Person: ORHAN, ADNAN
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ORHAN
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ADNAN
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Publication Laparoscopic sacral colpopexy with polyester fiber suture: Ozerkan modification(Springer London, 2020-08-01) Özerkan, Kemal; Orhan, Adnan; Kasapoğlu, Işıl; Ata, Barış; Uncu, Gürkan; ÖZERKAN, KEMAL; ORHAN, ADNAN; KASAPOĞLU, IŞIL; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; AAH-9791-2021; K-2269-2016; AAT-3479-2021; V-5292-2019Introduction and hypothesis Mesh-related problems are significant complications of laparoscopic sacral colpopexy. The conventional technique precludes performing laparoscopic sacral colpopexy without using a mesh. We describe the Ozerkan modification for laparoscopic sacral colpopexy using a polyester fiber suture instead of a standard mesh and report 1-year objective and subjective outcomes. Methods Women diagnosed with stage >= 2 vaginal vault prolapse were prospectively recruited for the Ozerkan modification between 2015 and 2017. The primary outcome was the anatomic success of the repair, defined by objective parameters using the pelvic organ prolapse quantification system (stage 0 or 1). Secondary outcomes were subjective outcomes assessed with the quality of life scores. Results Twenty-two women underwent the Ozerkan modified laparoscopic sacrocolpopexy. Mean operation time was 85.6 min. Mean estimated blood loss was 71 ml. One patient was lost during the clinical follow-up in the outpatient clinic up to 1 year. Nineteen of 21 patients had stage 0 or 1 prolapse at the end of 1 year. Two patients were not satisfied with their pelvic floor after 1 year. Both the objective and subjective cure rates were 90.4%. There were no bladder or bowel complications during the peri- or postoperative period. Conclusions The new modification of laparoscopic sacral colpopexy seems a feasible and safe option to avoid mesh complications in the treatment of vaginal vault prolapse.Publication Mesh complications on youtube(Elsevier, 2020-09-01) Orhan, Adnan; ORHAN, ADNAN; Göktürk, Gözde Güner; Özerkan, Kemal; ÖZERKAN, KEMAL; Kasapoglu, Işıl; KASAPOĞLU, IŞIL; Aslan, Kiper; ASLAN, MÜNİR KİPER; Uncu, Gurkan; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; 0000-0002-9277-7735; K-2269-2016; AAH-9791-2021; AER-7173-2022; AAH-9694-2021; AAT-3479-2021; V-5292-2019Objective: There has been a heated discussion about mesh materials in urogynecology in recent years. The role of social media in this discussion is critical. This study aims to make a systematic analysis of videos uploaded to YouTube about mesh complications in urogynecology.Study Design: YouTube was searched using specific terms about mesh materials. The primary outcome was the relationship between the video characteristics-which were publisher identity, attitude, the main focus of the video country, and year- and the mesh debate in urogynecology.Results: We analyzed 1128 YouTube videos about mesh complications. There was no distinction between stress urinary incontinence and pelvic organ prolapse when referring to the mesh material in 79 % of the videos. 35.2 % of the videos were in the News group, 31.2 % were in the Patients group, 19.6 % were in the Doctors group, and 14.0 % were in the Lawyers group. Videos in the News (75.7 %), Patients (92.6 %), and Lawyers (99.4 %) groups mostly had a negative attitude, while videos in the Doctors (48.9 %) group mostly had an informative attitude. News (43.2 %) and Patients (51.2 %) group videos were predominantly from the United Kingdom. However, Lawyers (81.0 %) and Doctors (44.3 %) videos were predominantly from the USA. In the last three years, the news and patients videos have increased by an average of 40 % each year.Conclusion: YouTube has influenced the mesh dilemma with a negative attitude. As long as social media is at the center of this discussion, a healthy outcome cannot be achieved.Publication Are all antral follicles the same? Size of antral follicles as a key predictor for response to controlled ovarian stimulation(Taylor & Francis, 2021-06-21) Kasapoğlu, Işıl; Orhan, Adnan; Aslan, Kiper; Şen, Esra; Kaya, Ayşenur; Avcı, Berrin; Uncu, Gürkan; KASAPOĞLU, IŞIL; ORHAN, ADNAN; ASLAN, MÜNİR KİPER; KAYA, AYŞENUR; AVCI, BERRİN; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Histoloji ve Embriyoloji Anabilim Dalı.; 0000-0002-7558-8166; 0000-0002-9277-7735; AAH-9694-2021; AER-7173-2022; CXJ-7203-2022; V-5292-2019; JWJ-7388-2024; ELU-2357-2022; AAT-3479-2021The aim of this study was to evaluate whether antral follicle size has any value with respect to antral follicle count (AFC) in predicting ovarian response to controlled ovarian stimulation. Patients who were considered to be normal responders based on their ovarian reserve markers were consecutively recruited. Total AFC was the number of 2-10 mm follicles in both ovaries. Antral follicles were separated into two subgroups according to the size: 2-5 mm and 6-10 mm follicles. Patients were divided into two main groups according to ovarian response to COS. Group 1 (suboptimal response, 4-9 oocytes retrieved, n = 61) and Group 2 (normal responders, >= 10 oocytes retrieved, n = 65). Demographic parameters were comparable between the groups. The number of 2-5 mm follicles was significantly lower in the suboptimal response group (5 [4:7] and 8 [6:10], respectively, p < .001). The ratio of 2-5 mm follicles to total antral follicles was also significantly lower in Group 1 (44.4% and 75%, respectively, p < .001). The ratio of small antral follicles was positively correlated with ovarian response (r = 0.587, p < .001). In conclusion, the ratio of small (2-5 mm) antral follicles could be a more specific predictive marker than AFC for ovarian response.IMPACT STATEMENT What is already known on this subject? Prediction of the ovarian response during ovarian stimulation is commonly based on antral follicle count and anti-mullerian hormone. The ovarian response may be inadequate even in patients with normal antral follicle count and anti-mullerian hormone. What do the results of this study add? A high ratio of small-size (2-5 mm) basal antral follicles is a predictive factor for higher ovarian response to ovarian hyperstimulation. What are the implications of these findings for clinical practice and/or further research? To obtain optimal ovarian response, the antral follicles should be evaluated initially in a more detailed and systematic way by taking their sizes into consideration in addition to their counts. Small antral follicle count rather than whole antral follicle count may be beneficial for optimising the ovarian response. Future studies may determine the cut off values of small antral follicle count for high/poor ovarian response.Publication A meshless practical laparoscopic sacrohysteropexy modification and long-term outcomes(Elsevier, 2020-11-01) Orhan, Adnan; Özerkan, Kemal; Kasapoglu,Işıl; Ocakoğlu, Gökhan; Aslan, Kiper; Uncu, Gürkan; ORHAN, ADNAN; ÖZERKAN, KEMAL; KASAPOĞLU, IŞIL; OCAKOĞLU, GÖKHAN; ASLAN, MÜNİR KİPER; UNCU, GÜRKAN; Uludağ Üniversitesi/ Tıp Fakültesi/Doğum ve Jinekoloji Bölümü/Ürojinekol ve Minimal İnvas Jinekol Ünitesi; Uludağ Üniversitesi/Sağlık Bilimleri Enstitüsü/Biyoistatistik Anabilim Dalı; 0000-0002-7558-8166; 0000-0002-1114-6051; 0000-0002-9277-7735; V-5292-2019; AER-7173-2022; AAH-9694-2021; AAT-3479-2021; AAH-9791-2021; AAH-5180-2021; K-2269-2016Study Objective: To describe a new modification of laparoscopic sacrohysteropexy without using a mesh and report the 3-year outcomes.Design: A prospective cohort study.Setting: Minimally Invasive Gynecology Unit, Bursa Uludag University Hospital, Turkey.Patients: Women who were diagnosed with >= stage 2 uterine prolapse.Interventions: A laparoscopic sacrohysteropexy modification using a polyester fiber suture instead of a standard polypropylene mesh.Measurements and Main Results: The primary outcome was the anatomic success of the repair, with success defined as objective parameters using the pelvic organ prolapse quantification system. The secondary outcomes were subjective outcomes, which were assessed using the quality-of-life scales. Forty-seven women who underwent the procedure were followed up for a minimum of 3 years. Forty-four of the 47 patients had stage 0 or 1 prolapse at the end of the second year, according to the primary outcomes. The anatomic success rate was 93.6%. In the secondary outcomes, 2 patients were not satisfied with their pelvic floor after the second year. The subjective cure rate was 95.7%. There was a statistically significant improvement in both pelvic organ prolapse quantification and quality-of-life scores in the third postoperative year. The mean operating time was 84.6 minutes, and the mean estimated blood loss was 21.3 mL. There were no bladder or bowel complications in the perioperative or postoperative period.Conclusion: Laparoscopic sacrohysteropexy can be performed safely with this meshless modification in uterine prolapse as an alternative. (c) 2020 AAGL. All rights reserved.Publication Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy?(Springer, 2020-05-26) Aslan, Kiper; Orhan, Adnan; Türkgeldi, Engin; Süer, Ebru; Düzok, Nergis; Özerkan, Kemal; Ata, Barış; Uncu, Gürkan; ASLAN, MÜNİR KİPER; ORHAN, ADNAN; SÜER, EBRU; DÜZOK, NERGİS; ÖZERKAN, KEMAL; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-9277-7735; 0000-0002-7558-8166; 0000-0002-5008-3292; K-2269-2016; AAH-9716-2021; AAT-3479-2021; AAH-9791-2021; AER-7173-2022; AAU-2710-2020; AAH-9694-2021; V-5292-2019Objective To determine whether hemorrhage and complication rates vary according to the location of the dominant fibroid following laparoscopic myomectomy. Background Laparoscopic myomectomy is associated with less postoperative pain, analgesic requirement, shorter hospitalization period, and less febrile complications when compared to conventional laparotomy. Despite the advantages, complications like hemorrhage, blood transfusion, bowel and urinary tract injury, and conversion to laparotomy may be seen in laparoscopic myomectomy. We do not know whether the fibroid location affects these complications. Materials and methods Women, who underwent laparoscopic myomectomy at two different tertiary academic hospitals, were analyzed retrospectively. Only women with at least one intramural fibroid (Monroe type 3, 4, or 5) were included. Patients were categorized according to localization of the dominant fibroid, i.e., anterior uterine wall, posterior uterine wall, and fundus. Change in hemoglobin levels before and after surgery and complication rates were compared across categories. Results Two hundred nineteen women with a mean age of 35.7 +/- 6 years were included. There were 81 women with fundal fibroid, 56 with anterior wall, and 72 with posterior wall fibroid. The other ten women with intraligamentary and isthmic fibroid were excluded. The mean fibroid diameter was 6.7 +/- 2.6, 6.6 +/- 2.3, and 6.7 +/- 2.3 cm in the fundal, anterior, and posterior groups, respectively (p = 0.9). The median (25th-75th percentile) changes in hemoglobin levels were 1.5 (0.8-2.2), 1.3 (0.6-2.1), and 1.3 (0.9-2) g/dl in fundal, anterior, and posterior wall groups, respectively (p = 0.55). There were 5 (6.2%), 5 (8.9%), and 2 (2.8%) complications in fundal, anterior, and posterior wall groups, respectively (p = 0.33). Conclusion The incidence of hemorrhage or complication does not seem to vary depending on the fibroid location. However, the sample size was limited; observed values suggest that fibroid location does not affect hemorrhage and complication rates.Publication The comparison of outcomes between the "skeleton uterus technique" and conventional techniques in laparoscopic hysterectomies(Wolters Kluwer Medknow Publications, 2019-04-01) Orhan, Adnan; ORHAN, ADNAN; Kasapoğlu, Işıl; KASAPOĞLU, IŞIL; Ocakoğlu, Gökhan; OCAKOĞLU, GÖKHAN; Yürük, Oğuzhan; YÜRÜK, OĞUZHAN; Uncu, Gürkan; UNCU, GÜRKAN; Özerkan, Kemal; ÖZERKAN, KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi; 0000-0002-7558-8166; 0000-0002-1114-6051; V-5292-2019; K-2269-2016; AAT-3479-2021; AAH-9791-2021; AAI-4169-2021; AAH-5180-2021; HLG-6346-2023Aim: The aim of this study is to compare demographic characteristics, operative data, and complication rates of women who underwent total laparoscopic hysterectomy by the skeleton uterus technique (Skeleton-TLH) with those of women who underwent TLH by the standard technique (Standard-TLH) in a university teaching and research hospital.Materials and Methods: This retrospective study included 932 laparoscopic hysterectomies in a university teaching and research hospital between January 1, 2013 and December 31, 2017. Clinical characteristics, operative outcomes, and complications were recorded and compared for the two techniques.Results: In total, 932 laparoscopic hysterectomies were performed, 454 by Skeleton-TLH and 478 by Standard-TLH. The general demographic characteristics of the patients were similar; only gravida and parity were statistically significantly different between the groups (P < 0.001). Based on the primary outcomes (the operative data), total anesthesia time and main operation time were similar in the two groups. Estimated blood loss was statistically significantly lower in the Skeleton-TLH group than in the Standard-TLH group. Hospital stay was longer for the Skeleton-TLH group, and specimen weight was heavier. The secondary outcome was the complication rate. There were no differences between the Skeleton-TLH and Standard-TLH groups in the rates of all minor and major complications.Conclusion: TLH with the skeleton uterus technique is feasible and safe, especially for advanced pelvic surgeons. This technique not only provides retroperitoneal access to the pelvic spaces and good anatomical visibility; but it also delivers a safer laparoscopic hysterectomy by clamping the uterine arteries and monitoring the ureter throughout the operation.Publication Meckel gruber syndrome, a case report(Taylor, 2015-01-01) Aslan, Kiper; Aslan, Elif Kulahçı; Orhan, Adnan; Atalay, Mehmet Aral; ASLAN, MÜNİR KİPER; ASLAN, ELİF; ORHAN, ADNAN; Atalay, Mehmet Aral; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı; 0000-0002-9277-7735; 0000-0002-6553-1350; 0000-0002-7558-8166; 0000-0002-9685-956X; AER-7173-2022; AAH-9694-2021; V-5292-2019; JRN-8064-2023; GBG-9889-2022Introduction: Meckel-Gruber Syndrome was first described by J R Meckel in 1822. It is an autosomal recessive disorder, and is caused by the failure of mesodermal induction. The typical triad of Meckel-Gruber Syndrome (MGS) involves meningo-encephalocele, polycystic kidneys and postaxial polydactyly. The worldwide incidence varies from 1 in 1.300 to 1 in 140.000 live births.Case: In this report, we present a case of MGS in which the diagnosis was made at 19 weeks of gestation based on ultrasonographic findings of the typical triad of the disease (encephalocele, polycystic kidneys, and polydactyly) These features were suggestive of the diagnosis of Meckel Gruber Syndrome (MGS). She had also placenta previa totalis. The patient was counselled regarding the lethal outcome of MGS. Unfortunately, the family did not approve the termination of pregnancy. At the 32nd week, she referred to hospital with complaints of vaginal bleeding and uterine contractions. An emergency cesarean section was perfomed due to plasental malposition. A 1380 gr, female fetus was delivered. First and 5th minute Apgar scores were 1 and 0, respectively. Consequently, the baby died after 45 minutes of neonatal resuscitation.Conclusion: MGS is a lethal disorder. One cannot speak about survival of the fetus because of the pulmonary hypoplasia. The parents should be counseled about prognosis of the fetus and the outcome. Counselers should strictly give information about the recurrence risk for the next pregnancies.Publication Cutaneous fistulization of an ovarian mature cystic teratoma: An unusual occurrence(Karger, 2015-01-01) Atalay, Mehmet Aral; Orhan, Adnan; Atalay, Fatma Öz; Saydam, İlkay; Demir, Bilge Çetinkaya; Atalay, Mehmet Aral; ORHAN, ADNAN; ÖZ ATALAY, FATMA; Saydam, İlkay; ÇETİNKAYA DEMİR, BİLGE; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Patoloji Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Doğum ve Jinekoloji Bölümü; 0000-0002-9685-956X; 0000-0002-7558-8166; 0000-0001-6845-9991; AAH-9834-2021; V-5292-2019; GBG-9889-2022; JHC-4482-2023; DRD-3800-2022A bilobulated mature cystic teratoma (MCT) at the left ovary measuring 6 cm in diameter fistulized to the left lower quadrant of the anterior abdominal wall, contralateral to McBurney's point. This is the first reported case of a MCT fistulized to the skin. Symptoms, if present, usually depend on the size of the teratoma. However, most patients with a MCT are asymptomatic. Complications such as rupture of the cyst capsule are quite rare. Moreover, complication of fistulization is highly infrequent.Publication Laparoscopic evacuation of an early pregnancy(Elsevier Science Inc, 2019-03-01) ÖZERKAN, KEMAL; ÇETİNKAYA DEMİR, BİLGE; ORHAN, ADNAN; Orhan, Adnan; Demir, Bilge Cetinkaya; Kasapoglu, Işıl; Uncu, Gürkan; UNCU, GÜRKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/KAdın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0002-7558-8166; 0000-0001-6845-9991; AAH-9791-2021; K-2269-2016; AAH-9834-2021; V-5292-2019; AAT-3479-2021