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  1. Article: Plastic and reconstructive uterus operations by minimally invasive surgery? A review on myomectomy.

    Hirschelmann, Anja / De Wilde, Rudy Leon

    GMS Interdisciplinary plastic and reconstructive surgery DGPW

    2012  Volume 1, Page(s) Doc09

    Abstract: Background: Plastic and reconstructive uterus operations are performed in congenital uterine anomalies or benign uterine conditions. Congenital uterine anomalies are relatively rare diseases with various approaches for surgical treatment. Therefore, to ... ...

    Abstract Background: Plastic and reconstructive uterus operations are performed in congenital uterine anomalies or benign uterine conditions. Congenital uterine anomalies are relatively rare diseases with various approaches for surgical treatment. Therefore, to address the question of the usefulness of a minimally invasive approach in plastic uterus operations, the most common uterine condition which requires reconstructive surgery, namely myomectomy, is discussed.
    Method: Searches were conducted in PubMed and The Cochrane Library to identify relevant literature.
    Findings: Compared with myomectomy by laparotomy and minilaparotomy, laparoscopic myomectomy is associated with improved short-term outcomes. Laparoscopy is further associated with less adhesion formation. Pregnancy rates after myomectomy in symptomatic patients might be higher after laparoscopy than after laparotomy. Although uterine ruptures following laparoscopic myomectomy are described in the literature, it seems to be a rare event. Concerning the recurrence, there is evidence that rates are similar after laparoscopy and laparotomy.
    Conclusion: Myomectomy by laparoscopy has several advantages over abdominal myomectomy (by conventional laparotomy and minilaparotomy) and should be the standard procedure. Despite the advantages of laparoscopy, abdominal myomectomy is still a frequently performed procedure. Lack of training in advanced laparoscopic procedures hampers the wide-spread use of laparoscopic myomectomy. Due to the advantages of laparoscopic surgery, efforts should be made to implement this procedure into daily practice. To provide the best care, physicians should offer patients the opportunity of a laparoscopic treatment of myomas.
    Language English
    Publishing date 2012-01-09
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2645026-4
    ISSN 2193-8091
    ISSN 2193-8091
    DOI 10.3205/iprs000009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Operative Strategien bei Adhäsionen

    Hirschelmann, Anja / De Wilde, Rudy Leon

    Frauenheilkunde up2date

    2012  Volume 6, Issue 4, Page(s) 221

    Language German
    Document type Article
    ZDB-ID 2274765-5
    ISSN 1439-3719
    Database Current Contents Medicine

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  3. Article ; Online: Plastic and reconstructive uterus operations by minimally invasive surgery? A review on myomectomy

    Hirschelmann, Anja / De Wilde, Rudy Leon

    GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW, Vol 1, p Doc

    2012  Volume 09

    Abstract: Background: Plastic and reconstructive uterus operations are performed in congenital uterine anomalies or benign uterine conditions. Congenital uterine anomalies are relatively rare diseases with various approaches for surgical treatment. Therefore, to ... ...

    Abstract Background: Plastic and reconstructive uterus operations are performed in congenital uterine anomalies or benign uterine conditions. Congenital uterine anomalies are relatively rare diseases with various approaches for surgical treatment. Therefore, to address the question of the usefulness of a minimally invasive approach in plastic uterus operations, the most common uterine condition which requires reconstructive surgery, namely myomectomy, is discussed. Method: Searches were conducted in PubMed and The Cochrane Library to identify relevant literature. Findings: Compared with myomectomy by laparotomy and minilaparotomy, laparoscopic myomectomy is associated with improved short-term outcomes. Laparoscopy is further associated with less adhesion formation. Pregnancy rates after myomectomy in symptomatic patients might be higher after laparoscopy than after laparotomy. Although uterine ruptures following laparoscopic myomectomy are described in the literature, it seems to be a rare event. Concerning the recurrence, there is evidence that rates are similar after laparoscopy and laparotomy. Conclusion: Myomectomy by laparoscopy has several advantages over abdominal myomectomy (by conventional laparotomy and minilaparotomy) and should be the standard procedure. Despite the advantages of laparoscopy, abdominal myomectomy is still a frequently performed procedure. Lack of training in advanced laparoscopic procedures hampers the wide-spread use of laparoscopic myomectomy. Due to the advantages of laparoscopic surgery, efforts should be made to implement this procedure into daily practice. To provide the best care, physicians should offer patients the opportunity of a laparoscopic treatment of myomas.
    Keywords minimally invasive surgery ; myomectomy ; plastic and reconstructive surgery ; infertility ; uterine rupture ; Medicine ; R ; Surgery ; RD1-811
    Subject code 610
    Language German
    Publishing date 2012-01-01T00:00:00Z
    Publisher German Medical Science GMS Publishing House
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Plastic and reconstructive uterus operations by minimally invasive surgery? A review on myomectomy

    Hirschelmann, Anja / De Wilde, Rudy Leon

    GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW

    2012  Volume 1, Page(s) 9

    Abstract: Hintergrund: Plastische und rekonstruktive Uterusoperationen werden aufgrund von angeborenen genitalen Fehlbildungen oder gutartigen Uteruserkrankungen durchgeführt. Bei angeborenen genitalen Fehlbildungen handelt es sich um relativ seltene Erkrankungen ...

    Title translation Minimal invasive Chirurgie bei plastischen und rekonstruktiven Uterusoperationen: die Myomentfernung
    Abstract Hintergrund: Plastische und rekonstruktive Uterusoperationen werden aufgrund von angeborenen genitalen Fehlbildungen oder gutartigen Uteruserkrankungen durchgeführt. Bei angeborenen genitalen Fehlbildungen handelt es sich um relativ seltene Erkrankungen mit unterschiedlichsten Behandlungsansätzen. Zur Beantwortung der Frage, ob es sinnvoll ist plastische Uterusoperationen minimalinvasiv durchzuführen, wird daher die häufigste gutartige Uteruserkrankung, welche eine Rekonstruktion des Uterus erfordert, nämlich die Myomentfernung, besprochen.
    Methodik: Es wurde eine Literaturrecherche in PubMed und der Cochrane Library durchgeführt.
    Ergebnisse: Die laparoskopische Myomentfernung ist, verglichen mit der Myomentfernung per Laparotomie und Minilaparotomie, mit einem besseren kurzfristigen Patientenoutcome verbunden. Zudem kann die Entstehung von Adhäsionen durch den Einsatz der Laparoskopie vermindert werden. Die Schwangerschaftsrate nach laparoskopischer Myomentfernung ist bei symptomatischen Patientinnen höher als nach Myomentfernung per Laparotomie. Obwohl Uterusrupturen nach laparoskopischer Myomentfernung in der Literatur beschrieben sind, scheint dies dennoch ein seltenes Ereignis zu sein. Bezüglich des Auftretens von Rezidiven gibt es Hinweise, dass es keinen Unterschied nach Laparoskopie und Laparotomie gibt.
    Schlussfolgerung: Die laparoskopische Myomentfernung hat gegenüber der Myomentfernung per Laparotomie (herkömmliche Laparotomie und Minilaparotomie) verschiedene Vorteile und sollte die Standardoperation darstellen. Trotz der Vorteile der Laparoskopie ist die Myomentfernung per Laparotomie immer noch ein häufig durchgeführter Eingriff. Ein Mangel an Training in technisch anspruchsvollen laparoskopischen Operationen erschwert den weitverbreiteten Einsatz der laparoskopischen Myomentfernung. Aufgrund der Vorteile der Laparoskopie, sollte man sich jedoch um die Implementierung dieser Operation in die tägliche Praxis bemühen. Um die bestmögliche Versorgung zu gewährleisten, sollten Ärzte ihren Patienten die Möglichkeit bieten Myome laparoskopisch entfernen zu lassen. ; Background: Plastic and reconstructive uterus operations are performed in congenital uterine anomalies or benign uterine conditions. Congenital uterine anomalies are relatively rare diseases with various approaches for surgical treatment. Therefore, to address the question of the usefulness of a minimally invasive approach in plastic uterus operations, the most common uterine condition which requires reconstructive surgery, namely myomectomy, is discussed.
    Method: Searches were conducted in PubMed and The Cochrane Library to identify relevant literature.
    Findings: Compared with myomectomy by laparotomy and minilaparotomy, laparoscopic myomectomy is associated with improved short-term outcomes. Laparoscopy is further associated with less adhesion formation. Pregnancy rates after myomectomy in symptomatic patients might be higher after laparoscopy than after laparotomy. Although uterine ruptures following laparoscopic myomectomy are described in the literature, it seems to be a rare event. Concerning the recurrence, there is evidence that rates are similar after laparoscopy and laparotomy.
    Conclusion: Myomectomy by laparoscopy has several advantages over abdominal myomectomy (by conventional laparotomy and minilaparotomy) and should be the standard procedure. Despite the advantages of laparoscopy, abdominal myomectomy is still a frequently performed procedure. Lack of training in advanced laparoscopic procedures hampers the wide-spread use of laparoscopic myomectomy. Due to the advantages of laparoscopic surgery, efforts should be made to implement this procedure into daily practice. To provide the best care, physicians should offer patients the opportunity of a laparoscopic treatment of myomas.
    Keywords Medizin, Gesundheit ; minimally invasive surgery ; myomectomy ; plastic and reconstructive surgery ; infertility ; uterine rupture
    Publishing date 2012-01-09
    Publisher German Medical Science GMS Publishing House; Düsseldorf
    Document type Article ; Online
    DOI 10.3205/iprs000009
    Database German Medical Science

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    Inter-library loan at ZB MED

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  5. Article ; Online: A review of the problematic adhesion prophylaxis in gynaecological surgery.

    Hirschelmann, Anja / Tchartchian, Garri / Wallwiener, Markus / Hackethal, Andreas / De Wilde, Rudy Leon

    Archives of gynecology and obstetrics

    2011  Volume 285, Issue 4, Page(s) 1089–1097

    Abstract: Background: Adhesions lead to considerable patient morbidity and are a mounting burden on surgeons and the health care system alike. Although adhesion formation is the most frequent complication in abdominal and pelvic surgery, many surgeons are still ... ...

    Abstract Background: Adhesions lead to considerable patient morbidity and are a mounting burden on surgeons and the health care system alike. Although adhesion formation is the most frequent complication in abdominal and pelvic surgery, many surgeons are still not aware of the extent of the problem. To provide the best care for their patients, surgeons should consistently inform themselves of anti-adhesion strategies and include these methods in their daily routine.
    Methods: Searches were conducted in PubMed and The Cochrane Library to identify relevant literature.
    Findings: Various complications are associated with adhesion formation, including small bowel obstruction, infertility and chronic pelvic pain. Increasingly, an understanding of adhesion formation as a complex process influenced by many different factors has led to various conceivable anti-adhesion strategies. At present, a number of different anti-adhesion agents are available. Although some agents have proved effective in reducing adhesion formation in randomised controlled trials, none of them can completely prevent adhesion formation.
    Conclusion: To fulfil our duty to provide best possible care for our patients, it is now time to regard adhesions as the most common complication in surgery. Further research is needed to fully understand adhesion formation and to develop new strategies for adhesion prevention. Large clinical efficacy trials of anti-adhesion agents will make it easier for surgeons to decide which agent to use in daily routine.
    MeSH term(s) Female ; Gynecologic Surgical Procedures/adverse effects ; Humans ; Tissue Adhesions/etiology ; Tissue Adhesions/prevention & control
    Keywords covid19
    Language English
    Publishing date 2011-10-30
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 896455-5
    ISSN 1432-0711 ; 0932-0067
    ISSN (online) 1432-0711
    ISSN 0932-0067
    DOI 10.1007/s00404-011-2097-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

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    In stock of ZB MED Cologne/Königswinter

    Um I Zs.55: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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