RODRIGO PINTO FERNANDES
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
24 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 24
- Segmental and Discoid Resection are Preferential to Bowel Shaving for Medium-Term Symptomatic Relief in Patients With Bowel Endometriosis(2016) AFORS, Karolina; CENTINI, Gabriele; FERNANDES, Rodrigo; MURTADA, Rouba; ZUPI, Errico; AKLADIOS, Cherif; WATTIEZ, ArnaudObjective: To evaluate and compare medium-term clinical outcomes and recurrence rates in the laparoscopic surgical management of bowel endometriosis comparing 3 different surgical techniques (shaving, discoid, and segmental resection). Design: Retrospective study (Canadian Task Force classification II-2). Setting: Endometriosis tertiary referral center. Patients: A retrospective cohort of 106 patients with histological confirmation of bowel endometriosis undergoing laparoscopic surgical treatment between January 1, 2010, and September 1, 2012. Intervention: Assessment of laparoscopic bowel shaving, discoid or segmental resection for the treatment of painful symptoms related to deep endometriosis (DE) involving the bowel with 24 months of follow-up. Measurements and Main Results: A total of 92 patients were included in the study and were divided into 3 groups according to the surgical procedure performed (shaving, n = 47; discoid resection, n = 15; segmental resection, n = 30). All symptoms improved significantly in the immediate postoperative follow-up, with significant reduction in all visual analog scale scores for pain. Compared with the discoid resection and segmental resection groups, the shaving group had a significantly higher rate of medium-term recurrence of dysmenorrhea and dyspareunia. Furthermore, the shaving group had a higher rate of re intervention for recurrent DE lesions compared with the segmental resection group (27.6% vs 6.6%; relative risk [RR], 4.14; 95% confidence interval [CI], 1.0-17.1). Postoperative complication rates were similar across all 3 groups with a rate of major complications of 4.2% in the shaving group, 6.6% in the discoid resection group, and 6.6% in the segmental resection group. According to our data, the patients with a nodule >3 cm had an RR of 2.5 (95% CI, 1.66-3.99) of requiring bowel resection. Conclusion: All 3 treatment modalities are effective in terms of immediate symptom relief with acceptable complication rates. However, significantly higher rates of symptom recurrence and reintervention were noted in the shaving group, whereas segmental resection is more likely to be indicated in cases of large nodules.
conferenceObject In Bag Morcellation: details and logistics of the technique(2016) FERNANDES, R.; ARAUJO, M.; SILVA, A. Silva e; CARVALHO, P. Mancusi de; ANTON, C.; GENTA, M. L. Nogueira Dias; RIBEIRO JR., A. Dias; SAMPAIO, D.; MIGLINO, G.; SADALLA, J. C.; CARVALHO, J. Paula- BORDERLINE OVARIAN TUMORS-10 YEARS SINGLE CENTER EXPERIENCE(2019) FERNANDES, R.; ANTON, C.; SILVA, A. Silva e; CARVALHO, J. P. Mancusi; ARAUJO, M.; GENTA, M. L. Dias; SAMPAIO, D.; MIGLINO, G.; DIAS JR., A.; SADALLA, J. C.; CARVALHO, J. Paula
conferenceObject BORDERLINE OVARIAN CANCER: 6 YEAR EXPERIENCE FROM A SINGLE INSTITUTE(2015) FERNANDES, R.; ANTON, C.; NOBREGA, F. S.; FARIA, M. B. S.; SILVA, A. Silva E; CARVALHO, J. P.- Pudendal Neurolysis: 6-Step Laparoscopic Approach(2021) HABIB, Nassir; LABANCA, Luca; FERNANDES, Rodrigo; AFORS, Karolina; SOLIMA, Eugenio; MOAWAD, Gaby; CENTINI, GabrieleObjective: To demonstrate the safety and feasibility of the laparoscopic approach to perform pudendal neurolysis in a case of pudendal nerve entrapment syndrome [1- 3]. Design: A video tutorial that highlights the laparoscopic steps to performing pudendal neurolysis, with a focus on the main anatomic landmarks [4,5]. Setting: A tertiary care regional hospital. Interventions: This video shows a 6-step approach to laparoscopic pudendal neurolysis for the treatment of pudendal nerve entrapment between the sacrospinous and sacrotuberous ligaments [2,6- 8]. Step 1: Identification of the umbilical artery. Step 2: Dissection and development of the lateral paravesical space until the pelvic floor. Step 3: Identification of the arcus tendineus of the endopelvic fascia. Step 4: Identification of the ischial spine and the sacrospinous ligament covered by the coccygeus muscle. Step 5: Coagulation and section of the coccygeus muscle and the sacrospinous ligament. Step 6: Medialization of the pudendal nerve until its entrance into the Alcock canal. Conclusion: This video demonstrates the safety, feasibility, and reproducibility of laparoscopic pudendal neurolysis in 6 steps. A minimally invasive approach is adequate to treat the pudendal compression until the Alcock canal [2].
- Stepwise Laparoscopic Myomectomy and the Baseball Closure(2021) FERNANDES, Rodrigo Pinto; FIN, Fabio; MAGALHAES, Raquel; PAREJA, Rene; ROMEO, Armando; TSUNODA, Audrey; WATTIEZ, ArnaudStudy Objective: To demonstrate the importance of planning all the steps of laparoscopic myomectomy, including incision, techniques to reduce blood loss, and suturing. Design: Step-by-step video demonstration of the technique, with narration in the background. The video was approved by the local institutional review board. Setting: Live surgery at Hospital PIO XII, Institute for Research into Cancer of the Digestive System and American Institute of Telesurgery, Barretos. Interventions: We describe a case of a 33-year-old woman with no pregnancy and diagnosed with endometriosis and chronic pelvic pain associated with a 5-cm posterior transmural myoma. We performed a laparoscopic myomectomy, with temporary clipping of the uterine arteries associated with the treatment of endometriosis lesions. Specimen extraction was performed inside a bag [1]. The patient was discharged the next day with no complications. Ten months after the procedure, the patient reported that there was no pain, and that her menses were normal. Conclusion: The laparoscopic approach remains the gold standard for myomectomy [2]. Planning the steps before execution is fundamentally important to ensure the security of the procedure. A seromuscularis baseball suture associated with figure-of-8 knotting with an H3H2 sequence at the internal layers seems to be an adequate technique for myometrium closure [3]. Choosing the correct angle for the incision, clipping the uterine artery, and developing the suture in 2 layers results in less bleeding, reduced operating time, decrease in hospital length of stay, and fewer complications.
- Laparoscopic Dissection of the Pelvic Ureter: Rules of Engagement(2019) CENTINI, Gabriele; LABANCA, Luca; AFORS, Karolina; ARGAY, Istvan; FERNANDES, Rodrigo; HABIB, Nassir; WATTIEZ, ArnaudStudy Objective: To point out the relevant anatomy of the ureter and to demonstrate its rules of dissection. Design: An educational video to explain how to use ureteral relevant anatomy and the principle of dissection to perform safe ureterolysis during laparoscopic procedures. Setting: A tertiary care university hospital and endometriosis referential center. Interventions: Anatomic keynotes of the ureter and examples of ureterolysis. Conclusion: This video shows the feasibility of laparoscopic ureteral dissection and provides safety rules to perform ureterolysis. Identification and dissection of the ureter should be part of all gynecologic surgeons' background to reduce the risk of complications [1]. Knowledge of anatomy plays a pivotal role, allowing the surgeon to keep the ureter at a distance and minimizing the need for ureterolysis. Unfortunately, the need for ureteral dissection is not always predictable preoperatively, and gynecologic surgeons need to master this technique, especially when approaching more complex procedures such as endometriosis [2]. An implicit risk of damage cannot be denied when performing ureterolysis; therefore, the ureter should be dissected only when strictly necessary and handled with care to minimize the use of energy [3]. (c) 2018 Published by Elsevier Inc. on behalf of AAGL.
- Persistent postoperative ascites successfully identified and treated with laparoscopic indocyanine green fluorescence(2020) FERNANDES, Rodrigo; ANTON, Cristina; LOPES, Andre; SILVA, Alexandre Silva e; LEBLANC, Eric; JR, Ulysses Ribeiro; CARVALHO, Jesus Paula
conferenceObject IATROGENIC INJURY OF THE OBTURATOR NERVE DURING PELVIC LAPAROSCOPIC LYMPHADENECTOMY: ANALYSIS OF THE CORRECTION 5 YEARS LATER(2016) DIAS, A. J. Ribeiro; SILVA, A. Silva e; FERNANDES, R. Pinto; ANTON, C.; ARAUJO, M.; MORAES, A.; BARROS, L.; CARVALHO, J. P.; BARACAT, E. C.- Standard Approach to Urinary Bladder Endometriosis(2018) FERNANDES, Rodrigo Pinto; CENTINI, Gabriele; AFORS, Karolina; PUGA, Marco; ALVES, Joao; WATTIEZ, Arnaud
- «
- 1 (current)
- 2
- 3
- »