Neoplasms

Symptoms and General Pathology

All Conditions

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Gland and Hormone Related Diseases

Cysts

Ovarian Cysts

Ovarian Diseases

Adnexal Diseases

Genital Diseases, Female

Genital Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Gonadal Disorders

Endocrine System Diseases

Laparoscopic ovarian cystectomy using bipolar

Laparoscopic ovarian cystectomy using ultrasonic scalpel

Laparotomic ovarian cystectomy using suture

Ovarian cystectomy

Laparoscopic ovarian cystectomy using ultrasonic scalpel electrocoagulation

changzhong li, M.D.

The purpose of this study is to investigate the impact of electrocoagulation on ovarian reserve after laparoscopic excision of ovarian cyst and the possible mechanisms.

Laparoscopic cystectomy is currently considered the treatment of choice in women with benign ovarian cysts and has gained increasing acceptance among gynecological surgeons(1). However, the safety of this technique in terms of ovarian damage to the operated gonad has recently been questioned. In the present study, with the combined use of serum hormonal evaluation and ultrasound examination, we planned to prospectively investigate the ovarian reserve after the excision of benign ovarian cysts. The damage to ovarian reserve will be evaluated through a 12-months follow-up after the application of bipolar, ultrasonic scalpel electrocoagulation or suture during ovarian cystectomy

The Impact of Electrocoagulation on Ovarian Reserve After Laparoscopic Excision of Ovarian Cyst

The Impact of Electrocoagulation on Ovarian Reserve After Laparoscopic Exc

Shandong University

Shandong Provincial Hospital

Xiayong Wang Ph.D

Wounds and Injuries

Nervous System Diseases

Rupture

Pain

Abdominal Pain

Dermoid Cyst

Neurologic Manifestations

Signs and Symptoms, Digestive

Teratoma

Neoplasms, Germ Cell and Embryonal

Neoplasms by Histologic Type

The three-channel single-port: a 1.5-cm horizontal intraumbilical skin incision, a 1.5-cm to 2-cm rectus fasciotomy to open the peritoneal cavity, and the insertion of an Alexis small wound retractor (Applied Medical, Rancho Santa Margarita, CA). The wrist portion of a size 6.5 surgical glove was fixed to the outer ring of the wound retractor. A 12-mm trocar was inserted through a small hole made in one of the fingertips of the glove and advanced into the abdominal cavity. Two additional holes for the accessory channels were made in another fingertip of the glove, and two conventional 5-mm trocars were inserted through the holes.

The 12-mm main troca was inserted via subumbilical incision after fully insufflation by verness needle and other 3 working 5-mm trocas were inserted under vision at right middle abdominal, left middle abdominal and suprapubic incisions.

Ben-Shian Huang, M.D.

Yi-Jen Chen, M.D., Ph D.

Minimally invasive surgery has become the standard treatment for many gynecologic disease processes. In the last decade, numerous studies have demonstrated that laparoscopic approaches to various gynecologic oncology conditions-particularly for early-stage endometrial and cervical cancers as well as select pelvic masses-is feasible and results in shorter hospital stays, improved quality of life and comparable surgical and oncologic outcomes to abdominal staging.For instance, the typical gynecologic robotic surgical procedure will require Two to three 5-mm ports and one 12-mm laparoscopic ports. Recently, an even less invasive alternative to conventional laparoscopy surgery has been developed: laparoendoscopic single-site surgery (LESS), also known as single-port surgery. Single port laparoscopy is an attempt to further enhance the cosmetic benefits of minimally invasive surgery while minimizing the potential morbidity associated with multiple incisions. Preliminary advances in LESS as applied to urologic and gastrointestinal surgery demonstrate that the techniques are feasible provided that both optimal surgical technical expertise with advanced skills and optimal instrumentation are available. Recently, several publication showed the single port laparoscopic surgery is feasibility in gynecologic surgery including oophorectomy, cystecomty, and myomecomty. To our knowledge, the sample size of recent publication about single port surgery including cystectomy and myomecomty is small. Furthermore, these studies lack the comparison of single port and convectional laparoscopic surgery. Base on our recent study demonstrated that either the single-port or the conventional approach can be used for LAVH, but the single-port LAVH technique yielded less postoperative pain (Chen et al., Obestet Gynecol, 2011). The purpose of this study was to assess the feasibility of single port laparoscopic surgery in the treatment of benign gynecologic disease.

This study was designed as a retrospective case-control study, and port placement was one of the differences in operative procedures between the two groups. Patients with ovarian dermoid cysts were evaluated at Taipei Veterans General Hospital from June 13, 2011 through June 12, 2013. Approval for the study was obtained from the hospital's ethics committee, and informed consent was obtained from all patients (VGHIRB 2011-06-004IA).

Single-port LC Might be Preferable for Managing Ovarian Dermoid Cyst.

Single-Port Compared With Conventional Laparoscopic Cystectomy for Ovarian Dermoid Cysts

The ovarian spillage and endobag rupture rates were compared between single-port and conventional laparoscopic cystectomy in managing ovarian dermoid cysts during operation.

The outcome measures included operative time, blood loss, postoperative pain, and analgesic use in the first 48 hours after surgery.

Ovarian reserve markers include serum estrogen (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and anti-Mullerian hormone (AMH) before and 4 weeks after surgery.

National Yang Ming Chiao Tung University

Taipei Veterans General Hospital, Taiwan

Yi-Jen, Chen, M.D., Ph D., Department of Obstetrics and Gynecology, Taipei Veterans General Hospital

Endometriosis

Coagulants

All Drugs and Chemicals

Hemostatics

Thrombin

Fibrin Tissue Adhesive

During laparoscopic ovarian cystectomy, bleeding will be controlled by using a hemostatic agent (EVICEL® Fibrin Sealant, Ethicon, USA), which consist of thrombin and coagulating proteins, mainly fibrinogen and fibronectin. If hemostasis is not fulfilled enough by using it, a additional intervention such as electrocoagulation with bipolar forceps and barbed suture is required to stop bleeding.

During operation, barbed suture will be applied to the inner surface of ovarian parenchyme where ovarian endometriosis was attached. In this group, if bleeding is continued after suturing, additional electrocoagulation with bipolar forceps will be conducted.

During laparoscopic ovarian cystectomy, bleeding will be controlled by using a hemostatic agent (EVICEL®)

Hemostatic agent (EVICEL®) application during laparoscopic ovarian cystectomy

During laparoscopic ovarian cystectomy, suturing of ovarian inner surface will be conducted to stop bleeding

suturing with barbed sutures during laparoscopic ovarian cystectomy

Hyunji Lim, MD

Hee seung Kim, MD/PhD

Ga Won Yim, MD/PhD

Chae Hyeong Lee, MD/PhD

Hee Seung Kim, MD/PhD

This study aims to evaluate the efficacy of preservation of ovarian function, hemostasis, and safety of a hemostatic agent versus suturing during laparoscopic ovarian cystectomy for ovarian endometriosis.

In women with endometrioma who plan to undergo laparoscopic ovarian cystectomy, surgical technique can influence postoperative ovarian function because of removal of normal ovarian tissue with ovarian cyst and damage to ovarian tissue during bleeding control after stripping of endometrioma. This study is designed to compare hemostatic sealant to suturing in terms of hemostatic function, safety and preservation of ovarian function.

Ovarian function of all patients will be evaluated on pre op, post op 12 weeks, post op 48 weeks by measuring AMH and ovarian volume. And Hemostatic function will be evaluated by measuring serum hemoglobin, blood loss during operation, etc.

Comparison of Hemostatic Agent to Suture in Terms of Hemostatic Function and Preservation of Ovarian Function

A Multi-center, Randomized, Investigator-initiated Trial to Evaluate the Efficacy of PRreservation of ovArian Function, Hemostasis, and sAfety of a Hemostatic Agent Versus Suturing During Laparoscopic Ovarian Cystectomy for Endometrioma

Reduction rate of AMH level in serum 12 weeks after surgery

Reduction rate of AMH level in serum 48 weeks after surgery

Stop-watch will be operated right after finishing stripping endometrioma. It will be evaluated how long the time have been spent for bleeding control

Stop-watch will be operated right after finishing stripping endometrioma. It will be evaluated whether hemostasis is finished within 10 minutes

The volume of blood loss will be estimated by using simple visual assessment technique referring to gauze count and irrigation bottle

whether patients are transfused during admission period

any adverse events during admission period

time from anesthesia start to delivery of patient to recovery room

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
The Impact of Electrocoagulation on Ovarian Reserve After Laparoscopic Excision of Ovarian Cyst	NCT00713778	Ovarian Cysts	Ovarian cystect... Ovarian cystect... Ovarian cystect...	18 Years - 40 Years	Shandong Provincial Hospital
Single-port LC Might be Preferable for Managing Ovarian Dermoid Cyst.	NCT02009228	Abdominal Pain Ovarian Spillag... Endobag Rupture Ovarian Reserve	Ovarian cystect...	-	Taipei Veterans General Hospital, Taiwan
Comparison of Hemostatic Agent to Suture in Terms of Hemostatic Function and Preservation of Ovarian Function	NCT04643106	Benign Ovarian ...	Hemostatic agen... suturing with b...	19 Years - 45 Years	Seoul National University Hospital
The Impact of Electrocoagulation on Ovarian Reserve After Laparoscopic Excision of Ovarian Cyst	NCT00713778	Ovarian Cysts	Ovarian cystect... Ovarian cystect... Ovarian cystect...	18 Years - 40 Years	Shandong Provincial Hospital

Spots Global Cancer Trial Database for ovarian cystectomy