Pelvic Congestion Syndrome without Venography: A Pragmatic Pathway Using Doppler Ultrasound, Laparoscopy and Ligation in Resource-Limited Settings |Chapter 5 | Medical Science: Updates and Prospects Vol. 3

 

Background: Pelvic congestion syndrome (PCS) is an under-recognised cause of chronic pelvic pain and a frequent driver of diagnostic wandering, particularly in low- and middle-income countries (LMICs). Recent adoption of the SVP (Symptoms-Varices-Pathophysiology) framework and more structured imaging pathways can shorten time to diagnosis and treatment.

 

Objective: To illustrate an SVP-harmonised, resource-adapted diagnostic–therapeutic pathway that resolves pain and ends diagnostic wandering.

 

Case presentation: A 42-year-old grand multipara (G9P9009) with >6-month non-cyclical pelvic pain and post-coital exacerbation underwent a stepwise work-up. Transvaginal duplex ultrasonography (TVUS) was used as the gatekeeper test; cross-sectional venous imaging and selective venography were not available. Persistent symptoms and high clinical suspicion led to diagnostic laparoscopy with planned concomitant intervention. Laparoscopy revealed parauterine varicosities consistent with venous reflux phenotype. Transperitoneal ligation of the culprit veins was performed in the same session. A venoactive agent was prescribed post-operatively for 30 days. The patient experienced complete resolution of pelvic pain and dyspareunia on follow-up, effectively terminating a prolonged diagnostic odyssey.

 

Conclusion: In settings where venography and endovascular therapy are limited, a graded pathway SVP-guided clinical phenotyping, standardised TVUS, and diagnostic-therapeutic laparoscopy is a pragmatic alternative that can deliver rapid, patient-centred benefit. Embolisation remains first-line where available; laparoscopy is a viable “when necessary” option. Prospective LMIC studies with harmonised outcomes are urgently needed.

 

 

Author(s) Details

Michèle Florence Mendoua
Department of Surgery and Specialties, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon.

 

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v3/6538

An Overview of Therapeutic Options between Proton Pump Inhibitors (PPI) and Fundoplication in Gastroesophageal Reflux Disease (GERD) Management | Chapter 4 | An Overview of Disease and Health Research Vol. 3

Introduction: Gastroesophageal reflux disease (GERD) is a prevalent, chronic condition characterised by the retrograde flow of gastric contents into the oesophagus, resulting in symptoms such as heartburn, regurgitation, and chest discomfort. The disease imposes a substantial burden on healthcare systems and significantly affects patients’ quality of life. First-line therapy for GERD typically includes lifestyle modifications and acid suppression with proton pump inhibitors (PPIs). While PPIs are effective in the majority of patients, a significant proportion report persistent symptoms or develop concerns about long-term use, including risks of nutrient malabsorption, renal complications, and infections. Surgical options, particularly laparoscopic Nissen fundoplication, provide symptomatic relief but carry the potential for adverse outcomes such as dysphagia, gas bloat, and surgical failure over time.

 

Aim: This review aimed to clarify the role of Stretta, transoral incisionless fundoplication (TIF), endoscopic full-thickness plication (EFTP), LINX® magnetic sphincter augmentation system, laparoscopic electrical stimulation (EndoStim®), and the RefluxStop™ implant in modern GERD management and define their potential in bridging the gap between conservative and surgical therapies.

 

Methods: This review evaluated current data on the emerging therapies, as well as techniques such as endoscopic mucosal resection and ablation seek to augment the anti-reflux barrier through mucosal remodelling.

 

Results: Evidence from multiple clinical studies and meta-analyses supports Stretta’s role in improving GERD-related quality of life, reducing oesophageal acid exposure, and, in many cases, lowering dependence on proton pump inhibitors. Moreover, both TIF and EFTP offer significant benefits as less invasive alternatives to traditional GERD surgery, with the potential for improved patient outcomes and quicker recovery times. While TIF is less invasive and focuses on reshaping the gastroesophageal junction to restore LES function, EFTP offers a more robust structural intervention, which may be preferable in patients with more severe GERD. As these therapies continue to evolve, understanding their efficacy, safety, and appropriate indications is critical. Minimally invasive and endoscopic therapies represent a significant advancement in the treatment of GERD, offering alternatives to conventional pharmacologic and surgical strategies. While data supporting these interventions are promising, particularly in terms of symptom relief and reduced acid exposure, most studies to date are limited by short follow-up periods, heterogeneity in study design, and variability in patient selection. Stretta, TIF, and EFTP show utility in enhancing lower oesophagal sphincter function with a favourable safety profile, particularly in patients with mild to moderate disease. Similarly, device-based interventions such as LINX® and EndoStim® offer innovative mechanisms of action with growing clinical support. More recently, anatomical solutions like the RefluxStop™ implant and endoscopic mucosal remodelling have opened new avenues for intervention, though they remain in earlier stages of evaluation.

 

Conclusion: In conclusion, while emerging GERD therapies do not yet replace conventional treatment, they significantly expand the therapeutic toolkit. Collaboration between gastroenterologists, surgeons, and patients is essential to select the most appropriate treatment strategy, balancing innovation with evidence-based care. With ongoing refinement and validation, these approaches have the potential to address unmet needs and reshape the standard of care for GERD. Future directions should focus on long-term outcomes, head-to-head comparative trials, and defining patient subgroups most likely to benefit from each therapy. Importantly, successful GERD management increasingly depends on a multidisciplinary approach that incorporates patient-specific factors such as motility patterns, anatomical features, symptom phenotype, and treatment preferences.

 

Author(s) Details

Harald Rosen
Centre of Surgery, Sigmund Freud Private University, A-1020 Vienna, Austria.

 

Christian Günther Sebesta
Science Center Donaustadt, Langobardenstrasse 122, A-1220 Vienna, Austria.

 

Marie Christine Sebesta
Science Center Donaustadt, Langobardenstrasse 122, A-1220 Vienna, Austria.

 

Christian Sebesta
Science Center Donaustadt, Langobardenstrasse 122, A-1220 Vienna, Austria and Department of Internal Medicine, Clinic Donaustadt, SMZ-Ost, Langobardenstrasse 122, A-1220 Vienna, Austria.

 

Please see the book here:- https://doi.org/10.9734/bpi/aodhr/v3/5540

Advances in Acute Abdomen: Etiologies, Diagnostic Approaches and Innovative Treatments | Chapter 9 | Medicine and Medical Research: New Perspectives Vol. 12

Acute abdomen is a critical clinical condition that demands immediate attention due to its association with severe pain and rapid progression. The therapeutic management of acute abdomen can vary depending on the underlying cause. While some cases, like acute appendicitis, may require surgical intervention, such as an appendectomy, other conditions may be managed conservatively with observation and antibiotic therapy. This article reviews key aspects of the causes, diagnostic strategies, and treatment options for acute abdomen. The study highlights the broad spectrum of etiologies, ranging from common conditions such as acute appendicitis to rarer instances like intestinal perforations caused by foreign bodies. Accurate diagnosis is essential, and it often requires a combination of clinical examination and advanced imaging techniques, such as computed tomography, due to the overlapping symptoms of various underlying conditions. Treatment approaches vary, from conservative management with clinical observation and antibiotic therapy to urgent surgical procedures like appendectomy and cholecystectomy. These cumulative insights underscore a nuanced understanding of the diagnostic paradigms surrounding acute abdominal pathologies, urging continued research endeavors to refine diagnostic methodologies and therapeutic interventions in pursuit of enhanced patient outcomes. Laparoscopy is emphasized as a favorable option, offering benefits in terms of recovery time and post-operative morbidity. However, the COVID-19 pandemic has introduced significant challenges, including delays in diagnosis and limited access to healthcare services. This review underscores the need for a multidisciplinary approach and continuous professional development to ensure accurate diagnosis and appropriate therapeutic interventions, ultimately improving clinical outcomes and reducing the morbidity and mortality associated with this complex condition.

 

Author (s) Details

Maria Carolina de Almeida Santos
Department of Medicine, Universidade do Oeste Paulista, Guarujá, Brazil.

 

Lucas de Oliveira Varca
Department of Medicine, Universidade do Oeste Paulista, Guarujá, Brazil.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v12/2512

Oral Clonidine: A Simple, Effective and Safe Sedative Agent for Hemodynamic Stability during Laparoscopic Surgery and a Calm Post-surgical Phase | Chapter 7 | Achievements and Challenges of Medicine and Medical Science Vol. 6

 Background: Laparoscopic surgery is the quintessence of modern surgical practice due to its cosmetic scar, early ambulation, less mortality (less than 0.1%), and less compromised postoperative respiratory and gastro-intestinal functions. Carbon dioxide pneumoperitoneum (PNP), the hallmark of laparoscopic surgery and patient positioning leads to significant hemodynamic changes in laparoscopic surgeries. Laparoscopy is the essence of modern surgery but the carbon dioxide pneumoperitoneum used therein significantly impairs patient’s cardiopulmonary function. Clonidine, by its central sympatholysis, reduces perioperative hemodynamic instability and also has multiple added advantages in the post-operative period.

Methods: In this prospective, randomized, double-blind, placebo-controlled study on 60 ASA I/II patients, clonidine 150 µg for weight <55 kg and 200 µg for weight >55 kg was administered per oral to 30 patients (clonidine group) 90 minutes before induction of general anaesthesia and intra-operative haemodynamics were monitored at specific time periods and compared with the placebo group patients (n=30) who received oral vitamin C. The tablet Arkamin (100 µg/ tablet), manufactured by Unichem laboratories, India for pre-medicating all the patients in the clonidine group, was used. A pre-operative anxiety score, post-operative sedation and pain scores and the presence of nausea-vomiting, shivering and dry mouth at the end of the first and sixth postoperative hours, were noted. An α error of 0.05 and power of study 80% after permitting β error of 0.2 was assumed.

Results: Clonidine group patients remained haemodynamically stable throughout the intra-operative period. In the clonidine group, less number of patients required fentanyl for tachycardia (1 vs 11) and NTG for hypertension (none vs 7). Similarly, the pain and anxiety scores were significantly less in clonidine group patients. At the end of the first postoperative hour incidence of pain, shivering and vomiting in the placebo group was 33%, 36% and 20% respectively whereas in the clonidine group incidence was 6%, 0 and 0. At the end of 6 post-operative hours, the incidence of pain and vomiting was 73% and 36% in the placebo group whereas it was 10% and 0 in the clonidine group.

Conclusions: Oral clonidine in the present dose is able to maintain stable intra-operative haemodynamics and achieve a calm post-operative period during laparoscopic surgeries in ASA I/II patients. Further studies are needed to confirm its safety in elderly patients and patients with compromised cardiovascular function.

 

Author (s) Details

 

Ketaki Marodkar
Department of Anaesthesiology, NKPSIMS & RC and LMH, Nagpur, Maharashtra, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v6/3163

Laparoscopic Elective Total Splenectomy: A Review | Chapter 1 | Medical Science: Trends and Innovations Vol. 6

With rapid advances in technology and improvements in noninvasive imaging tests, laparoscopic splenectomy is now being advocated for massive splenomegaly. Laparoscopic splenectomy is now becoming the procedure of choice for elective splenectomy wherever the expertise is available. Initially, laparoscopic Splenectomy was performed only for benign hematological conditions, but now with the advancement of technology its use has been extended to massive splenomegaly, other benign conditions and infective pathologies of the spleen and also in cirrhosis of the liver with portal hypertension. Extensive searches have been made on internet websites. With the recent successes of laparoscopic splenectomy in selected cases, the future of splenic surgery will undoubtedly bring many more changes. Reasons for review are the paucity of literature, wide acceptance of the procedure as the method of choice for elective splenectomy, to assess the feasibility of the procedure and also to expand the use of laparoscopic splenectomy. Laparoscopic splenectomy lacks a long-term follow-up single institutional study with a large number of patients. Such studies need to be carried out in institutes where hematological specialized centers are available for a large number of referrals and postoperative care.

 

Author (s) Details

Ashok Suryabhanji Gajbhiye
Department of Surgery, GMC, Chandrapur, Maharashtra, India.

 

Ayyappa Sai Kumar Kolasani
Department of Surgery, GMC, Chandrapur, Maharashtra, India.

 

Sunil Motiram Lanjewar
Department of Surgery, GMC, Chandrapur, Maharashtra, India.

 

Kuntal Mahavir Surana
Department of Surgery, GMC, Chandrapur, Maharashtra, India.

 

Mukteshwar Narendra Deshmukh
Department of Surgery, GMC, Chandrapur, Maharashtra, India.

 

Nithin SD. Raj
Department of Surgery, GMC, Chandrapur, Maharashtra, India.

 

Manik Gedam
Department of Surgery, GMC, Chandrapur, Maharashtra, India.

 

Vaibhav Nasre
Department of Surgery, GMC, Chandrapur, Maharashtra, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v6/3065

Applying Different Innovative Ideas in Reduction of Post-operative Adhesion Formation: A Systematic Review and Meta-analysis | Chapter 8 | New Advances in Medicine and Medical Science Vol. 7

 Development of adhesions is ultimate common significance of intra-abdominal and pelvic enucleation and a significant, still poorly recognizable, reason of melancholy in post-operative patients.. Use of ‘good surgical technique’and use of PRP (red body fluid rich plasma) is recommmended as a earlier step in stop of adhesions. However, confirmation is needed for the evidence for various surgical techniques to defeat adhesion establishment. This review add to the expanding pool of information by illuminating determinants that certainly influence the incident of adhesions.The PubMed database was used to conduct a search for all suitable English-language items in the literature, which were therefore evaluated accompanying a focus on the risk determinants for the development of post-operative adhesions. Each item's reference lists were further examined to find some additional pertinent everything.A new ray of predict adhesion stop in the form of plasma rich protein (PRP) is good option. Various determinants have been proved to directly exaggerate the risk of post-operative adhesion growth; namely, sure genetic polymorphisms in the interleukin-1 receptor foe, increased estrogen exposure, and endometriosis. In addition, many determinants are known to improve the chance of fibrosis, thereby growing the possibility of adhesion incident concomitantly.28 documents with 27 studies have existed included for a systematic review. Of these, 17 studies were worthy for meta-analysis and 11 for subjective assessment only. The predominance of adhesive small bowel obstacle was not significantly decreased by any of the techniques that were distinguished. The rate of pregnancy raised following subserous fixation of stitching knots in a small, low-quality trial. However, distinguished to open surgery, laparoscopic abscission had a lower incidence of adhesions (relative risk (RR) 0.14; 95% assurance interval (CI): 0.03-0.61) and non-peritoneal closure (RR 0.36; 95% CI: 0.21-0.63).The essay reviewed in this place paper will help to explicit future research in understanding of the mechanisms that focus on the connection of certain determinants with incident of adhesions. This information will be important in the plotting appropriate preventative and situation techniques.None of the distinguishing techniques that were compared were smart to lower the two chief grip-related dispassionate consequences, small bowel obstacle and infertility. The meta-study contributes little evidence for the surgical law that usage of fewer obtrusive techniques, launch of fewer offshore bodies or causing slight ischaemia decrease the range and severity of adhesions. Platelet-rich red body fluid has a diminishing effect on the postoperative peritoneal adhesions in rats.

Author(s) Details:

Rekha Rani,
Department of Obstetrics & Gynaecology, S.N.M.C., Agra, India.

Shikha Singh,
Department of Obstetrics & Gynaecology, S.N.M.C., Agra, India.

Urvashi,
Department of Obstetrics & Gynaecology, S.N.M.C., Agra, India.

Ruchika Garg,
Department of Obstetrics & Gynaecology, S.N.M.C., Agra, India.

Neelam Singh,
Department of Obstetrics & Gynaecology, S.N.M.C., Agra, India.

Sangita Sahu,
Department of Obstetrics & Gynaecology, S.N.M.C., Agra, India.

Monica Golani,
Department of Obstetrics & Gynaecology, S.N.M.C., Agra, India.

Please see the link here: https://stm.bookpi.org/NAMMS-V7/article/view/11038

Potential Port Site Consequences in Laparoscopic Cholecystectomy Using an Open versus Closed Approach of Pneumoperitoneum: A Comparative Study | Chapter 6 | Perspective of Recent Advances in Medical Research Vol. 11

 The standard pattern for cholecystectomy is laparoscopic surgery, and pneumoperitoneum maybe performed in either a closed or open method. However, exposure to the traffic's consequences may improve the patient's morbidity. As a result, this study was completed activity to compare two together approaches in terms of complications at the traffic site of each process and potential risk factors.A potential study was carried out in the department of medical procedure, in hospitals owned by Kirkuk and Diyala governorates in Iraq, from January 2019 to March 2022. The 200 patients who accepted part in the study were divided into two groups, each accompanying 100 patients. The two processes were compared for intraoperative and postoperative questions that could have stood from port insert up to 18 weeks.The findings demonstrated that the highest allotment was for the following: females (84.0%), ages between 50 and 59 age (43.5%), and body bulk index (BMI) range 25-30 kg/m2 (49.0%). No significant distinctness was observed between those variables for two together surgical techniques (p-worth > 0.05). No death was recorded in the study. The following snags were observed at the traffic site in 10.5% of victims, with the majority stated in the open approach (8.5%): draining (3.0%), hematoma (2.0%), wound infection (1.5%), break (1.5%), and vascular injury (0.5%).Thus, we concluded that traffic site problems are lowest in closed laparoscopic abscission which was not proved to be statistically important but values showed less obstacles. Furthermore, samples could be used to gain a good mathematical significance.

Author(s) Details:

Awni Ismail Sultan,
Department of Surgery, College of Medicine, Tikrit University, Iraq.

Sami Hassoon Ali,
Department of Surgery, Jalawla General Hospital, Iraq.

Ozdan Akram Ghareeb,
Department of Community Health, Northern Technical University, Kirkuk, Iraq.

Please see the link here: https://stm.bookpi.org/PRAMR-V11/article/view/9513

HSG with Laparoscopic Correlation in Infertility Patients: An Observational Study | Chapter 3 | Perspective of Recent Advances in Medical Research Vol. 11

 Uterine anomalies account for 10% of unproductiveness cases and 50% of women who happening recurrent early gestation loss, while fallopian tube deformities account for 20% of aforementioned cases. HSG was performed on 61 unproductiveness and subfertility patients who were withstanding evaluation and situation at our centre. A total of 25 patients from this group underwent demonstrative laparoscopy, and their results were retrospectively correlated accompanying HSG findings. All of the cases included in the study had either primary or subordinate infertility. There were 49 basic infertility patients and 12 subordinate infertility sufferers among the 61 unproductiveness patients. Patients ranged in age from 23 to 35 age. The average duration of basic infertility was 5 age, and 3.5 years for secondary unproductiveness. Total 61 patients seen HSG, 42(68.8%) patients had normal judgments and 19(31.14%) patients had anomalous findings. In atypical findings 4(6.55%) were Mullerian abnormalities and 15(24.59%) were either one-sided or bilateral tubal block. Total 25 cases underwent diagnostic laparoscopy at a distance 61 patients. The feeling of HSG was 90% and specificity was 60 % accompanying positive predictive profit of 60% and negative predictive worth of 90% as compared to diagnostic laparoscopy. Peri-adnexal adhesions were found in 5 (20%) of the obstructed tubes all along our laparoscopic examinations. One (4%) of the blocked tubes had endometriosis, and two (8%) had possible intra-tubal block. In 3 (12%) cases, pelvic inflammatory disease was discovered expected a factor. In our study, HSG demonstrates extreme sensitivity. As a result, it bear be used as the beginning in determining uterine abnormality and tubal patency. Because the particularity is low, we trust that laparoscopy is required to identify cases of tubal block that were misplaced or incorrectly labeled on HSG. Furthermore, in patients the one were found to have tubal block on HSG, laparoscopy assists in determining the cause of unproductiveness, such as the ghost of peritubal adhesions and endometriosis, which can guide appropriate therapy.

Author(s) Details:

Avinash Dubbewar,
Department of Obstetrics and Gynecology, AFMS, New Delhi, India.

Saumen Kanti Nath,
Department of Radiodiagnosis, AFMS, New Delhi, India.

Ravishekar N. Hiremath,
Department of Community Medicine, AFMS, New Delhi, India.

Sandhya Ghodke,
Department of Anaesthesia, Rainbow Childrens Hospital, Banaglore, India.

Prathyusha Gouru,
Department of Obstetrics and Gynecology, AFMS, New Delhi, India.

Preeti Yadav,
Department of Obstetrics and Gynecology, AFMS, New Delhi, India.

Please see the link here: https://stm.bookpi.org/PRAMR-V11/article/view/9510

Simple Suture and Drainage as the Treatment of an Anastomotic Leak after a Laparoscopic Left Colectomy | Chapter 17 | Recent Developments in Medicine and Medical Research Vol. 2

 Atypical polypoid adenomyoma (APA) is a benign endometrial polypoid tumour that commonly occurs in women of reproductive age [1]. Atypical polypoid adenomyoma (APAM) is a rare uterine tumour characterised by complicated endometrioid glands and squamous morular metaplasia with fibromuscular stroma [2]. On histological evaluation of endometrial tissue with polyp in a lady with abnormal uterine haemorrhage, an atypical polypoid adenomyoma was discovered. We provide this case report since atypical polypoid adenomyoma is uncommon. The histological analysis of an endometrial polyp in a 38-year-old woman who presented with severe vaginal bleeding and endometrial polyp underwent dilation and curettage, and the endometrial polyp was consistent with 'Atypical Polypoid Adenomyoma' with significant morular metaplasia. The diagnosis of morular metaplasia was confirmed using the immunohistochemical marker CD10. After that, the patient had a total abdominal hysterectomy. Despite the high recurrence rate and link to endometrial cancer, cautious therapy is recommended for young nullipara women [1].

Author (S) Details 

Sorin Cimpean
Iris Hospitals South, Brussels, Belgium.

Ion Surdeanu
Iris Hospitals South, Brussels, Belgium.

Mehdi El Chouckri
Iris Hospitals South, Brussels, Belgium.

Mohamad Rakka
Iris Hospitals South, Brussels, Belgium.

Jordan Marcelis
Iris Hospitals South, Brussels, Belgium.

Hamid El Khaddouri
Iris Hospitals South, Brussels, Belgium.

Sorin Cimpean
Iris Hospitals South, Brussels, Belgium.

View Book :- https://stm.bookpi.org/RDMMR-V2/article/view/4288

 

Butterfly Gastric Bypass | Chapter 2 | Highlights on Medicine and Medical Science Vol. 7

 Perforation, haemorrhage, and cancer of the bypassed stomach, duodenum, and biliary tree are significant problems that can be deadly if not detected early, which is difficult with RYGBP and micro bypass procedures. Butterfly gastroplasty is an option for patients who are suitable for bariatric surgery. When comorbidities are present, the BMI should be greater than 30 or greater than 25. The success of butterfly gasroplasty as a laparoscopic restrictive technique, as evidenced by the fact that over 1000 cases have been performed (since 2008) in numerous centres and the Ahmed Maher teaching hospital in Cairo, Egypt. We recommend laparoscopic butterfly gastric bypass (BB) as the treatment of choice for morbid obesity because it combines all of the benefits of a mini gastric bypass with the added benefit of a gastro-gastric banded outlet that allows for easy endoscopic and radiological diagnosis and treatment of the bypassed stomach.

Author (S) Details

Essam Abdel-Galil
Department of Surgery, Ahmed MAHER Teaching Hospital, Cairo, Egypt.

View Book :- https://stm.bookpi.org/HMMS-V7/article/view/2030

Study on Conversion Rate and Complications of Laparoscopic Myomectomy | Chapter 6 | Highlights on Medicine and Medical Research Vol. 12

 The goal of this study was to determine the conversion rate and complications associated with laparoscopic myomectomy. Material and Methods: From December 2015 to March 2018, a retrospective review of 43 laparoscopic myomectomy cases performed at Vinayaka Missions Medical College & Hospital was conducted. Demography, myomectomy symptoms, the location and quantity of fibroids, the operation done, the difficulties and complications encountered, and the need for conversion to open surgery were all investigated. On 43 individuals, a total of 108 myomas were excised. The average age of patients receiving laparoscopic myomectomy was 32.16 years. In 24 patients, there was only one fibroid. Only five patients had more than four fibroids. The greatest fibroid was less than 5 cm in 8 cases, 6-12 cm in 6 others. There are 34 women in all. One patient had a 15-centimeter fibroid. Eighty percent of the 108 fibroids excised were intramural. There was only one laparotomy conversion. Two patients suffered significant blood loss, and eight patients required blood transfusions during or after surgery. There are a total of 34 women in the group. A 15-centimeter fibroid was found in one patient. The intramural fibroids accounted for 80% of the 108 fibroids removed. Only one laparotomy conversion occurred. Two of the patients lost a lot of blood, and eight of them needed blood transfusions during or after surgery.

Author (s) Details

Dr. G. Ambujam
Vinayaka Mission’s Medical College & Hospital, Karaikal, Vinayaka Mission’s Research Foundation (DU), Salem, India

Dr. Alla Satyanarayana Reddy
Vinayaka Mission’s Medical College & Hospital, Karaikal, Vinayaka Mission’s Research Foundation (DU), Salem, India.

View Book :- https://stm.bookpi.org/HMMR-V12/article/view/1368