Robotically assisted delayed total laparoscopic hysterectomy for placenta percreta

• Main Authors: Devon M. Rupley (Author), Ana I. Tergas (Author), Katherine L. Palmerola (Author), William M. Burke (Author)
• Format: Book
• Published: Elsevier, 2016-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2352-5789; 10.1016/j.gore.2016.05.009
• Keywords: Placenta percreta; Laparoscopic hysterectomy; Robotic surgery; Minimally invasive surgery; Morbidly adherent placenta; Delayed hysterectomy; Gynecology and obstetrics; RG1-991; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; RC254-282
• Source: Gynecologic Oncology Reports, Vol 17, Iss C, Pp 53-55 (2016)

Background: The prevalence of morbidly adherent placenta has dramatically increased in the setting of the rising cesarean rate in the United States. Delayed surgical management of placenta accreta and its variants is emerging as methods that may significantly decrease bleeding and perioperative complications; however, optimal surgical approaches have not yet been determined. In this report, we present a case of robotic-assisted delayed interval hysterectomy in a patient with placenta percreta. Method: A minimally invasive approach, via a robotic-assisted total laparoscopic hysterectomy, was utilized for a 39-year-old gravida 9 para 3 with placenta percreta with placenta left in situ ten weeks after a tertiary cesarean section. Experience: The robotic approach provided excellent visualization to facilitate fine planes of dissection, lower than expected estimated blood loss, and faster recover times when compared with conventional surgical approaches traditionally utilized for interval hysterectomies for placenta percreta. Conclusion: Robotic-assisted hysterectomy may be considered as an alternative to laparotomy for the delayed interval surgical management of morbidly adherent placenta percreta.