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| Name | Laparoscopic-Assisted Myomectomy During the Second Trimester of Pregnancy |
| Video Uploader | Video From CanSAGE Secretariat |
| Upload Date | This Video Uploaded At 15-04-2024 17:47:30 |
| Video Discription | This video provides an in-depth look at laparoscopic-assisted myomectomy during the second trimester, focusing on a case at 15 weeks gestation. The video outlines the procedure's objectives: reviewing fibroid literature, discussing indications for surgery during pregnancy, and detailing a step-wise surgical approach. Key points include the rare but necessary consideration of myomectomy in pregnancy due to severe symptoms like pain and risks of necrosis, and the thorough surgical planning and execution demonstrated, which involves meticulous hemostatic techniques and careful fibroid enucleation to manage risks and preserve pregnancy. See full transcript here: https://cansagevideos.com/laparoscopic-assisted-myomectomy-during-the-second-trimester-of-pregnancy/ Presented By Dr. Meghan O’Leary Dr. Michael B. Secter Dr. Ari P. Sanders Affiliations University of Calgary Timestamps (00:07) Objectives (00:21) Fibroids in Pregnancy (00:35) Myomectomy in Pregnancy (02:13) Step-wise Approach to Laparoscopic Myomectomy in Pregnancy (03:10) Approach to Laparoscopic Myomectomy in Pregnancy (03:33 - 06:11) Procedure Video (06:11) Follow-Up This instructional video meticulously outlines the approach to laparoscopic-assisted myomectomy during the second trimester of pregnancy, focusing on managing a case at 15 weeks gestation where the patient presents with severe symptoms attributed to fibroids. The procedure is detailed in a structured format, beginning with a literature review to set the context about the prevalence and impact of fibroids during pregnancy, which affect up to 10% of pregnancies but often do not cause symptoms severe enough to necessitate surgical intervention. The indications for considering myomectomy at this stage include intractable pain, potential necrosis, and risks such as peritonitis or severe hemorrhage that outweigh the inherent risks of surgery during pregnancy. The video then transitions into the practical aspects of surgical management, emphasizing a strategic, step-wise approach that begins with comprehensive pre-operative imaging and planning to accurately map the fibroids and assess their relationship with the uterine cavity and placenta. It highlights the meticulous intraoperative techniques required to minimize risk to the mother and fetus, such as avoiding traditional myomectomy adjuncts like vasopressin and careful handling of the uterus to prevent triggering preterm labor or miscarriage. Special considerations are taken to minimize blood loss and avoid uterine perforation, using advanced energy devices and ensuring precise surgical maneuvers. Postoperatively, the patient's management is geared towards ensuring recovery with minimal complications, evidenced by the patient's significant pain relief and subsequent stable progression of pregnancy. The case study underscores the necessity of individualized patient care and thorough surgical planning, illustrating that while laparoscopic myomectomy during pregnancy is rare and fraught with potential complications, it can be successfully executed with careful consideration and expert surgical technique, leading to favorable outcomes for both mother and fetus. |
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