Additional videos from SGS are available here, including these recent offerings:
Laparoscopic management of bladder fibroids: Surgical tips and tricks
Dr. Ramirez is a staff physician in the Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Brooke Army Medical Center, Fort Sam Houston, Texas.
Dr. Mansuria is Associate Professor and Assistant Director of Gynecologic Minimally Invasive Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Dr. Mansuria reports being a speaker for Medtronic and Olympus. Dr. Ramirez reports no financial relationships relevant to this video.
Brought to you by the Society of Gynecologic Surgeons. In this video, the authors review steps for the safe laparoscopic excision of bladder fibroids, starting with a review of basic bladder anatomy. Preoperatively, leuprolide is administered for at least 3 months prior to the fibroid excision to reduce the size of the fibroid and diagnostic cystoscopy is recommended to confirm the bladder fibroid location in relation to the trigone. Intraoperatively, cystoscopy is repeated with placement of ureteral stents and the bladder is backfilled to delineate the fibroid borders. The fibroid is excised layer by layer, and the cystostomy is reassessed laparoscopically, with relaxing incisions used as necessary. Angle stitches facilitate intracorporeal knot tying for a 2-layer watertight cystostomy closure. Cystoscopy is repeated at completion of the surgery to reassess the repair site and ureters.