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Background: Myomectomy is the surgical procedure of choice for symptomatic myoma in the reproductive age, especially if future fertility is desired. LM is the surgical removal of uterine myoma through small incisions in the abdomen. It is an appropriate, if not preferred, alternative to abdominal myomectomy in well-selected patients since it offers shorter hospitalization, short recovery period and resumption of activities within 1-2 weeks, reduced risk of blood transfusion, and intraoperative adhesions. Aim: The aim of the current study was to determine the diagnostic accuracy of different ultrasonographic characters of uterine myoma in predicting success of laparoscopic myomectomy. Methods: The present study was prospective interventional study that was carried out on 35 cases with Chronic pelvic pain. All patients had radiological evaluation by TVS and TAS. All Laparoscopic myomectomies done under general anaesthesia. Outcomes included determining ultra-sonographic predictors for successful laparoscopic myomectomy as regards site, size, and character of Myoma, presence of capsule and line of separation around myoma. Results: The most common complain among the studied cases was bleeding followed by pain and lastly infertility. Regarding location, the most common site was posterior followed by fundal, then anterior and lastly at the cornu. Operative times, blood loss amount, method of extraction, need laparoscopic suturing, complications during surgery recovery and hospital stay after operation demonstrated significant relation with outcomes. Myoma characters, numbers and type demonstrated insignificant relation with outcomes. Conclusion: The current study concluded that, myoma characters, numbers and type could not be used as predictors for successful LM; outcomes. However, operative times, blood loss amount, complications during surgery recovery and hospital stay after operation were less in successful LM than in LAM; and laparoscopic suturing and morcellation have less time consumption and better results than LAM. [ABSTRACT FROM AUTHOR]

Background. Most of the publications about Laparoscopically harvested omental flap after skin sparing mastectomy were case reports or case series. Most of them were designed for partial breast reconstruction and were lacking long-term follow-up for cosmetic results, oncologic safety, and detailed methodology. Our study aimed at highlighting the place of this method of reconstruction with long-term oncologic safety and cosmetic outcome. Methods. This study included 95 women who were candidates for skin-sparing mastectomy. Those with body mass index below 25 and above 40, those with omental resection or expected marked adhesions were excluded. All patients were consented to then undergo breast reconstruction using pedicled laparoscopically harvested omental flap. Results. The mean BMI was 34. The mean tumor size was 3.4 cm. The mean total operative time was 129 minutes. Inadequate volume occurred in 12 patients (13%). The mean total drainage output was 750 ml with 8.7% incidence of seroma. Partial breast envelop necrosis was encountered in 5 cases. Partial flap loss occurred in 2 patients. Fat necrosis occurred in 11 cases. Mastectomy and abdominal complications were accepted. Local recurrence was met in one patient and distant metastases occurred in 3 cases. 83.7% of patients expressed excellent and good aesthetic outcomes. Conclusion. When skin sparing mastectomy is chosen with suitable body mass index, laparoscopically harvested omental flap is a very safe and attractive option for total breast reconstruction with a minimal donor site morbidity, satisfactory cosmetic outcome with no compromise of the oncologic safety. [ABSTRACT FROM AUTHOR]

Background: The problem of unplanned surgical resection of breast cancer is a common clinical problem encountered in our practice. It represents a demanding challenge for oncoplastic surgeons that often limits the available options for definitive surgery due to unplanned skin incision, unreliable vascular anatomy, and obscure safety margin status. Patients and Methods: The authors retrospectively reviewed the data system of the hospital for patients diagnosed with breast cancer between June 2008 & June 2018. 490 patients had unplanned resected breast cancers (Tx) and were enrolled in this study. The epidemiologic, pathologic, and operative data of these patients were analysed. Results: The average annual rate of unplanned resected breast cancer (Tx) in our hospital was about 17% among the new cases diagnosed with breast cancer. The age of the patients ranged from 21 to 57 (median 42.2)years. 409 patients underwent mastectomy (MRM or radical) without reconstruction and 14 patients received conventional conservative breast surgery. While 10 patients had volume displacement oncoplastic surgery and 57 patients had volume replacement oncoplastic surgery. Subjective patient satisfaction was excellent in 55 cases, good in 22 cases, fair in 3 cases & poor in one case. Conclusion: Unplanned excision of breast cancer is still a surgical challenge; however, the application of oncoplastic techniques with wise selection results in a satisfactory aesthetic outcome, low morbidity, and comparable oncologic outcome. [ABSTRACT FROM AUTHOR]

Background: There are some debates in the use of laparoscopic hysterectomy for the morbidly obese patients as some surgeons find it superior to open hysterectomy. Others reported that laparoscopic surgeries for obese patients with gynecologic malignancy associated with technical difficulties and a smaller number of harvested lymph nodes compared to open surgery. Patients and Methods: Thirty-seven morbid obese patients with gynecological diseases underwent laparoscopic hysterectomy in the period between December 2017 and May 2021 at the Department of Surgical Oncology, Oncology Center, Mansoura University (OCMU). Results: The operative time was 175.14 min, the estimated blood loss (EBL) was 404.32 ml. Three patients (8.1%) had intraoperative blood transfusion. Conversion to laparotomy was done in 1 patient. The patients were ambulant in POD 1 and the oral intake was started in POD zero. Postoperative complications occurred in 4 patients in the form of wound infection, blood transfusion and 2 cases with port-site hernia. The patients had a median duration of hospital stay of 3 days (range: 1-5 days). Conclusion: laparoscopic hysterectomy for obese patients is a safe procedure and preferable to open hysterectomy in the terms of cost per patient and of peri-operative complications. [ABSTRACT FROM AUTHOR]

Background. Over time, there was an emerging need to shift from laparotomy to minimally invasive laparoscopic surgery, with the success of laparoscopic surgery in the last decade in gyne-oncology. Patients and Methods. This is a prospective randomized controlled trial conducted in Surgical Oncology Unit, Oncology Centre, Mansoura University, in the period between February 2016 and October 2019. Fifty female patients planned for total hysterectomy were randomized into two equal groups; the first underwent conventional laparoscopic hysterectomy (CLH), while the second underwent single-incision laparoscopic hysterectomy (SILH). Results. The mean operative time in the SILH group was 120.00 ± 28.72 minutes vs 103.20 ± 23.04 minutes in the CLH group (P=.027). Median hospital stay in the SILH group was 1 day (range: 1–3 days), the same as that in the CLH group, with no statistical significance (P =.384). Postoperative pain assessment using the Visual Analogue Scale (VAS) after 6 hours had a median score of 6 (2–8) in the SILH group and 6 (4–7) in the CLH group with significant increase in experienced pain in the SILH group (P =.004), while no significant difference was noted after 12 hours and 24 hours in both SILH and CLH groups. Conclusion. Single-incision laparoscopic hysterectomy (SILH) has similar outcomes when compared to conventional laparoscopic hysterectomy as regard blood loss, hospital stay, conversion to laparotomy, intraoperative and postoperative complications with the disadvantages of longer operative time, increased surgeon's workload, and relatively more postoperative pain. [ABSTRACT FROM AUTHOR]

Background. Laparoscopic splenectomy (LS) is considered the operation of choice on elective basis for managing patients with certain hematological disorders. Hemostatic control of the splenic pedicle is one of the crucial steps in LS. This study compares the safety and efficacy of using endoscopic staplers and vessel sealing devices to control the splenic pedicle in patients with nonsevere splenomegaly. Methods. Fifty-one consecutive patients with different blood disorders including idiopathic thrombocytopenic purpura (ITP), hypersplenism, and lymphoma were randomized for elective LS. Traditional steps of LS, via lateral approach, were followed, and pedicle control was done with either endovascular gastrointestinal anastomosis stapler (n = 26) or vessel sealing device (Ligasure) (n = 25). Results. No difference was noted with different splenic spans when using either methods of pedicle control (P =.145). The volume of blood loss was higher in the Ligasure group compared to the staplers group (182 mL vs 131 mL, respectively), but was not statistically significant (P =.249). Conversion to open was notably higher in the Ligasure group (P =.034), but the intraoperative complications were comparable in both groups (P =.357). Conclusion. The use of vessel sealing devices for splenic pedicle control has comparable surgical outcomes compared with the use of endoscopic staplers for LS, but with higher rate of conversion to open surgery. [ABSTRACT FROM AUTHOR]

Objective To compare between manual and rotary protaper filing techniques in partially pulpectomized primary molars from microbiological point of view. Materials and methods This study was performed on 60 badly decayed primary molars indicated for partial pulpectomy. Molars were selected from children attending the outpatient clinic of Pedodontics and Oral Health Department, Faculty of Dental Medicine, Al-Azhar University. The selected teeth were classified into two equal groups. GP 1: 30 primary molars were received partial pulpectomy using manual protaper filing system. GP 2: 30 primary molars were received partial pulpectomy using rotary protaper filing system. Microbiological assessment for the canal preparation were done after collection of initial and postfiling samples for each group. Results Rotary group offers highest percent of bacterial reduction when compared with manual group with statistically significant differences. Conclusion Rotary protaper instrumentation was more effective in reducing bacterial numbers in infected root canal than manual instrumentation. Both filing techniques did not give bacteria-free canal. [ABSTRACT FROM AUTHOR]