ectomy is combined with segmental resection of therectosigmoid where its peritoneum cannot be detached. Themain focus of the video is to demonstrate the feasibility andefficacy of this ultra-extensive resection, en bloc resectionof the uterus, adnexas and low rectum along with totalpelvic peritoneum, using minimally invasive laparoscopictechniques.

391

Robot-assisted Laparoscopic Sacrocolpopexy for theTreatment of Recurrent, Isolated Apical Pelvic OrganProlapse – A Video Presentation of Surgical TechniqueAscher-Walsh CJ, Zhou S, Brodman M, Vardy M. MountSanai Medical Center, New York, New York

The objective of this video is to present the surgical man-agement of a patient with recurrent, isolated apical pelvicorgan prolapse with the aid of the daVinci robotic system inperforming a laparoscopic supracervical hysterectomy, bi-lateral salpingo-oophorectomy, and sacrocolpopexy withsynthetic mesh. A 72 year old female with a previous rightsacrospinous ligament fixation and anterior and posteriorcolporrhaphy two years earlier, had a resection of the rightsacrospinous ligament fixation stitch one year later, second-ary to persistent, right-sided gluteal pain. Apical descentrecurred within one year. Procedural time � 3 hours 32minutes. EBL � 50cc. No surgical complications. Hospi-talization � 1 day. 2 months post-operative the patient hadno prolapse.

392

Simplifying Laparoscopic Staging in the Obese Patient:A Combined Retroperitoneal and IntraperitonealTechniqueBurnett AF. University of Arkansas for Medical Sciences,Little Rock, Arkansas

The present study details experience combining retroperi-toneal para-aortic lymphadenectomy with transperitonealpelvic lymph node removal and hysterectomy to stage gy-necologic cancer patients. Seventeen women were staged bya combined retroperitoneal/transperitoneal approach. Theaortic lymph nodes were removed extraperitoneally. Stag-ing was then completed with transperitoneal pelvic lymph-adenectomy and laparoscopic hysterectomy. The mean BMIwas 30.8. No patient required blood transfusion. The meanaortic lymph nodes was 5.7 and the mean pelvic lymphnodes was 9.3. Average length of stay was 1.9 days. Therewere no post-operative complications. By combining retro-peritoneal and transperitoneal approaches, surgical stagingof gynecologic cancer patients can be simplified. This ap-proach will work particularly well in the obese patient.

393

Uterine Polypoid Hemangioma: An Uncommon Case ofVaginal Bleeding Treated by HysteroscopyChang Y, Kay N. Chang Gung Memorial Hospital, Tao-Yuan, Taiwan

Objective: Polypoid hemangiomas are rare entities in gy-necology.Design: The patient suffered from menorrhagia for oneyear. Under hysteroscopy, a polypoid lesion was found andlarge amount of bleeding during polypectomy was noted.Placement of a Foley bulb in the uterus was performed. Thediagnosis of hemangioma was confirmed by histopathology.Results: Three months follow-up by hysteroscopy reveal noresidual lesion.Conclusion: Hysteroscopic treatment of a polypoid heman-gioma was successful. An inflated Foley probe may be anefficient means of stopping hemorrhage.

394

Laparoscopic Lysis of Adhesions for SevereEndometriosis with a Right Ureteral Stricture1Choi SJ, 2Jang A, 1S Choi. 1Gwangju City, Choennam,Korea; 2Philadelphia, Philadelphia

This video presents a 36 year old nulliparous female withcomplaints of persistent right flank pain eight months afterher initial diagnostic laparoscopy for ablation of endome-trial implants. An IVP was performed, showing right hy-dronephrosis and extrinsic compression of the right ureter.This video demonstrates successful laparoscopic lysis ofadhesions surrounding the right ureter. The ureteral strictureis revealed, the ureter is repositioned, and wrapped withomentum and Intercede [Tc7] to prevent further adhesionformation. The patient had improvement of pain and anormal IVP 3 months post-operatively.

395

Total Vaginal Hysterectomy With Transvaginal AssistedSacrocolpopexyChoi SJ, Jung H, Lim Y. Gwangju City, Choennam,Korea

This video demonstrates a novel approach to the femalewith uterine prolapse. Using a combination of vaginal andlaparoscopic techniques, the patient’s prolapse was treatedeffectively.A 65 year old female with complaints of pelvic heaviness,a protruding mass from the vagina and difficulty with uri-nation underwent surgery. A total vaginal hysterectomy wascompleted.We then performed sacrocolpopexy via a vaginal and lapa-roscopic approach. The mesh was attached to the vagina viaa transvaginal approach. The mesh was fixed in the longi-tudinal ligament over the sacral promontory laparoscopi-cally. As a result of the operation, the vagina is in good

S141DVD Presentations