Dr. Foram Vora – Laparosacopy Experts

DR. FORAM VORA

(M.S.,GYNAEC ENDOSCOPIC SURGEON)

JYOTI MATERNITY HOSPITAL AND MINIMUM INVASIVE SURGERY CENTRE,

AHMEDABAD; Phone : 079-26731759,26766491

TIME : 10:30AM-1:00PM; 3:00PM-6:00PM

(CONSULTATION WITH PRIOR APPOINTMENT)

Mobile : 9925950916; E-mail ID : jyotimaternityhosp@gmail.com

Case of Adenomyoma Removal

A 39years old Nulligravida(no issue) patient with complaint of
- Severe pain during menses
- Heavy & prolonged menstrual flow
- Pain during intercourse
USG finding : uterus enlarged with 6x6cm size adenomyoma in posterior wall of uterus.
Management : LAPAROSCOPIC ADENOMYOMA REMOVAL along with hysteroscopic uterine cavity evaluation & laparoscopic infertility evaluation
Intra-operative findings : Uterus bulky upto the size of about 10-12weeks ( 2-3months of pregnancy); the adenomyotic nodule removed in piecemeal with help of Rotocut MORCELLATOR; water-tight defect closure done
Post-operative benefits :
- Better cosmetics – NO big scar on abdomen
- Uterus PRESERVED for fertility purpose
- Minimal blood-loss & post-operative adhesions
- Fast post-operative recovery- discharged on full diet on 2^nd day of operation

Case of patient with complaint of
- Severe pain during menses
- Severe pain while passing stool during menses
- Infertility
USG finding : chocolate cyst
A segment of about 4-5 cm of rectosigmoid was adherent to uterus and both ovaries
Right sided chocolate cyst of about 4-5cm was present
Extensive adhesiolysis done
The rectosigmoid separated from the above mentioned structures, confirming rectal patency
Chocolate cyst wall excised, removed and sent for histopathological examination( confirmed to be chocolate cyst in HPE report)
End result :Tubo-ovarian relationship restored on both sides
Benefit : c/o pain during menses reduced & fertility enhanced

A 28 years old patient with no history of any issue, married life of 6 years & history of Ectopic pregnancy in right tube treated medically 4 years back and complaint of
- Severe acute lower abdominal pain
- Sudden giddiness and dizziness
- Spotting p/v
- One & half months of amenorrhea
UPT positive
USG finding : uterus normal. Mix echogenic lesion of 8x6cm in right adnexa s/o Ruptured Ectopic Pregnancy. Hemoperitoneum present.
Immediate decision taken for laparoscopy.
Intra-operative findings :
- About 1-1.5 liter of blood with clots was present in peritoneal cavity, which all suctioned out
- Right sided half affected part of the tube removed (partial salpingectomy)
- Hemostasis checked. Copious suction irrigation done.
Post-operative course uneventful. On 2^nd post-op day, patient discharged on full oral diet.

A 48 years old patient with complaint of
- Profuse menstrual bleeding
- Feeling of heaviness in lower abdomen
- Feeling of mass upto umbilicus (as about 4-5 months of pregnancy)
USG finding : Uterus markedly enlarged & lobulated. Multiple posterior and lateral wall fibroids noted, largest measuring 8x6cm.
TOTAL LAPAROSCOPIC HYSTERECTOMY(TLH+BSO) done for the condition.
Intra-operative findings :
- Uterus appeared enlarged of about 20-22 weeeks of pregnancy size with a 10x10cm subserosal fibroid present on fundus
- Hysterectomy with bilateral salpingo-oophrectomy done in ususal manner
- Uterus with fibroids removed in multiple strips with help of ROTOCUT MORCELLATOR
Benefits of laparoscopic surgery :
- No big scar, only 1cm scars on abdomen
- Very fast recovery – full diet started and discharged 2^nd day of OT

A known case of uterine anomaly, diagnosed during first trimester ultrasound scan
Delivered through cesarean section at 38 weeks+4 days gestational period
A healthy full-term baby of 2.6 kg delivered
After delivery of the baby, the placenta found to be present in another horn of the uterus, other than the one carrying the baby, which was removed completely in piecemeal
Hemostasis achieved, No PPH, No postoperative complications
Patient discharged in stable condition

Dr. Foram Vora