Intraoperative Vasopressin Injection During Hysteroscopic Myomectomy скачать в хорошем качестве

Intraoperative Vasopressin Injection During Hysteroscopic Myomectomy

The video demonstrates a hysteroscopic myomectomy on a 40-year-old woman using an intrauterine tissue removal device to resect a large submucosal fibroid, detailing techniques such as the flow-by method for clear visualization and intraoperative injection of Vasopressin for hemostasis. The procedure highlights the challenges of maintaining clear surgical fields with normal saline and illustrates the effectiveness of Vasopressin in managing brisk intraoperative bleeding, ultimately achieving complete fibroid resection. Read the full transcript here: https://cansagevideos.com/intraoperative-v... Presented By: Dr. Jackie Ferguson Dr. John Thiel Dr. Laura Weins Dr. Darrien Rattray Affiliations: University of Saskatchewan Timestamps (00:10) Objective (00:30) Patient History (00:42 - 05:51) Procedure Video (05:52) Conclusion The instructional video showcases a hysteroscopic myomectomy procedure to treat a 40-year-old woman with significant menstrual issues due to a 4cm submucosal fibroid. Initially, a 0-degree hysteroscope is introduced through the cervix, identifying the large fibroid occupying the uterine cavity. The hysteroscopic intrauterine tissue removal device is employed using normal saline as the distension medium. Despite the challenge of blood mixing with saline and obscuring the surgical field, the flow-by technique is demonstrated to enhance visibility by allowing high-flow saline to clear the field effectively. During the surgery, the resection of the fibroid is complicated by brisk bleeding, highlighting a common challenge in such procedures. To manage this, Vasopressin is directly injected into the myometrium, showcasing its rapid efficacy in achieving hemostasis and allowing the continuation of the fibroid resection. This step is crucial as it prevents significant blood loss and maintains clear visualization, which is vital for the safety and success of the procedure. Additionally, the unexpected visibility of a second posterior wall fibroid leads to its subsequent resection, emphasizing the need for thorough intraoperative assessments. The video concludes by reinforcing the effectiveness of the flow-by technique and Vasopressin injection in overcoming the operational challenges of hysteroscopic myomectomy. These techniques not only ensure a clearer surgical field through improved hemostasis but also contribute to the procedure's overall safety and efficacy, allowing for complete resection of fibroids and restoration of normal uterine structure. The final pathology confirms the fibroid's nature and demonstrates the procedure's success in addressing the patient's symptomatic concerns.