director.

Feza H. Remzi MD, FACS, FASCRS

Complications of Laparoscopic Surgery for Diverticulitis

1 Jaime Ponce, MD FACS FASMBS Director of Bariatric Surgery Hamilton Medical Center Dalton GA Outpatient Bariatric Surgery: Is it Here? MISS Morbid Obesity.

Anastomotic Leak (lower GI)

Shane McNevin MD FASCRS Spokane, WA.  None except I took the ABCRS qualifying/certifying exam before the emphasis on good question writing.

T4 Colon Cancer and Laparoscopic Approach Gustavo Plasencia MD FACS, FASCRS Clinical Professor of Surgery Gustavo Plasencia MD FACS, FASCRS Clinical Professor.

Immunologic and Angiogenic Effects of Open & Closed Abdominal Surgery Richard L. Whelan, MD St. Luke’s Roosevelt Hospital Columbia University New York,

Crohn’s Colitis Patients Should Never Be Offered an Ileoanal Pouch Asher Kornbluth, MD Clinical Professor of Medicine The Henry D. Janowitz Division of.

Change in bowel habits … 60 year old male Complains of progressive constipation for the past 6 months.

Laparoscopic Pancreatectomy Attila Nakeeb, M.D., F.A.C.S. Department of Surgery Indiana University School of Medicine 7th Annual Symposium on Gastrointestinal.

Single-port Resection for Colorectal Cancer

Laparoscopic Colon Surgery in the Obese Patient Alessio Pigazzi City of Hope Duarte, CA.

SILS Complications Dan Geisler, MD, FACS, FASCRS.

Colonic stenting for intestinal obstruction due to left colon and rectal cancer Dr Sherman Lam TKOH JHSGR 26 April 2014.

Single Incision Bariatric Surgery Ninh T. Nguyen, MD, FACS University of California, Irvine Medical Center, Orange, CA.

Anal Cancer - Case 1  62 years old woman with 6 months history of anal pain  Clinically T 3 squamous cell carcinoma growing anteriorly  Which staging.

Extraction sites for colon resection: What’s out there right now? Extraction sites for colon resection: What’s out there right now? Morris E. Franklin.

Open Approaches for Rectal Prolapse John Hartley Academic Surgical Unit University of Hull.

How to ID and treat intraoperative complications Part 2

Basics Skills for Laparoscopic Colon Surgery

Severe Adhesions Bradley R. Davis, MD, FACS, FASCRS Associate Professor of Surgery Director Surgical Education/Surgical Skills Lab Program Director Residency.

Transanal extraction: Is it worth it?

Anastomosis in IBD Barry Salky, MD FACS Professor of Surgery Chief (Emeritus), Division of Laparoscopic Surgery The Mount Sinai Hospital New York.

Morcellation Gustavo Plasencia MD, FACS, FASCRS Clinical Professor of Surgery Florida International University Stelio Rekkas MD.

Laparoscopic vs. Conventional Resections for Colorectal Carcinoma 2LT Pil (Pete) Kang New York University School of Medicine 28 September 2000.

Oxford Colorectal People, Pouches and Places:The Generation Game - Pouch Salvage and Reconstruction Prof Neil Mortensen MA, MB ChB, MD, FRCS Eng hon FRCS.

Ileoanal Pull-Through Straight vs. J Pouch

Moving Toward Universal Colon Cancer Screening: Methods In Unsedated Colonoscopy Christopher Forest, PA-C Darenie Goodman, MD Kelly Jones, MD Wm MacMillan.

Lecture Fifteen Biomedical Engineering for Global Health.

Surgical treatment of inflammatory bowel disease Aleš Tomažič Dept. of Abdominal Surgery, University Medical Center Ljubljana.

Laparoscopic surgery for rectal cancer What is the evidence?

Natural Orifice Transluminal Laparoscopic Surgery

Newer Techniques in Benign Coloproctology: The LASER

ERAS Sandra J. Beck, MD, FACS, FASCRS

Intra-operative complications of laparoscopic colonic surgery

A comparison between 3D & conventional laparoscopic colectomy

A Review of Evidence on Method of Choice of Intestinal Anastomosis

Single incision laparoscopic resection for diverticulitis

Maie Abdalla, Kalle Landerholm, Peter Andersson, Roland E

Zheng Wang, Xing-Mao Zhang, Jun-Jie Hu, Zhi-Xiang Zhou

Volume 4, Issue 6, Pages (June 2019)

Presentation transcript:

Transvaginal Extraction: Feasible Howard Ross, MD, FACS, FASCRS Chief, Colon and Rectal Surgery Riverview Medical Center Clinical Associate Professor of Surgery UMDNJ

Disclosures Consultant and Course Director: Applied Medical Covidien Woke at 4 am to watch royal wedding

Natural Orifice Surgery

50% of Population Have a Vagina

Transvaginal Extraction

Transvaginal Extraction

Published Results Studies Small Selected patients As of February 2011: 23 articles 130 patients Complications Related to Transvaginal Extraction Rectovaginal fistula Pelvic Seroma Diana M, Perretta S, Wall J, Costantino FA, Leroy J, Demartines N, Marescaux J. Colorectal Dis. 2011 Jun;13(6):e104-11.

Laparoscopic restorative proctocolectomy 7 patients 2004-2007 An Innovative Technique for Colorectal Specimen Retrieval: A New Era of “Natural Orifice Specimen Extraction” (N.O.S.E) Laparoscopic restorative proctocolectomy 7 patients 2004-2007 Familial adenomatous polyposis with cancer Posterior vaginal vault was opened with an ultracision shears, endobag placed in the vagina All vaginal wounds healed No vaginal metastasis 1 DVT, 1 anastamotic leak Palanivelu C, Rangarajan M, Jategaonkar PA, Anand NV. Dis Colon Rectum. 2008 Jul;51(7):1120-4. Epub 2008 May 15.

88 yr old woman, 4 cm cecal cancer Transvaginal Extraction of the Specimen After Total Laparoscopic Right Hemicolectomy With Intracorporeal Anastomosis First US report 88 yr old woman, 4 cm cecal cancer 3-cm transvaginal posterior colpotomy No complications Franklin ME Jr, Kelley H, Kelley M, Brestan L, Portillo G, Torres J Surg Laparosc Endosc PercutanTech. 2008 Jun;18(3):294-8.

Case Reports Lead Author Country Op Type Disease n Complication Year Dozois USA JPouch Vag hys FAP 1 None 2008 Garcia Florez Spain LAR RSO (Alexis ring) Colon Ca 2010 McKenzie (Pigazzi) R Colectomy 2 Cancer 2 polyp 4 (sbo unrelated) Park S Korea R colectomy 14 2 aborted extractions d/t colpotomy issues

Laparoscopic Right Colectomy Case Controlled Study Laparoscopic Right Colectomy vs. Laparoscopic R Colectomy with natural orifice specimen extraction (NOSE) 34 Patients Each Group NOSE patients less pain POD 1 and POD 3 (0.01) Visual analogue and blinded observer Improved Cosmesis No morbidity difference J. S. Park, G.-S. Choi, H. J. Kim, S. Y. Park and S. H. Jun British Journal of Surgery 2011; 98: 710–715

Trans-Vaginal Extraction

For Discussion Patient Selection Process to begin Who should try? IRB, Ethics Who should try?