ABSTRACT
Intraoperative sigmoidoscopy is underused by the majority of practicing gynecologists and is not widely taught in obstetrics and gynecology training programs. In this report, a step-by-step approach is provided in order to perform sigmoidoscopy. Indications for use, along with various intraoperative applications, are discussed. Results from our center's experience with its use during laparoscopic treatment of adhesions, endometriosis, and associated disease of the bowel also are provided. Intraoperative sigmoidoscopy is a safe and efficacious procedure that can aid in the evaluation and treatment of pelvic pathology and facilitate identification and management of bowel injuries. It should be considered a valuable adjunct when such cases are encountered by gynecologic and pelvic surgeons.
Subject(s)
Gynecologic Surgical Procedures/instrumentation , Intraoperative Care/methods , Sigmoidoscopy/methods , Endometriosis/surgery , Female , Gynecologic Surgical Procedures/methods , Humans , Intraoperative Care/standards , Intraoperative Complications , Sigmoidoscopy/standardsABSTRACT
A postmenopausal woman was scheduled to undergo laparoscopic treatment of an 8-cm simple ovarian cyst. During abdominal entry, umbilical trocar insertion caused a gastric perforation that was diagnosed immediately and repaired laparoscopically. Following completion of the procedure, the patient was observed for 24 hours with a nasogastric tube in place and was discharged to home on the second postoperative day without further complications. The possibility of gastric distension and perforation is almost always present during laparoscopic abdominal entry. When perforation occurs, repair can be accomplished safely by laparoscopy.