Using an extracorporeal suturing technique, a laparoscopic oophoropexy was performed to prevent any further rotatory movement and torsion of ovary. This appears to be the one of many reported case of laparoscopic oophoropexy for a recurrent ovarian torsion; we encourage the use of this simple, minimally invasive procedure in cases of recurrent adnexal torsion.
For more information please contact: World Laparoscopy Hospital Cyber City, DLF Phase II, Gurgaon NCR Delhi, 122002, India Phone & WhatsApp: +919811416838, + 91 9999677788 contact@laparoscopyhospital.com
00:00This is a case of ovary and torsion. This patient has left-sided ovary and torsion and you can see that ovary is completely gangrenous. There was a large ovary and cyst and unfortunately it get torted.
00:17So we will do the ofrectum because it is unviable and the ultrasound has shown that it was a dermoid cyst and it's completely torted. The ovary is not visible.
00:30An entire adnexa is blue color. So we will do first the aspiration to confirm that what is the type of cyst and what is the content that we can send for the histopathology FNSE also.
00:45So we will connect this aspiration needle with the suction. We will aspirate the fluid.
01:00Now this is partially aspirated and we can see the torsion here.
01:08Now this is partially aspirated and we can see the torsion here.
01:14This is the pedicle and with the harmonic we will start ophrectomy.
01:20This is the pedicle and with the harmonic we will start ophrectomy.
01:28First we should do little detorsion so that it will be easy for us to get the major ovarian.
01:48This is the pedicle where it was torted and this is detorsion procedure.
02:10Now it is detorted.
02:40We can use lyga shawl as well as harmonic.
02:52Both the instruments are good enough for the ophrectomy.
02:58We can use lyga shawl as well as harmonic.
03:06Both the instruments are good enough for the ophrectomy.
03:22It started from the infondulo ovarian ligament and then slowly approaching to the meso ovarian.
03:52This is the pre-series and improvisation.
03:58This is called the clairvoyant.
03:59This prevView for the ophrectomy is the best but not worthwhile.
04:04This is theamed seminal administration.
04:06This is the length of the the ophrectomy has gained the ability to change the code.
04:09This is the control of the ophrectomy.
04:13And this is the greatest risk of the ophrectomy and the fuel heater.
04:20Now this is the last part that is the proper ovary and ligament and now ovary is separated.
04:50Suction is used to suck the spilled fluid, here it is near cecum, this is the right tube.
05:16We are using an endo bag to transfer the cyst into the endo bag.
05:35Opening the endo bag to make a space for the cyst to accommodate.
05:48And now it is getting transferred inside the endo bag.
06:02Now the mouth of endo bag will be closed.
06:25And this left iliac fossa 10 mm port is taken out and outside manual motion will be done.
06:39And the ovary will be taken out.
06:41The endo bag will also use here as a wound protector.
06:46And slowly with crushing the cystic content it is taken out.
06:51Now little suction and irrigation just to clean the pelvis.
07:06Clean the wound so that there should not be any content in the abdominal valve.
07:18Now little suction bladder is a little full, you have not applied the foliage actually.
07:36And now the port closure.
07:39Port closure is essential in these cases.
07:45Because if you will not close the port properly there is a very high chance of hernia.
07:52As when you will use endo bag and you will manually try to take the large cyst out the wound will
07:59get a little stretched and the rectus also will get a little teared out.
08:04So it is better to close the port.
08:06And here we are using the facial closure needle and three knot were given to close the port.
08:20So that absolutely there will be no chance of hernia.
08:24And now it is done.
08:39So you will try again final suction irrigation just to clean that area.
08:46So this was just a simple case of ophrectomy for retorted gangrenous ovarian cysts.
08:55Left right ovary is fine, right tube is okay.
09:00So thank you very much for watching this video.
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