#253 Finding a Way Out in Captive Uterine Syndrome- Dr. Rohit Raina
This is one of the 2023 KS International Innovation Awards videos selected for inclusion in the Vattikuti Foundation – ORSI Humans on the Cutting Edge of Robotic Surgery Conference, October 6, 7 & 8, 2023 in Ghent, Belgium. Posting does not imply that is has been selected as a Finalist, just that the content will be discussed at the Conference.
From the entry:
FINDING A WAY OUT IN – CAPTIVE UTERINE SYNDROME ABSTRACT On surgical exploration, incidentally adhesions are found between uterus, anterior abdominal wall, and bladder. Presentation can be variable, mostly asymptomatic. Most common risk factors are caesarean section and previous history of surgeries.
The adhesions between the bladder and the lower uterine segment, particularly after caesarean section can be dense or tough in the midline, usually central three-fifths but never in lateral one- fifth.
The lateral space between the bladder and the leaves of the broad ligament as well as adjoining lateral uterocervical border, surface near the isthmic notch-is usually free of adhesions. It is therefore possible to enter this space by dissecting near the lateral uterocervical margin.
Adhesiolysis in captive uterine syndrome consists of two parts – I) Uterolysis and II) Bladder adhesiolysis. Here, in this video presentation, we have demonstrated anatomical boundaries and dynamic approaches for uterolysis and bladder adhesiolysis. Our video series presents head on approach and reverse approach. It starts from getting the nascent space from lateral side and proceeding for adhesiolysis from cephalic to caudal direction with the target to reach vesicouterine space.
Our technique helps to Find a way Out in Captive Uterine Syndrome and we have considered it as “FOCUS” approach, which is safe, simple, and reproducible. We have followed ERAS protocol for both of our patients and patients got discharged within 24 hours without any complications.