1. Hollow Abdominal Visceral Injuries following Minimally Invasive Gynecological Procedure: A 16 Year Experience
1. Nazimuddin Jat 2. Farhat Bano 3. Iqbal Ahmed Memon 4. Pir Bakhsh Khokhar
5. Muhammad Ahmed Azmi
1. Assoc. Prof. of Surgery, Al-Tibri MC, Karachi 2. Asstt. Prof. of Surgery, Al-Tibri MC, Karachi 3. Prof. of Surgery, Al-Tibri MC, Karachi 4. Prof. of Community Medicine, Al-Nafees Medical College Islamabad
5. Prof. of Physiology, Al-Tibri MC, Karachi.
ABSTRACT
Objective: To study the pattern of hollow abdominal visceral injuries during minimally invasive gynecological procedures.
Study Design: Retrospective, Descriptive Study.
Place and Duration of Study: This study was conducted at Fauji Foundation Hospital Karachi, Gulshan General Hospital Karachi, Star General Hospital Karachi and Al-Tibri Medical College Hospital from July 1997 to December 2013.
Materials and Methods: All patients admitted to above mentioned hospitals for minimally invasive gynecological procedures electively or in emergency were included in the study.
Results: Total 3050 minimally invasive gynecological procedures were carried out in the above mentioned hospitals and 77 (2.5 %) patients had complications following the procedures. Mean age was 28 years ranged from 20-55 years. 40 % patients had history of previous gynaecological surgery.Abdominal visceral injuries included small bowel perforation 30 (38.96 %) patients, sigmoid colon perforation 20 (25.97%)patients. Both small bowel and sigmoid colonic perforation 08 (10.38%) patients, Caecal perforation 01(1.29 %) patient and Urinary Bladder 01 (1.29%) patient. 52 % cases were diagnosed within two days of primary surgery and rest within 10 days.
Conclusion: All gynecologists must be skilled, vigilant and careful while doing minimally invasive gynecological procedures that visceral injury should not happen or ready to deal if it happens accidentally.
Key Words: Bowel perforation. Illegally induce abortions, Dilatation and Curettage, Dilatation and Evacuation, and
Hysteroscopy.