S134 Abstracts / Journal of Minimally Invasiv

491

Comparative Study of Laparoscopic Radical Hysterectomy and

Abdominal Radical Hysterectomy in Patients with Early Cervical

Cancer: 10 Year Experience at Asan Medical Center

Roh HJ, Lee SW, Park JY, Cho YH, Seo DS, Kim JH, Kim DY, Kim YM,

Kim YT, Nam JH. Obstetrics and Gynecology, University of Ulsan College

of Medicine, Asan Medical Center, Seoul, Republic of Korea

Study Objective: To compare the outcomes of patients treated bylaparoscopic radical hysterectomy (LRH), to those of patients treated byabdominal radical hysterectomy (ARH).Design: Retrospective study of 185 cases of Laparoscopic radicalhystrectomy with pelvic lymphadenectomy and 142 case of abdominalradical hysterectomy with pelvic lymphadenectomy.Setting: Asan Medical Center.Patients: 327 paitens with FIGO stage IA to IIA.Intervention: Laparoscopic radical hystrectomy with pelviclymphadenectomy.Measurements and Main Results: The number of lymph nodes and therate of perioperative complications were similar in both groups. The meansurgery duration and the median length of hospital stay was significantlyshorter in laparoscopy group. Five patients of 140 LRH group and four of142 ARH group had recurrences. The Five year recurrence-free survivalrates were 94.8% in the LRH group and 96.8% in the RH grouprespectively (p 5 0.392).Considering the time period, the mean durationof surgery was significantly shorter and the number of lymph nodesobtained were also significantly more in the second time period. Overall,there were 13 (7.0%) major perioperative complications. Eight (8/65)cases of those complications occurred during the first period, compared tofive (5/120) during the second period (p! 0.001). Three year recurrence-free survival rates were 91.8% in first period and 98.8% in second periodrespectively (p 5 0.16).Conclusion: Laparoscopic radical hysterectomy for the treatment of earlycervical cancer is a safe and effective procedure. Complications andrecurrences of LRH are comparable to conventional ARH. Thecomplications related to surgery were decreased after substantial learningperiod.

492

Robot Assisted Laparoscopic Surgery in Gynecologic Oncology:

Initial Results of a Single Institutional Pilot Study

Sert MBMBS Division of Gyne-Oncology, Rikshospitalet, Oslo, Norway

Study Objective: This study aimed to analyze the authorspreliminaryexperience using the Da Vinci robotic system in relation to gyne-oncological operations.Design: Retrospective analysis of 53 consecutive gyne-oncological caseswho was operated by the same surgeon in a single institution.Setting: University hospital setting, gynecological oncology division,minimally invasive surgery section.Patients: 53 women ranged in age from 27 to 70 years (mean, 45,8 years)with gyne-oncological diseases was operated in a period from October 2005to May 2008.Intervention: Many different operation was performed including radicalhysterectomy (n:24) and various other operations such as restaging withomentectomy and bilateral pelvic and paraaortic lymph node dissection.Measurements and Main Results: The cervical pathology in 69,8% ofpatients, the corpus uteri pathology in 17% of the cases and ovarial casesin 13,2 % of patients was reported in this retrospective analysis.The meanoperative time 218,9 min.(range,110-530 min). The mean console time(robot time)169,7 min.(range,60-445 min). The mean estimated bloodloss 57 ml.(range,0-300 ml).The mean post-operative hospital stay 3days(range,1-6 days). No robot- related complications and nolaparoscopic convertion were noted. Mean follow up time 16 months.Conclusion: The authorsearly experience with robotic surgery suggests thatit is a safe technique and could be an effective alternative to bothconventional laparoscopy and open surgery, could allow to performcomplex radical operations with greater precision and better outcomes.

493

PELVIC PAIN

Hysteroscopic Cervical Fiber Ablation for the Treatment of Cervical

Stenosis

Escobar LF, Ayala R, Bustos HH, Herrerıas T. Unidad Tococirugıa/

Ginecologıa, Instituto Nacional de Perinatologıa, Mexico, DF, Mexico

Study Objective: Report a case of cervical stenosis repaired byhysteroscopic cervical fiber ablation.Setting: University Hospital, general population attention.Patients: A 15-year-old patient developed recurrent haematometra andendometriosis secondary to cervical stenosis. At first, the patient hadcervical dilation and laparoscopic surgery for cervical stenosis andhematometra. A urinary catheter was placed on the cervical canal for a 1month. Six months later, bilateral endometriomas and hematometra werefound by ultrasonography. Dismenorrhea and pelvic pain remainedunresolved. A second laparoscopy with hysteroscopic cervical fiberablation was proposed.Intervention: Three puncture laparoscopy and operative hysteroscopy wasperformed. Ablation of cervical fibers with versapoint was done to createa wide cervical canal. The cutting of cervical fibers was done parallel tothe endocervical canal. Ablation of endometriosis and lysis of adhesionswere done simultaneously to treat pelvic pain. Also bilateral ovariancystectomy due to endometriomas was performed. A weekly follow upwas given over a 3-month period.

Measurements and Main Results: After three months, follow up revealedthe patient was asymptomatic, showing normal menstruation charateristicsand dysmenorrhea had disappeared. Chronic pelvic pain also improved. Theuterus and ovaries were normal after control ultrasound. No complicationswere reported during or after the procedure.Conclusion: Cervical stenosis is a difficult condition to treat. Differenttechniques and instruments have been described to relief such a condition.Cutting the cervical fibers in a parallel way is a novel technique to createa wide open cervical canal and the subsequent relief of cervical stenosissymptoms. The procedure is simple to perform and has a lowcomplications rate. Operative hysteroscopy with ‘‘Versapoint’’ may bea good procedure for the ablation of cervical fibers and treatment ofrecurrent cervical stenosis. Endometriosis and other conditions related tocervical stenosis can be treated at the same time during the laparoscopic

e Gynecology 15 (2008) S1eS159