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Boris GABRIEL

St Josefs Hospital
Wiesbaden, Germany
MD
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Ureteral endometriosis: general outcomes, our experience
This lecture presents ureteral endometriosis, which is a rare pathology (0.1% of cases). In 50% of cases, the condition is asymptomatic and can lead to loss of renal functions. In the literature, ureteral endometriosis increases with the presence of rectovaginal endometriosis, which does not appear in the study presented (221 cases of endometriosis, 19.5% of which are ureteral tract endometriosis). It seems to be significantly associated with uterosacral ligament (USL) endometriosis (p=0.01) but not with bladder endometriosis. Medical treatment is not indicated and conservative laparoscopic surgical management shows a long-term relief of symptoms and a low rate of anatomical recurrence (0-11%).
B Gabriel
Lecture
7 years ago
518 views
6 likes
0 comments
14:29
Ureteral endometriosis: general outcomes, our experience
This lecture presents ureteral endometriosis, which is a rare pathology (0.1% of cases). In 50% of cases, the condition is asymptomatic and can lead to loss of renal functions. In the literature, ureteral endometriosis increases with the presence of rectovaginal endometriosis, which does not appear in the study presented (221 cases of endometriosis, 19.5% of which are ureteral tract endometriosis). It seems to be significantly associated with uterosacral ligament (USL) endometriosis (p=0.01) but not with bladder endometriosis. Medical treatment is not indicated and conservative laparoscopic surgical management shows a long-term relief of symptoms and a low rate of anatomical recurrence (0-11%).
Laparoscopic hysterectomy: removal of a large (1300g) uterus
Some believe that laparoscopy is almost impossible to perform in cases of very big uterus or large adnexal masses that obstruct our view to the pelvis. However, if the same surgical steps are always followed and a specific strategy is determined, it is feasible and safe to choose laparoscopy even in the case of large organs. In this video, we present the case of a 45-year-old patient with a large fibromatous uterus, suffering from abdominal discomfort and bleeding. The patient was anemic and decision was made to perform a laparoscopic total hysterectomy. With the appropriate surgical steps and some safety tips, the operation took place quickly and with success. The weight of the specimen was 1300g.
A Wattiez, P Trompoukis, J Nassif, B Gabriel
Surgical intervention
8 years ago
5284 views
53 likes
0 comments
10:21
Laparoscopic hysterectomy: removal of a large (1300g) uterus
Some believe that laparoscopy is almost impossible to perform in cases of very big uterus or large adnexal masses that obstruct our view to the pelvis. However, if the same surgical steps are always followed and a specific strategy is determined, it is feasible and safe to choose laparoscopy even in the case of large organs. In this video, we present the case of a 45-year-old patient with a large fibromatous uterus, suffering from abdominal discomfort and bleeding. The patient was anemic and decision was made to perform a laparoscopic total hysterectomy. With the appropriate surgical steps and some safety tips, the operation took place quickly and with success. The weight of the specimen was 1300g.
Laparoscopic myomectomy: tips 'n tricks
Surgery is the treatment of choice for myomas. Myomectomy has undergone a dramatic evolution over the years. Laparoscopic myomectomy provides a preferable alternative to abdominal myomectomy for women with symptomatic fibroids who desire uterine preservation. It is also an excellent method for women who have infertility primarily related to fibroids. A lot of patients prefer myomectomy over hysterectomy even if they do not desire pregnancy. However, laparoscopic myomectomy is not easy and needs some practice. Together with the basic steps, some tips and tricks are provided to make this technique even more safe and feasible for surgeons. For good results, the use of a few technical tricks provides an optimal solution for all issues.
A Wattiez, P Trompoukis, AM Furtado Lima, J Nassif, B Gabriel
Surgical intervention
8 years ago
9580 views
188 likes
0 comments
08:35
Laparoscopic myomectomy: tips 'n tricks
Surgery is the treatment of choice for myomas. Myomectomy has undergone a dramatic evolution over the years. Laparoscopic myomectomy provides a preferable alternative to abdominal myomectomy for women with symptomatic fibroids who desire uterine preservation. It is also an excellent method for women who have infertility primarily related to fibroids. A lot of patients prefer myomectomy over hysterectomy even if they do not desire pregnancy. However, laparoscopic myomectomy is not easy and needs some practice. Together with the basic steps, some tips and tricks are provided to make this technique even more safe and feasible for surgeons. For good results, the use of a few technical tricks provides an optimal solution for all issues.
The pelvic floor - muscles, fasciae, ligaments
In this lecture, the anatomy of the female pelvic floor is presented laying the emphasis on pelvic floor muscles, fasciae, and ligaments. The anatomical terms “fasciae” and “ligaments” are scrutinized critically in this context, and the different levels of pelvic floor support are presented from a clinical point of view. An answer is provided on where the “White line” is and what exactly constitutes the “endopelvic fascia”. Clinical examples for pelvic floor defects considering the different levels of support are shown. The summary points out that pelvic floor reconstructive surgery should not only restore the anatomy, but also the primary function.
B Gabriel
Lecture
8 years ago
1527 views
18 likes
0 comments
28:46
The pelvic floor - muscles, fasciae, ligaments
In this lecture, the anatomy of the female pelvic floor is presented laying the emphasis on pelvic floor muscles, fasciae, and ligaments. The anatomical terms “fasciae” and “ligaments” are scrutinized critically in this context, and the different levels of pelvic floor support are presented from a clinical point of view. An answer is provided on where the “White line” is and what exactly constitutes the “endopelvic fascia”. Clinical examples for pelvic floor defects considering the different levels of support are shown. The summary points out that pelvic floor reconstructive surgery should not only restore the anatomy, but also the primary function.
Laparoscopic total hysterectomy and unilateral adnexectomy with resection of urinary bladder nodule for endometriosis
This video demonstrates the technique of a total laparoscopic hysterectomy with unilateral adnexectomy and the excision of a vesical endometriotic nodule.
This patient is a 46-year-old lady with a previous surgical history of one laparotomy for a hemoperitoneum (endometriotic ovarian cyst rupture) and 6 laparoscopies because of endometriosis, the last one 3 years ago with a segmental sigmoid resection. After this last surgery, the patient starts to complain of dysmenorrhea, chronic pelvic pain and dysuria. She has never had any urinary infection.
Because of urinary stress incontinence, she had botulinic toxin injection and underwent a cystoscopy, which revealed a bladder nodule.
A Wattiez, S Barata, AM Furtado Lima, P Trompoukis, B Gabriel, J Nassif
Surgical intervention
8 years ago
429 views
30 likes
1 comment
10:14
Laparoscopic total hysterectomy and unilateral adnexectomy with resection of urinary bladder nodule for endometriosis
This video demonstrates the technique of a total laparoscopic hysterectomy with unilateral adnexectomy and the excision of a vesical endometriotic nodule.
This patient is a 46-year-old lady with a previous surgical history of one laparotomy for a hemoperitoneum (endometriotic ovarian cyst rupture) and 6 laparoscopies because of endometriosis, the last one 3 years ago with a segmental sigmoid resection. After this last surgery, the patient starts to complain of dysmenorrhea, chronic pelvic pain and dysuria. She has never had any urinary infection.
Because of urinary stress incontinence, she had botulinic toxin injection and underwent a cystoscopy, which revealed a bladder nodule.
Laparoscopic treatment of a chronic mesh infection 4 years after sacral colpopexy
In this video, we present the case of a late infectious complication after abdominal hysterectomy and sacral colpopexy using mesh interposition. We demonstrate the complete laparoscopic removal of the infected mesh, including excision of all the affected surrounding tissue. This is the case of a 57-year-old patient who had a total hysterectomy with bilateral adnexectomy and sacrocolpopexy in 2005. In 2009, she started to complain of an abundant, continuous and smelly vaginal discharge. The microbiological exam revealed a vaginal infection by Proteus mirabilis and the gynecologic examination showed a painful vaginal tumor with a drainage hole.
A Wattiez, S Barata, B Gabriel, J Nassif
Surgical intervention
8 years ago
3961 views
25 likes
0 comments
09:55
Laparoscopic treatment of a chronic mesh infection 4 years after sacral colpopexy
In this video, we present the case of a late infectious complication after abdominal hysterectomy and sacral colpopexy using mesh interposition. We demonstrate the complete laparoscopic removal of the infected mesh, including excision of all the affected surrounding tissue. This is the case of a 57-year-old patient who had a total hysterectomy with bilateral adnexectomy and sacrocolpopexy in 2005. In 2009, she started to complain of an abundant, continuous and smelly vaginal discharge. The microbiological exam revealed a vaginal infection by Proteus mirabilis and the gynecologic examination showed a painful vaginal tumor with a drainage hole.