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All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Fani, Erliana
Indonesian Socety of Obstetrics and Gynecology
Health Professions Medicine & Pharmacology Public Health

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How to Recognize, Prevent and Address Complications of Laparoscopic Gynecologic Surgery Pramayadi, cepi T; Fani, Erliana
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 (244.523 KB) | DOI: 10.32771/inajog.v6i4.896

Abstract

AbstractObjective: to highlight the needs of awareness on recognizing, prevent and address complications in laparoscopic gynecologic surgery.Method: Literature reviewDiscussion: The complications of laparoscopic gynecologic surgery mainly can be classified as complications related to anesthesia, entry technique, electrosurgical, postoperative and visceral due to surgical procedure itself. Lam proposed a 6 phase-based classification of laparoscopic surgery complications; patient identification, anesthesia and positioning, abdominal entry and port placement, surgery, postoperative recovery and counselling. The aim of this classification is to promote a culture risk management to improve patient safety and outcome. Each and every phase above should be able to assessed, analyzed and executed properly to prevent complications. Conclusion: Complication in operative laparoscopy is generally minor and can be handled successfully. However, although very rare, major complications are detrimental to the patient. It also becomes heavy burden for the surgeons. Preventive measures should be implemented not only by the operator but also the anesthesiologist, and theatre practitioners. Systematic drills, which regularly re rehearsed is important in order to maintain team proficiencies. Keywords: complications, gynecologic laparoscopy, operative Laparoscopy   Abstrak Tujuan: Untuk menekankan pentingnya mengenali, mencegah dan mengatasi secara dini komplikasi operasi laparoskopi ginekologi. Metode: Kajian pustaka Diskusi : Komplikasi operasi ginekologi laparoskopi dapat diklasifikasikan menjadi komplikasi yang berhubungan dengan anestesi, teknik masuknya trokar utama, terkait elektro surgikal, komplikasi pascaoperasi dan komplikasi visera (pembuluh darah, usus, cedera traktus urinarius) terkait tindakan operasi itu sendiri. Lam mengusulkan suatu klasifikasi berbasis fase, antara lain, identifikasi pasien, anestesi dan posisi pasien, akses masuk abdomen dan penempatan trokar, terkait operasi, pemulihan pascaoperasi dan konseling. Tujuan dari klasifikasi ini adalah untuk meningkatkan budaya sadar risiko,guna meningkatkan keselamatan pasien. Setiap tahap harus dapat dilaksanakan, dinilai dan dianalisis dengan baik untuk mencegah terjadinya komplikasi. Kesimpulan: Komplikasi pada operasi ginekologi laparoskopi umumnya ringan dan dapat ditangani dengan baik. Walaupun jarang terjadi, komplikasi berat umumnya sangat merugikan pasien dan menjadi beban operator. Langkah-langkah pencegahan ini harus dilaksanakan oleh operator, tim anestesi serta seluruh tim kamar operasi. Simulasi  harus dilaksanakan, guna mempertahankan kecakapan tim Kata kunci : komplikasi, laparoskopi ginekologi, laparoskopi operatif
Hysterectomy to the Unicornuate Uterus Suffering of Hematometra Pramayadi, Cepi T; Nurliana, Imma; Fani, Erliana
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (405.7 KB) | DOI: 10.32771/inajog.v5i4.571

Abstract

Objective: Unicornuate uterus with rudimentary cavity is anextremely rare Mullerian duct anomaly. It is frequently misdiagnosedor under treated, since women who suffer from thiscondition tend to be asymptomatic. We aimed to report thisinteresting case and review the available background literature.Methods: Case report.Case: A thirty two-year-old nulligravid woman was presentedwith severe abdominal pain. Laparoscopic surgery demonstratedunicornuate uterus with arudimentary cavity and hematometra.Partial hysterectomy was conducted to the right rudimentaryuterus.Conclusion: Thorough diagnosis is essential to prevent thecomplications of unicornuate uterus. Unicornuate uterus withrudimentary cavity is associated with increased rate of pregnancycomplications such as preterm labor and fetal malpresentation.Pregnancy can also occurred on the rudimentary cavity and leadsto recurrent pregnancy loss. Laparoscopy is essential for confirmatorydiagnosis. Surgical intervention should be considered asthe first line therapy to avoid associated morbidity.[Indones J Obstet Gynecol 2017; 5-4: 246-249]Keywords: hematometra, hysterectomy, unicornuate uterus
CC-Human Menopausal Gonadotropin Combined with Growth Hormone in Mini-stimulation Protocol could Improve Clinical Outcome in Poor Ovarian Responders Polim, Arie A; Sini, Ivan R; Anwar, Indra NC; Pradana, Aryando; Kurniawati, Kurniawati; Fani, Erliana
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (19.045 KB) | DOI: 10.32771/inajog.v3i2.43

Abstract

Objective: To investigate the role of CC-highly purified Human Menopausal Gonadotropin (hpHMG) and Growth Hormone (GH) in mini-stimulation protocol to improve outcome in poor ovarian responders (POR). Method: All patients were given clomiphene citrate 150 mg from day 3 to day 7 of menstrual cycle followed by 150 IU hpHMG daily from day 8 until ovulation trigger. Two groups were observed where one group received GH and the other arm did not. In the GH group, 8 IU of GH were given from day 1 of stimulation until stimulation was stopped. GnRH antagonist was used to suppress ovulation. Result: Among 51 eligible women, 29 patients with GH and 22 patients without GH, no difference was observed in the number of oocytes retrieved (2.21 versus 2.64) and the number of embryos transferred (1.24 versus 1.68) in the GH group versus the group without GH, respectively. Total clinical pregnancy rate was 17.6%. No significant difference in pregnancy and ongoing pregnancy rate in both groups (17.2% versus 18.2%) and (13.8% versus 13.6%), respectively. In patients older than 40 years old, GH showed a 4-fold likelihood in producing top quality embryos (44.8% vs 13.6%, OR=3.6, p=0.05). Conclusion: CC-HMG regimen in mini-stimulation protocol is an effective option in poor responders. Additional GH in ministimulation program provided a higher number of top quality embryos in women older than 40 years old, although there were no difference in clinical or ongoing pregnancy rate. Keywords: CC-HMG, growth hormone, IVF, mini-stimulation protocol, poor ovarian responders
Hysterectomy to the Unicornuate Uterus Suffering of Hematometra Pramayadi, Cepi T; Nurliana, Imma; Fani, Erliana
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (405.7 KB) | DOI: 10.32771/inajog.v5i4.571

Abstract

Objective: Unicornuate uterus with rudimentary cavity is anextremely rare Mullerian duct anomaly. It is frequently misdiagnosedor under treated, since women who suffer from thiscondition tend to be asymptomatic. We aimed to report thisinteresting case and review the available background literature.Methods: Case report.Case: A thirty two-year-old nulligravid woman was presentedwith severe abdominal pain. Laparoscopic surgery demonstratedunicornuate uterus with arudimentary cavity and hematometra.Partial hysterectomy was conducted to the right rudimentaryuterus.Conclusion: Thorough diagnosis is essential to prevent thecomplications of unicornuate uterus. Unicornuate uterus withrudimentary cavity is associated with increased rate of pregnancycomplications such as preterm labor and fetal malpresentation.Pregnancy can also occurred on the rudimentary cavity and leadsto recurrent pregnancy loss. Laparoscopy is essential for confirmatorydiagnosis. Surgical intervention should be considered asthe first line therapy to avoid associated morbidity.[Indones J Obstet Gynecol 2017; 5-4: 246-249]Keywords: hematometra, hysterectomy, unicornuate uterus
How to Recognize, Prevent and Address Complications of Laparoscopic Gynecologic Surgery Pramayadi, cepi T; Fani, Erliana
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 (244.523 KB) | DOI: 10.32771/inajog.v6i4.896

Abstract

AbstractObjective: to highlight the needs of awareness on recognizing, prevent and address complications in laparoscopic gynecologic surgery.Method: Literature reviewDiscussion: The complications of laparoscopic gynecologic surgery mainly can be classified as complications related to anesthesia, entry technique, electrosurgical, postoperative and visceral due to surgical procedure itself. Lam proposed a 6 phase-based classification of laparoscopic surgery complications; patient identification, anesthesia and positioning, abdominal entry and port placement, surgery, postoperative recovery and counselling. The aim of this classification is to promote a culture risk management to improve patient safety and outcome. Each and every phase above should be able to assessed, analyzed and executed properly to prevent complications. Conclusion: Complication in operative laparoscopy is generally minor and can be handled successfully. However, although very rare, major complications are detrimental to the patient. It also becomes heavy burden for the surgeons. Preventive measures should be implemented not only by the operator but also the anesthesiologist, and theatre practitioners. Systematic drills, which regularly re rehearsed is important in order to maintain team proficiencies. Keywords: complications, gynecologic laparoscopy, operative Laparoscopy   Abstrak Tujuan: Untuk menekankan pentingnya mengenali, mencegah dan mengatasi secara dini komplikasi operasi laparoskopi ginekologi. Metode: Kajian pustaka Diskusi : Komplikasi operasi ginekologi laparoskopi dapat diklasifikasikan menjadi komplikasi yang berhubungan dengan anestesi, teknik masuknya trokar utama, terkait elektro surgikal, komplikasi pascaoperasi dan komplikasi visera (pembuluh darah, usus, cedera traktus urinarius) terkait tindakan operasi itu sendiri. Lam mengusulkan suatu klasifikasi berbasis fase, antara lain, identifikasi pasien, anestesi dan posisi pasien, akses masuk abdomen dan penempatan trokar, terkait operasi, pemulihan pascaoperasi dan konseling. Tujuan dari klasifikasi ini adalah untuk meningkatkan budaya sadar risiko,guna meningkatkan keselamatan pasien. Setiap tahap harus dapat dilaksanakan, dinilai dan dianalisis dengan baik untuk mencegah terjadinya komplikasi. Kesimpulan: Komplikasi pada operasi ginekologi laparoskopi umumnya ringan dan dapat ditangani dengan baik. Walaupun jarang terjadi, komplikasi berat umumnya sangat merugikan pasien dan menjadi beban operator. Langkah-langkah pencegahan ini harus dilaksanakan oleh operator, tim anestesi serta seluruh tim kamar operasi. Simulasi  harus dilaksanakan, guna mempertahankan kecakapan tim Kata kunci : komplikasi, laparoskopi ginekologi, laparoskopi operatif
Co-Authors Anwar, Indra NC Aryando Pradana Kurniawati Kurniawati Nurliana, Imma Polim, Arie A Pramayadi, cepi T Sini, Ivan R