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NEZHAT’S OPERATIVE GYNECOLOGIC

LAPAROSCOPY AND HYSTEROSCOPY

During the past 25years, gynecologic endoscopy has evolved into a major surgical tool used to treat a multitude of gynecologic indications. Laparoscopy and hysteroscopyarethe most common surgical procedures performed by gynecologists today.

This book catalogs the full spectrum of laparoscopic and hysteroscopic procedures in gynecology, oncology, and infertility treatment. The authors describe different techniques in minimally invasive surgery and review the evidence-based medical literature supporting these techniques. The book includes sections on the management of complications during laparoscopy, ranging from vascular injury to bladder or bowel injury. It contains expanded chapters on laparoscopicanatomy, infertility procedures, operative hysteroscopy, pelvic ﬂoor repair, and laparoscopic management of gynecologic malignancy. High-quality color pictures supplement many of the presentations.

The three editors have pioneered some of the most important laparoscopic procedures used today. Their work has opened up the ﬁeld of operative endoscopy for surgeons worldwide. The contributors have extensive experience in laparoscopy and hysteroscopy, andmanyofthem haveestablished some of the surgical techniques discussed.

Dr. Camran Nezhat is Clinical Professor of Obstetrics and Gynecology at the University ofCalifornia,San Francisco,andStanford University Medical Schools and Fellowship Director of the Center for Special Minimally Invasive and Robotic Surgery. He has served as president of the Society of Laparoendoscopic Surgeons. He is coauthor of Endometriosis: Advanced Management and Sur- gical Techniques (1995) and has published articles in numerous journals.

Dr. Farr Nezhat is Professor and Director of the Gynecologic Minimally Invasive Surgery, Robotic, and Gynecologic Oncology Fellowship Program in the Department of Obstetrics and Gynecology at Mount Sinai School of Medicine. He is coauthor of Endometriosis: Advanced Management and Surgical Techniques (1995) and has published extensively.

Dr. Ceana Nezhat is Director of the Nezhat Medical Center in Atlanta and Associate Clinical Professor of Obstetrics and Gynecology at the Stanford University School of Medicine.He is coauthor of Endometriosis: Advanced Management and Surgical Tech- niques (1995) and has published articles in multiple journals.

NEZHAT’S OPERATIVE

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GYNECOLOGIC LAPAROSCOPY

AND HYSTEROSCOPY

Third Edition

EDITED BY

Camran Nezhat

Stanford University Medical School, Palo Alto

Farr Nezhat

Mount Sinai Hospital, New York

Ceana Nezhat

Nezhat Medical Center, Atlanta

CAMBRIDGE UNIVERSITY PRESS

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Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo

Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK

Published in the United States of America by Cambridge University Press, New York

www.cambridge.org Information on this title: www.cambridge.org/9780521862493

This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written

ermission of Cambridge University Press.

First published in print format

ISBN-13 978-0-511-40869-4

ISBN-13 978-0-521-86249-3

2008

eBook (EBL)

hardback

Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not

uarantee that any content on such websites is, or will remain, accurate or appropriate.

Every effort has been made in preparing this book to provide accurate and up-to-date information that is in accord with accepted standards and practice at the time of publication. Nevertheless, the authors, editors, and publisher can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors, and publisher therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.

Contents

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Contributing Authors vii Forewords xiii

Thomas M. Krummel, Linda C. Giudice,

Carmel J. Cohen, and Jonathan S. Berek xiii Alan H. DeCherney and H. C. Mult Kurt Semm xvii Alan H. DeCherney and Yona Tadir xix

Preface xxi

HISTORY OF MODERN OPERATIVE LAPAROSCOPY

Barbara J. Page, Jaime Ocampo, Mario Nutis, and Anthony A. Luciano

EQUIPMENT

Jaime Ocampo, Mario Nutis, Camran Nezhat, Ceana Nezhat, and Farr Nezhat

ANESTHESIA 35

Lindsey Vokach-Brodsky

LAPAROSCOPIC ACCESS 40

4.1 Principles of Laparoscopy

Camran Nezhat, Ceana Nezhat, Farr Nezhat, and Roger Ferland

4.2 Laparoscopic Trocars and Complications

Roger Ferland

LAPAROSCOPIC SUTURING 64

Camran Nezhat, Ceana Nezhat, and Farr Nezhat

INTRAPERITONEAL AND RETROPERITONEAL

ANATOMY

Jyoti Yadav, M. Shoma Datta, Ceana Nezhat, Camran Nezhat, and Farr Nezhat

FERTILITY 83

7.1 Frontiers in Fertility

Kutluk Oktay and Amr M. A. Azim

7.2 Assessment of the Endometrial Cavity in the Patient with Infertility

Richard O. Burney and Amin A. Milki

7.3 Ultrasound Oocyte Retrieval

106

Rosa Moghadam and Salli Tazuke

7.4 Ultrasonography and the Embryo Transfer

115

Eric Flisser and Jamie A. Grifo

7.5 Salpingostomy and Salpingectomy

129

Jaime Ocampo, Mary Jacobson, Mario Nutis, and Camran Nezhat

HYSTEROSCOPY 134

8.1 Evaluation and Management of the Uterine Septum

134

Eric J. Bieber and Edie L. Derian

8.2 Intrauterine Adhesions: Hysteroscopic Evaluation and Treatment

143

Rafael F. Valle

8.3 Hysteroscopic Myomectomy

152

Charles J. Ascher-Walsh and Michael Brodman

8.4 Hysteroscopic Tubal Cannulation

162

Tommaso Falcone and Jeffrey M. Goldberg

Stephanie N. Morris and Keith Isaacson

8.6 Global Endometrial Ablation

8.5 Hysteroscopic Sterilization

165

173

Philip G. Brooks

MANAGEMENT OF ADNEXAL MASSES 179

9.1 The Adnexal Mass

179

Sophia Rothberger, Tanja Pejovic, and Farr Nezhat

9.2 Ovarian Cystectomy

187

Camran Nezhat, Ceana Nezhat, and Farr Nezhat

9.3 Laparoscopic Operations on the Ovary

199

Tanja Pejovic and Farr Nezhat

9.4 Management of the Ectopic Pregnancy

215

Bulent Berker, Ceana Nezhat, Farr Nezhat, and Camran Nezhat

9.5 Management of Tubo-ovarian Abcesses

237

Daniel S. Seidman, Bulent Berker, and Camran Nezhat

9.6 Surgical Management of Polycystic Ovarian Syndrome

244

Michelle Tham and Alan B. Copperman

9.7 Ovarian Remnant

247

Ceana Nezhat

ENDOMETRIOSIS 251

10.1 The Pathogenesis of Endometriosis

251

Richard O. Burney and Linda C. Giudice

10.2 Thoracic Endometriosis

258

Georgios E. Hilaris and Camran Nezhat

10.3 Laparoscopic Treatment of Endometriosis

263

Bulent Berker, Thomas H. S. Hsu, Keith L. Lee, Ceana Nezhat, Farr Nezhat, and Camran Nezhat

LAPAROSCOPIC ADHESIOLYSIS AND ADHESION

PREVENTION

304

Bulent Berker, Senzan Hsu, Ceana Nezhat, Farr Nezhat, and Camran Nezhat

LEIOMYOMAS 316

12.1 Minimally Invasive Approaches to Myomectomy

316

Mark H. Glasser

12.2 Uterine Fibroid Embolization

334

Mahmood K. Razavi

vi — Contents

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13 HYSTERECTOMY 341

13.1 Laparoscopy and Hysterectomy

341

Farr Nezhat and Jyoti Yadav

13.2 Laparoscopic Excision of a Rudimentary Uterine Horn

363

Togas Tulandi

PELVIC FLOOR 366

14.1 Laparoscopic Burch Colposuspension

366

Jim W. Ross and Mark R. Preston

14.2 Minimally Invasive Slings

378

Alan D. Garely and Cedric K. Olivera

14.3 Laparoscopic Uterine Suspension, Scrocolpopexy, Vault Suspension

394

James E. Carter and Senzan Hsu

14.4 Laparoscopic Repair of Cystourethrocele, Vesicovaginal Fistula, and Vaginal Vault Prolapse

407

Bulent Berker, Babac Shahmohamady, Naghmeh Saberi, and Camran Nezhat

14.5 Laparoscopic Rectovaginal Fistula Repair

413

Ceana Nezhat, Patrick Yeung, and Deidre T. Fisher

14.6 Laparoscopic Assisted Neovaginoplasty

417

Luigi Fedele, Stefano Bianchi, Nicola Berlanda, Eleonora Fontana, and Alessandro Bulfoni

LAPAROSCOPIC TREATMENT OF CHRONIC

PELVIC PAIN

15.1 Presacral Neurectomy

425

James E. Carter

15.2 Uterosacral Transection and Ablation

430

James E. Carter

GYNECOLOGIC MALIGNANCY

16.1 Introduction

435

Farr Nezhat

16.2 Laparoscopic Lymphadenectomy

436

Farr Nezhat and M. Shoma Datta

16.3 Laparoscopic Sentinel Lymph Node Identiﬁcation in Cervical Cancer

447

Pedro T. Ramirez, Charles Levenback, and Robert L. Coleman

16.4 Schauta Radical Vaginal Hysterectomy and Total Laparoscopic Radical Hysterectomy

453

Yukio Sonoda and Nadeem R. Abu-Rustum

16.5 Laparoscopy for Endometrial Cancer

465

Javier F. Magrina, Andrea Mariani, and Paul M. Magtibay

16.6 Laparoscopic Management of Ovarian Cancer

475

Ali Mahdavi and Farr Nezhat

16.7 Second-Look Surgery for Gynecologic Malignancy

482

Sharyn N. Lewin and Thomas Herzog

16.8 Port-Site Metastasis and Pneumoperitoneum

489

Chandrakanth Are and Nadeem R. Abu-Rustum

LAPAROSCOPY IN THE PREGNANT PATIENT

499

Maureen M. Tedesco and Myriam J. Curet

MINIMAL ACCESS PEDIATRIC SURGERY 509

Venita Chandra, Sanjeev Dutta, and Craig T. Albanese

LAPAROSCOPIC VASCULAR SURGERY IN 2007 516

Jean Picquet, Oscar J. Abilez, J´erˆome Cau, Olivier Go¨eau-Brissonni`ere, and Christopher K. Zarins

COMPLICATIONS IN LAPAROSCOPY

20.1 Major Vascular Injury

520

Oscar J. Abilez, Jean Picquet, and Christopher K. Zarins

20.2 Ureteral Injury

527

Tatum Tarin and Thomas H. S. Hsu

20.3 Laparoscopic Management of Intestinal Endometriosis

529

Andrew A. Shelton

ADDITIONAL PROCEDURES FOR

PELVIC SURGEONS

21.1 Cystoscopy

537

Ceana Nezhat and Deidre T. Fisher

21.2 Intraoperative Sigmoidoscopy in Gynecologic Surgery

541

Ceana Nezhat and Andrew DeFazio

21.3 Appendectomy

544

Bulent Berker, Farr Nezhat, Ceana Nezhat, and Camran Nezhat

LAPAROSCOPY SIMULATORS FOR TRAINING BASIC

SURGICAL SKILLS, TASKS, AND PROCEDURES

552

Wm. LeRoy Heinrichs

ROBOT-ASSISTED LAPAROSCOPY

562

23.1 Computer-Assisted Surgery and Surgical Robotics

562

Sanjeev Dutta and Thomas M. Krummel

23.2 Minimally Invasive Gynecologic Surgery: The Evolving Role of Robotics

567

Arnold P. Advincula and Tommaso Falcone

HYSTEROSCOPY AND ENDOMETRIAL CANCER 577

William H. Bradley and Farr Nezhat

OVERVIEW OF COMPLICATIONS 582

Camran Nezhat, Farr Nezhat, and Ceana Nezhat

Appendix 601

Atlas 609 Index 617

Contributing Authors

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OSCAR J. ABILEZ,MD

Postdoctoral Fellow Department of Vascular Surgery Division of Vascular Surgery Stanford University Medical Center Palo Alto, CA

NADEEM R. ABU-RUSTUM,MD,FACOG

Associate Professor Department of Obstetrics and Gynecology Weill Medical College of Cornell University Director, Minimally Invasive Surgery Gynecology Service, Department of Surgery Memorial Sloan-Kettering Cancer Center New York, NY

RNOLD

Associate Professor Director, Minimally Invasive Surgery Program & Fellowship Department of Obstetrics and Gynecology University of Michigan Medical Center AnnArbor,MI

P. A DVINCULA,MD

CRAIG T. ALBANESE,MD,MBA

Professor and Chief Department of Surgery, Division of Pediatric Surgery Stanford University Medical Center John A. and Cynthia Fry Gunn Director of

Surgical Services Lucile Packard Children’s Hospital Stanford, CA

CHANDRAKANTH ARE, MD, FRCS, FACS

Assistant Professor Department of General Surgery University of Nebraska Medical Center Omaha, NE

CHARLES J. ASCHER-WALSH,MD

Assistant Professor Department of Obstetrics, Gynecology,andReproductive Science Mount Sinai School of Medicine New York, NY

AMR M. A. AZIM,MD,MSC,FACOG

Fellow Center for Reproductive Medicine and Infertility Weill Medical College of Cornell University New York, NY

BULENT BERKER,MD

Associate Professor Department of Obstetrics & Gynecology Ankara University School of Medicine Ankara, Turkey

NICOLA BERLANDA,MD

Department of Obstetrics and Gynecology San Paolo Hospital University of Milan Milan, Italy

STEFANO B IANCHI,MD

Department of Obstetrics and Gynecology San Paolo Hospital University of Milan Milan, Italy

RIC J. BIEBER, MD, MSHCM

Chairman Department of Obstetrics and Gynecology Geisinger Health Systems Danville, PA

WILLIAM H. BRADLEY,MD

Division of Gynecologic Oncology Department of Obstetrics and Gynecology Mount Sinai School of Medicine New York, NY

MICHAEL B RODMAN,MD

Professor and Chairman Department of Obstetrics, Gynecology, and

Reproductive Science Mount Sinai School of Medicine New York, NY

PHILIP G. BROOK S,MD

Clinical Professor Department of Obstetrics and Gynecology David Geffen School of Medicine at UCLA Attending Physician Department of Obstetrics and Gynecology Cedars-Sinai Medical Center Los Angeles, CA

vii

viii — Contributing Authors

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ALESSANDRO BULFONI,MD

Department of Obstetrics and Gynecology San Paolo Hospital University of Milan Milan, Italy

RICHARD O. BURNEY,MD,MSC

Clinical/Research Fellow Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology Stanford University School of Medicine Stanford, CA

AMES E. CARTER,MD

†

Clinical Professor Department of Obstetrics and Gynecology University of California at Irvine School of Medicine Irvine, CA

ERˆOME

CAU

Department of Vascular Surgery University Hospital Poitiers, France

VENITA CHANDRA,MD

Resident Department of Surgery Stanford University Medical Center Palo Alto, CA

OBERT

L. C

OLEMAN,MD

Associate Professor Department of Gynecologic Oncology The University of Texas M. D. Anderson Cancer Center Houston, TX

ALAN B. COPPERMAN,MD

Associate Clinical Professor Director, Reproductive Endocrinology Department of Obstetrics, Gynecology, and

Reproductive Science Mount Sinai School of Medicine New York, NY

MYRIAM J. CURET,MD

Professor Director, Minimally Invasive Surgery Program Department of Surgery Stanford University Medical Center Palo Alto, CA

M. SHOMA DATTA,MD

Department of Obstetrics and Gynecology St. Luke’s–Roosevelt Hospital New York, NY

ANDREW DEFAZIO,MD

Clinical Fellow Atlanta Center for Specialty Pelvic Surgery Atlanta, GA

†

Deceased

EDIE L. DERIAN,MD

Department of Obstetrics and Gynecology Geisinger Medical Center Danville, PA

SANJEEV

DUTTA,MD,MA

Assistant Professor Division of Pediatric Surgery Department of Surgery Stanford University Medical Center Lucile Packard Children’s Hospital Palo Alto, CA

TOMMASO FALCONE,MD

Professor and Chairman Department of Obstetrics and Gynecology Cleveland Clinic Foundation Cleveland, OH

LUIGI FEDELE,MD

Professor Department of Obstetrics and Gynecology San Paolo Hospital University of Milan Milan, Italy

ROGER FERLAND,MD

Associate Clinical Professor Department of Obstetrics and Gynecology Brown University School of Medicine Providence, RI

DEIDRE T. FISHER, MD, MHA, FACOG

Clinical Fellow Atlanta Center for Special Pelvic Surgery Nezhat Medical Center Associate The Center for Endometriosis Care Atlanta, GA

ERIC FLISSER,MD

Medical Director, Long Island Ofﬁce Reproductive Medicine Associates of New York New York, NY

ELEONORA FONTANA,MD

Department of Obstetrics and Gynecology San Paolo Hospital University of Milan Milan, Italy

ALAN D. GARELY,MD

Vice-Chairman and Chief of Gynecology Director, Urogynecology and Pelvic Reconstructive Surgery Department of Obstetrics and Gynecology Winthrop-University Hospital Mineola, NY Clinical Associate Professor Department of Obstetrics and Gynecology School of Medicine in the State University

ofNewYorkatStonyBrook

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