Abstract
Previously we reported laparoscopic removal of compression sutures due to uterine ischemia and related pain, which has two of the difficult aspects: (1) maneuvering the curved needle to perform compression suturing in the narrow surgical field, and (2) distinguishing between the threads of the cesarean section wound sutures versus the vertical compression sutures during removal, as the threads are the same white color. We performed vertical compression sutures for intrapartum hemorrhage with total placental previa, and modified both the needle type and the color of the thread used for uterine compression sutures during cesarean section. After the operation, we performed successful laparoscopic removal of compression sutures for postoperative focal pain. Changing the needle type and color helped to perform operations. The present case supports the concept that the laparoscopic removal of uterine compression suturing is useful for controlling pain in cases where general analgesics are ineffective.
Highlights
We reported laparoscopic removal of compression sutures due to uterine ischemia and related pain, which has two of the difficult aspects: (1) maneuvering the curved needle to perform compression suturing in the narrow surgical field, and (2) distinguishing between the threads of the cesarean section wound sutures versus the vertical compression sutures during removal, as the threads are the same white color
Contrast-enhanced magnetic resonance imaging (MRI) did not clearly reveal uterine ischemia and necrosis, but due to the small hematoma (20 Â 5 mm) surrounding the ligation of the right descending uterine artery and/or right vertical compression suture on postoperative day 1, we considered that the local pain was associated with uterine ischemia (►Fig. 1b–e)
To the best of our knowledge, at least four case reports described the use straight needles for uterine compression sutures, but did not discuss the effectiveness of this method,[5,6,7,8] while recently one retrospective study was first reported the use of dedicated blunt straight needles and sutures for uterine compression sutures of modified Hayman suture.[4]
Summary
We reported laparoscopic removal of compression sutures due to uterine ischemia and related pain, which has two of the difficult aspects: (1) maneuvering the curved needle to perform compression suturing in the narrow surgical field, and (2) distinguishing between the threads of the cesarean section wound sutures versus the vertical compression sutures during removal, as the threads are the same white color. We performed vertical compression sutures for intrapartum hemorrhage with total placental previa, and modified both the needle type and the color of the thread used for uterine compression sutures during cesarean section.
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