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All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Wachyu Hadisaputra
Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Indonesia, Jakarta
Health Professions Medicine & Pharmacology Public Health

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Distention Media in Hysteroscopy for Diagnostic and Operative Procedure Hadisaputra, Wachyu
Indonesian Journal of Obstetrics and Gynecology Volume. 34, No. 3, July 2010
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (35.434 KB)

Abstract

Objective: Hysteroscopy is the "gold-standard" procedure used to describe the morphology of uterine cavity and the presence of intrauterine lesions and it is a minimally invasive intervention that can be used to diagnose and treat many intrauterine and endocervical problems. Hysteroscopy requires uterine distention for the effective visualization of the uterine cavity and the clearing of blood and tissue debris. Options for uterine distention include insufflation with carbon dioxide (CO2) gas, and instillation with electrolytic and nonelectrolytic liquid distention media. In this review, we would like to review known available distending media and its characteristics for diagnostic and operative hysteroscopy. Method: Literature review. Conclusion: Carbon dioxide and normal saline are the most preferable distention media for diagnostic hysteroscopy. There is no significant difference between these medium in terms of visualization quality, but most practitioners prefer to use normal saline because of it’s availability and acceptability, quick performance, fewer additional procedures, more satisfaction rate, and good visualization. Low viscosity fluids are the most preferable media for operative hysteroscopy. Low viscous-electrolytic fluids, mostly normal saline is recommended in operative cases using mechanical, laser or bipolar energy that requires no electricity. Nonelectrolytic low-viscosity fluids are most preferable for extensive operative procedures using electrosurgery. Mannitol are chosen over glycine or sorbitol when using monopolar electrosurgery. [Indones J Obstet Gynecol 2010; 34-3: 150-4] Keywords: hysteroscopy, distention media, diagnostic procedure, operative procedure
Fertility Outcomes after Laparoscopic Reversal of Tubal Sterilization Hadisaputra, Wachyu
Indonesian Journal of Obstetrics and Gynecology Volume. 36, No. 3, July 2012
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (172.123 KB)

Abstract

Objective: To know pregnancy outcome in the tubal reversal of sterilized women. Method: Literature review. Results: Sterilization is considered the most common contraception methods in United States of America, approximately 39% women in reproductive age (15 - 44 years) used this method. However, approximately 15% of these patients deplored this decision due to the influence of their own environment and some factors, such as: young age, the death of a child, the disability of child, and change of partner/ remarried. Tubal reanastomosis or tubal reversal is a surgical procedure that attempts to restore the fallopian tube patency following sterilization. To date, the modern procedure is performed by doing an excision of the tubal segment and reanastomosis by transabdominal laparoscopy. Recently, the laparoscopic technology has developed and evolved rapidly as the robotic assisted laparoscopy was invented. There is alternative method for restoring the fertility in sterilized women who regretted the decision of being sterilized. Unlike the tubal reversal which is conducted in order to restore the tubal function, the IVF is performed to bypass the function of tubes in fertility. The major advantage for laparoscopic surgery is short postoperative stay duration with minimal tissue handling, less postoperative adhesions, and diminish morbidity rate. Despite of its major drawback, high-cost of robotic machine and machine maintenance; there are advantages of robotic laparoscopy compared to the conventional laparoscopy, such as improved dexterity, more precise and accurate articulation, reduced tremor, and better visualization of the operating field. In vitro fertilization (IVF) is the hallmark in the era of assisted reproductive technology and became an alternative option to regain the fertility in sterilized women. Conclusion: The pregnancy rate and live birth rate in laparoscopy, robotic and open surgery were relatively similar. Surgical reversal to women younger than 40 is recommended and laparoscopic reversal should be performed if the expertise is available. It is reasonable to counsel IVF to over 40 women. [Indones J Obstet Gynecol 2012; 36-3: 154-60] Keywords: gynecology, IVF, pregnancy outcomes, reanastomosis, robotic laparoscopy, tubal reversal
Adhesion Prevention in Operative Laparoscopy Hadisaputra, Wachyu
Indonesian Journal of Obstetrics and Gynecology Volume. 34, No. 4, October 2010
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (88.729 KB)

Abstract

Objective: To know the modalities used for prevention of adhesion formation in operative laparoscopy. Method: Literature study. Results: Methods of prevention of adhesion in laparoscopy include: modification of surgical technique, anti-inflammatory agents, peritoneal instillates and barrier adjuvants. Modification of surgical techniques such as adherence to basic principles of microsurgery, the use of electrothermal bipolar vessel sealer, liberal irigation of the abdominal cavity and instillation of a large amount of Ringer’s lactate at the completion of the procedure. This technique alone, eventhough seems effective, is insufficient. The anti-inflammatory agents used are the NSAIDs, corticosteroids, antihistamines, progestogens, GnRH agonists and calcium channel blocker. But none of them demonstrated to be significantly effective. Barrier adjuvants consist of: oxidized regenerated cellulose (ORC) and expanded polytetrafluoroethylene (ePTFE) and peritoneal instillates are the crystalloids, icodextrin, hyaluronic acid (HA), solution of HA, viscoelastic gel, hydrogel, and fibrin sealent. There is insufficient evidence data regarding the methods above for the prevention of adhesiogenesis in laparoscopy. But one study evaluating the use of viscoelastic gel did significantly reduce adnexal adhesion in laparoscopy. Conclusion: Laparoscopy does not trully eliminate the adhesiogenesis problem. No single therapy is effective for prevention of adhesion formation. The multimodal methods shall be used to increase the successful rate in adhesion prevention. [Indones J Obstet Gynecol 2010; 34-4: 204-7] Keywords: laparoscopy, adhesion, microsurgery, anti-inflammatory, peritoneal instillates, barrier adjuvants
Laparoscopic Robotic Surgery in Gynecology Hadisaputra, Wachyu
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 3, July 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (484.006 KB)

Abstract

Objective: To know the development and application of robot assisted laparoscopy in gynecology. Method: Literature review. Result: Laparoscopy procedure has been widely used since the last three decades where minimally invasive surgery cases and demands increase in urology, cardiac surgery, general surgery, and particularly, gynecology. To date, laparoscopy has developed into robot-assisted laparoscopy due to needs of precise dissection of delicate structures, procedures which requires sophisticated technique, and surgeon’s fatigue through the laparoscopy procedure. There are three robotic system which are commercialized and had been approved by FDA: AESOP, ZEUS, and Da Vinci, the latest robotic system which is used worldwide nowadays. There are advantages of robotic systems and conventional laparoscopy to open surgery laparotomy, such as diminished morbidity rate; less esthetical incisions; decreased post and intra operative blood loss, postoperative pain, use of pain medication, less cosmetic problems, and shorter length of hospital stay. Advantages of robotic surgery compared to conventional laparoscopy and laparotomy; include improved dexterity, more precise and accurate articulation, reduced tremor and surgeon’s fatigue, and better visualization of the operating field because of 3D image. Robotic system has drawbacks such as limited area of surgery field in trocar-placing to avoid collision of the robotic arms, longer operative time, and a higher cost. Conclusion: The major drawback of robot-assisted laparoscopy is in the term of cost; because of the high cost of robotic system; which could be overcome by a lower morbidity rate, less incisional aesthetic problem, less total intra operative blood loss, decreased demand of analgesics post operative, and shorter length of hospitalization stay and recovery time; as compensation of the high cost of robotic system. Further researches to study about the learning curve of robotic laparoscopy to achieve a faster operative time are needed. A longer operative time in robotic system can be anticipated with accurate simulation training in robotic system. There is also a need for further researches to discuss the total peri-operative cost. [Indones J Obstet Gynecol 2011; 35-3: 146-50] Keywords: laparoscopy, robotic system, robot-assisted, Da Vinci system, learning curve, gynecology
The Role of Biomarkers in Diagnosing the Early Stage of Endometriosis Hadisaputra, wachyu
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 2 April 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (64.747 KB) | DOI: 10.32771/inajog.v6i2.720

Abstract

N/A
Identification of microorganisms in vaginal swab and peritoneal fluid of women with endometriosis Gunardi, Eka R; Hadisaputra, Wachyu; Judio, Johny
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 4 October 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (100.325 KB) | DOI: 10.32771/inajog.v6i4.847

Abstract

Abstract Objective: to discover correlation between microorganisms found in vaginal swab culture and in peritoneal fluid culture from laparoscopy in reproductive age women diagnosed with endometriosis. Methods: This cross sectional study was conducted in Bunda Hospital and YPK Hospital, Central Jakarta. Thirty one subjects was includedby consecutive sampling. Data were analyzed using SPSS 20.0 for Windows. Bivariate analysis was used to identify the correlation between independent and dependent variable. Results: From 31 subjects with mean age 34.42+5.056 years old, 87.1% were infertile. Vaginal swab culture was found positive in 83.9% subjects while peritoneal fluid culture was found positive only in 9.6% subjects. There was moderate correlation between chronic pelvic pain and positive vaginal swab culture (r=0.601; p=0.001), but weak correlation between Ca125 and vaginal swab culture (r=0.440; p=0.010). Peritoneal fluid culture had significant inverse correlation with left tubal patency (r=-0.346; p=0.047). There was weak correlation between vaginal swab culture and peritoneum fluid culture with correlation coefficient of 0.13. Conclusion: Most of bacteria found in vaginal swab culture and peritoneal fluid culture were the ones found in gastrointestinal tract. However, vaginal swab and peritoneal fluid culture were not sufficient to prove the hypothesis that infection has a role in pathogenesis of endometriosis. Therefore, advance and more complete examination such as LPS and PCR might be needed to be done in the future research with cohort study, to overcome the limitation of this study. Keywords: endometriosis, ascending bacterial contamination, vaginal swab, peritoneal fluid, culture   Abstrak Tujuan : Membuktikan adanya korelasi antara mikroorganisme yang ditemukan pada hasil kultur bilasan vagina dengan mikroorganisme yang ditemukan pada cairan peritoneum hasil laparoskopi perempuan usia reproduksi yang terdiagnosis endometriosis Metode :Penelitian ini menggunakan desain penelitian analitik poltong lintang yang bertujuan untuk melihat adanya hubungan korelasi serta mengetahui tingkat korelasi antara mikroorganisme kultur bilasan vagina dengan mikroorganisme pada cairan peritoneum pasien endometriosis. Hasil: Hasil kultur bilasan vagina dari 31 subjek penelitian yang diteliti, mikroorganisme terbanyak adalah Enterococcus faecalis (32.3%), Eschericia coli (29.1%), dengan 16.1 % dengan hasil kultur negatif. Sedangkan dari hasil kultur bilasan peritoneum terdapat 3 subjek (9.6%) dengan hasil positif yaitu dengan jenis bakteri Eschericia coli, Enterococcus faecalis, dan Pseudomonas. Terdapat korelasi lemah antara hasil kultur bilasan vagina dengan kultur bilasan peritoneum (r 0.13). Terdapat korelasi sedang antara kultur positif bilasan vagina dengan nyeri pelvik kronis, korelasi lemah antara kultur positif bilasan vagina dengan nilai Ca 125, dan korelasi lemah antara kultur positif cairan peritoneum dengan tuba kiri yang non paten. Kesimpulan:          Sebagian besar bakteri dari bilasan vagina dan bilasan peritoneum pada pasien endometriosis memiliki hasil bakteri dari organ pencernaan. Terdapat korelasi lemah antara hasil kultur bilasan vagina dengan kultur bilasan peritoneum pada pasien endometriosis. Kata kunci: endometriosis, kontaminasi bakteri asenden, kultur, bilasan vagina, cairan peritoneum
Contraception for Women with Diabetes Mellitus Hadisaputra, Wachyu
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 4, October 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (117.102 KB) | DOI: 10.32771/inajog.v2i4.414

Abstract

use in women with diabetes mellitus. Method: Literature review. Result: Women in the reproductive age who are affected by a wide range of chronic medical conditions, one of which is diabetes mellitus (DM), may experience adverse health effects pre-conception and in pregnancy. This condition will influence outcome of pregnancy and contraceptive choice after delivery. Planning the use of contraception for women with DM who would experience high-risk pregnancy is a necessity, and counseling must consider the safety of different types of contraception that in comparison to the risk of pregnancy. WHO has provided a guideline on choosing contraception, which is available from the UK Medical Eligibility Criteria for Contraceptive Use (UKMEC), as the basis for contraception selection for women with DM. For DM patients without complication any type of contraception can be used in consideration for the advantages and disadvantages of each type of contraception. For diabetics with complications or multiple risk factors, in the selection of contraceptive, hormonal contraception (especially for combined hormonal contraception (CHC) pill and injection method) requires proper consideration and consultation with health care providers. [Indones J Obstet Gynecol 2014; 4: 226-231] Keywords: complications, contraception, diabetes mellitus, hormonal, pregnancy
Contraception for Women with Diabetes Mellitus Hadisaputra, Wachyu
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 4, October 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (117.102 KB) | DOI: 10.32771/inajog.v2i4.414

Abstract

use in women with diabetes mellitus. Method: Literature review. Result: Women in the reproductive age who are affected by a wide range of chronic medical conditions, one of which is diabetes mellitus (DM), may experience adverse health effects pre-conception and in pregnancy. This condition will influence outcome of pregnancy and contraceptive choice after delivery. Planning the use of contraception for women with DM who would experience high-risk pregnancy is a necessity, and counseling must consider the safety of different types of contraception that in comparison to the risk of pregnancy. WHO has provided a guideline on choosing contraception, which is available from the UK Medical Eligibility Criteria for Contraceptive Use (UKMEC), as the basis for contraception selection for women with DM. For DM patients without complication any type of contraception can be used in consideration for the advantages and disadvantages of each type of contraception. For diabetics with complications or multiple risk factors, in the selection of contraceptive, hormonal contraception (especially for combined hormonal contraception (CHC) pill and injection method) requires proper consideration and consultation with health care providers. [Indones J Obstet Gynecol 2014; 4: 226-231] Keywords: complications, contraception, diabetes mellitus, hormonal, pregnancy
Fertility Outcomes after Laparoscopic Reversal of Tubal Sterilization Hadisaputra, Wachyu
Indonesian Journal of Obstetrics and Gynecology Volume. 36, No. 3, July 2012
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (172.123 KB) | DOI: 10.32771/inajog.v36i3.317

Abstract

Objective: To know pregnancy outcome in the tubal reversal of sterilized women. Method: Literature review. Results: Sterilization is considered the most common contraception methods in United States of America, approximately 39% women in reproductive age (15 - 44 years) used this method. However, approximately 15% of these patients deplored this decision due to the influence of their own environment and some factors, such as: young age, the death of a child, the disability of child, and change of partner/ remarried. Tubal reanastomosis or tubal reversal is a surgical procedure that attempts to restore the fallopian tube patency following sterilization. To date, the modern procedure is performed by doing an excision of the tubal segment and reanastomosis by transabdominal laparoscopy. Recently, the laparoscopic technology has developed and evolved rapidly as the robotic assisted laparoscopy was invented. There is alternative method for restoring the fertility in sterilized women who regretted the decision of being sterilized. Unlike the tubal reversal which is conducted in order to restore the tubal function, the IVF is performed to bypass the function of tubes in fertility. The major advantage for laparoscopic surgery is short postoperative stay duration with minimal tissue handling, less postoperative adhesions, and diminish morbidity rate. Despite of its major drawback, high-cost of robotic machine and machine maintenance; there are advantages of robotic laparoscopy compared to the conventional laparoscopy, such as improved dexterity, more precise and accurate articulation, reduced tremor, and better visualization of the operating field. In vitro fertilization (IVF) is the hallmark in the era of assisted reproductive technology and became an alternative option to regain the fertility in sterilized women. Conclusion: The pregnancy rate and live birth rate in laparoscopy, robotic and open surgery were relatively similar. Surgical reversal to women younger than 40 is recommended and laparoscopic reversal should be performed if the expertise is available. It is reasonable to counsel IVF to over 40 women. [Indones J Obstet Gynecol 2012; 36-3: 154-60] Keywords: gynecology, IVF, pregnancy outcomes, reanastomosis, robotic laparoscopy, tubal reversal
The Role of Biomarkers in Diagnosing the Early Stage of Endometriosis Hadisaputra, wachyu
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 2 April 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (64.747 KB) | DOI: 10.32771/inajog.v6i2.720

Abstract

N/A
Co-Authors Biran Affandi Eka R Gunardi Judio, Johny Peter A.W. Rogers Sandhy Prayudhana T. D. Anggraeni Yohanes Handoko