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Objetivo. Revisar los resultados del tratamiento quirúrgico, mediante abordaje laparoscópico, de los cuadros de dolor abdominal agudo habidos en un Servicio de Urgencias de un hospital general. Material y método. Estudio observacional, prospectivo, de las urgencias ginecológicas originadas por un cuadro de dolor abdominal y tratadas mediante cirugía laparoscópica. Los parámetros fundamentalmente evaluados fueron el origen del cuadro de dolor, el tipo de cirugía realizada y las complicaciones habidas. Resultados. En el periodo comprendido entre enero de 2009 y diciembre de 2011 hemos realizado 110 cirugías laparoscópicas urgentes por dolor abdominal: 40 casos (36,7%) por rotura de un quiste de ovario, 24 (21,8%) por embarazo ectópico, 23 (20,9%) por enfermedad inflamatoria pélvica, 12 (10,9%) por torsión anexial y 11 (10%) por otras causas. En estas 110 cirugías hemos tenido una reintervención por hemoperitoneo (0,9%) y un caso de conversión a cirugía laparotómica (0,9%). Conclusiones. El abordaje laparoscópico de la enfermedad ginecológica urgente es seguro y efectivo (AU)

Objectives. To assess the effectiveness of the laparoscopic approach in acute abdominal pain in women of reproductive age presenting to the Emergency Department. Material and methods. We performed an observational, prospective study of acute abdominal pain treated by gynecological laparoscopic procedures. The main variables evaluated were the cause of pain, type of surgery, complications, and conversions to open surgery. Results. Between January 2009 and December 2011, we performed 110 urgent laparoscopic interventions. The reasons for surgery were rupture of an ovarian cyst in 40 interventions (36.7%), an ectopic pregnancy in 24 (21.8%), a pelvic inflammatory disease in 23 (20.9%), adnexal torsion in 12 (10.9%), and other reasons in 11 (10%). In these 110 interventions, there was one case of postoperative bleeding requiring reintervention and one case of conversion. Conclusions. The laparoscopic approach is safe and effective in urgent gynecological surgery (AU)

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Objetivo. Revisar las indicaciones y resultados de 1.000 cirugías laparoscópicas consecutivas. Material y métodos. Estudio observacional, retrospectivo, mediante los registros de las historias clínicas de los 1.000 primeros casos de patología ginecológica tratados mediante cirugía laparoscópica. Los parámetros fundamentalmente evaluados fueron la tasa de complicaciones quirúrgicas y la tasa de conversión. Resultados. En el periodo comprendido entre enero de 2005 y noviembre de 2011 hemos realizado 1.000 cirugías laparoscópicas: 452 casos (45,2%) por cirugía sobre los anejos, 200 (20%) por histerectomía por causa benigna, 105 (10,5%) por neoplasia ginecológica, 88 (8,8%) por esterilización tubárica, 75 fueron (7,5%) laparoscopias diagnósticas, 56 (5,6%) por miomectomía, 19 (1,9%) por colposacropexia y en 5 casos (0,5%) se realizó una apendicetomía. En estas 1.000 cirugías hemos tenido 22 complicaciones mayores (2,2%) y 32 conversiones a cirugía laparotómica (3,2%). Conclusión. El abordaje laparoscópico de la patología ginecológica es seguro y efectivo(AU)

Objectives: To review the indications and outcomes of 1,000 consecutive laparoscopic surgeries. Material and methods: We carried out an observational, retrospective study of the first 1,000 gynecological laparoscopic procedures performed in our hospital. Data on complications and conversions were recorded. Results: Between January 2005 and November 2011, we performed 1000 laparoscopic surgeries: 452 (45.2%) ovarian procedures, 200 (20%) hysterectomies for benign causes, 105 (10.5%) gynecological neoplasms, 88 (8.8%) tubal ligations, 75 (7.5%) diagnostic laparoscopies, 56 (5.6%) myomectomies, 19 (1.9%) sacropexies and 5 (0.5%) appendectomies. There were 22 major complications (2.2%) and 32 conversions to open surgery (3.2%). Conclusion: The laparoscopic approach to gynecological surgery is safe and effective(AU)

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La cirugía reductora de los labios menores es un proceso poco común, cuya demanda va en aumento. Aunque existen causas funcionales para realizar la reducción, cada vez más se realiza por problemas estéticos y psicológicos. Recientemente, se han desarrollado varias técnicas conservadoras, dado que la simple amputación no asegura un resultado funcional favorable. Revisamos las técnicas quirúrgicas y presentamos el caso de una paciente adolescente con hipertrofia labial resuelta exitosamente con cirugía(AU)

Labia minora reduction surgery is uncommonly performed but demand for this procedure is increasing. Although there are functional reasons for this type of surgery, it is increasingly performed for aesthetic and psychological motives. Recently, various conservative techniques have been developed to minimize the possible negative consequences of more aggressive techniques. In this article, we review the different approaches to this surgery and present the case of a young adolescent girl who was successfully treated(AU)

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Objetivo. Valorar la eficacia del abordaje laparoscópico en los casos de adenocarcinoma endometrioide de endometrio. Material y método. Estudio observacional, retrospectivo, mediante los registros de la historias clínicas de los casos de adenocarcinoma endometriode de endometrio diagnosticados en nuestro hospital entre los meses de enero de 2005 y diciembre de 2009 y tratados mediante cirugía laparoscópica. Los parámetros fundamentalmente evaluados fueron la tasa de complicaciones quirúrgicas y la tasa de supervivencia. Resultados. De los 60 casos de adenocarcinoma endometrioide diagnosticados, 52 (86,7%) fueron tratados mediante cirugía primaria por vía laparoscópica. Se produjeron un 5% de complicaciones intra y postoperatorias inmediatas y la tasa de supervivencia en el momento del análisis fue del 93,3%. Conclusiones. El abordaje laparoscópico de la cirugía del adenocarcinoma endometrioide de endometrio es factible, seguro y presenta unas tasas de éxito similares a la vía abdominal clásica (AU)

Objectives. To assess the efficacy of the laparoscopic approach in cases of endometrioid carcinoma of the corpus uteri. Material and methods. We performed an observational, retrospective study of cases of endometrial carcinoma diagnosed in our hospital between January 2005 and December 2009 and treated by laparoscopic surgery. The main variables analyzed were the rates of surgical complications and survival. Results. Of the 60 cases of endometrial endometrioid adenocarcinoma diagnosed, 52 (86.7%) were treated with the laparoscopic approach. The rate of intra- and immediate postoperative complications was 5% and the overall survival rate at the time of the analysis was 93.3%. Conclusions. In endometrial endometrioid carcinoma, the laparoscopic approach is safe and provides similar success rates to the classical abdominal approach (AU)

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OBJECTIVE: To assess the acceptability of the levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena®) in the long-term treatment of heavy menstrual bleeding. STUDY DESIGN: Retrospective study of all consecutive women who had a LNG-IUS inserted for control of idiopathic heavy menstrual bleeding between January 2000 and December 2003. Duration of use, reasons for early removal, number of devices removed after 5 years of use, and number of women who decided to use a second LNG-IUS were assessed. RESULTS: Of a total of 216 devices inserted, 129 (59.7%) were removed after 5 years of use, 68 (31.5%) were removed anytime before the completion of 5 years, and the remaining 19 (8.8%) patients were lost to follow-up. In 32 of the 68 cases (47.1%) with early removal of the LNG-IUS, the main reason for discontinuation was the appearance of the menopause. After the 5-year effective lifetime of the LNG-IUS, 51 of the 129 women (39.5%) chose to have a second device inserted. Of the 78 women who completed the 5-year treatment period and did not decide to use the LNG-IUS again, 71 (91%) had reached the menopause. CONCLUSION: The LNG-IUS was well accepted by women with idiopathic heavy menstrual bleeding as shown by 39.5% of users (or 87.9% if menopausal women are excluded) deciding to use a second device when the first LNG-IUS expired after 5 years of use.

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