Gynaecological Endoscopy最新文献

{"title":"Complications of laparoscopic entry","authors":"R. Garry MD frcog","doi":"10.1111/j.1365-2508.1997.151-gy0558.x","DOIUrl":"10.1111/j.1365-2508.1997.151-gy0558.x","url":null,"abstract":"","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"6 6","pages":"319-329"},"PeriodicalIF":0.0,"publicationDate":"2003-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-2508.1997.151-gy0558.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78571614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of intestinal obstruction following transperitoneal laparoscopic colposuspension","authors":"A. Govind mrcog,&nbsp;C. W. F. M. Cox frcog","doi":"10.1111/j.1365-2508.1997.127-gy0544.x","DOIUrl":"10.1111/j.1365-2508.1997.127-gy0544.x","url":null,"abstract":"<p>We present the case of a patient who underwent a seemingly uneventful laparoscopic colposuspension. She appeared to bleed from one of the laparoscopic ports postoperatively and her haemoglobin level dropped. She became unwell on the eighth postoperative day. A diagnosis of small bowel obstruction was made from a plain X-ray film and the cause of this was revealed only at laparotomy. This case highlights a previously unreported cause of small bowel obstruction secondary to haematoma.</p>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"6 6","pages":"369-371"},"PeriodicalIF":0.0,"publicationDate":"2003-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-2508.1997.127-gy0544.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88817182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histological results of salpingectomy for ectopic pregnancy: a series of 344 tubal pregnancies","authors":"J.-B. Dubuisson md,&nbsp;C. Chapron md,&nbsp;P. Morice md,&nbsp;M.-C. Vacher-Lavenue md","doi":"10.1111/j.1365-2508.1997.138-gy0546.x","DOIUrl":"10.1111/j.1365-2508.1997.138-gy0546.x","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To find out if knowledge of the type, location and extent of histological lesions to the tube might influence the choices for surgical treatment of ectopic pregnancy (EP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective clinical study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Department of Gynaecological Surgery, Clinique Universitaire Baudelocque, CHU Cochin Port-Royal, Paris, France.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects</h3>\u0000 \u0000 <p>Histological study of 344 cases of laparoscopic salpingectomy for EP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The EP was in a proximal location in 14.8% of cases (51 patients) and in a distal location in 85.2% of cases (293 patients). The tube was histologically normal in 17.7% of cases (61 patients). The rate of histologically normal tubes was significantly greater in patients with no past history of tubal problems (28.9%, 22 patients vs. 14.5%, 39 patients; <i>P</i> = 0.0004). In 32.3% of cases (111 patients) tube pathology was bifocal. The rate of bifocal tubal pathologies was significantly greater in cases of proximal EP (45.1%, 23 patients vs. 30%, 88 patients; <i>P</i> = 0.03). Proximal pathology is less often isolated than distal pathology (4.5%, 19 patients, vs. 44.5%, 153 patients).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Laparoscopic surgical treatment needs to be more radical (salpingectomy) when the EP is proximal and when the patient presents a past history of tubal surgery and/or infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"6 6","pages":"341-345"},"PeriodicalIF":0.0,"publicationDate":"2003-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-2508.1997.138-gy0546.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74827504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disinfection and sterilization in gynaecological endoscopy: problems and costs","authors":"M. Franchini md,&nbsp;L. Cianferoni md,&nbsp;A. Appicciafuoco md,&nbsp;A. R. Marseglia md","doi":"10.1111/j.1365-2508.1997.133-gy0551.x","DOIUrl":"10.1111/j.1365-2508.1997.133-gy0551.x","url":null,"abstract":"Objective \u0000To determine and compare the total costs of two low-temperature sterilization systems. \u0000 \u0000Design \u0000The direct and indirect costs of ethylene oxide and hydrogen peroxide plasma sterilization were recorded over a 6-month period. Break-even point analysis was performed to establish when the use of the gas plasma system represented a cost saving. \u0000 \u0000Results \u0000Hydrogen peroxide plasma sterilization represented a cost saving after 95 units of sterilization. \u0000 \u0000Conclusions \u0000Gas plasma sterilization was shown to be a valid method in hospital procedures with respect to both economy and quality.","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"6 6","pages":"359-362"},"PeriodicalIF":0.0,"publicationDate":"2003-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-2508.1997.133-gy0551.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85716334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic aspiration of ovarian cysts: an unreliable technique in primary diagnosis of (sonographically) benign ovarian lesions","authors":"F. W. Jansen md phD,&nbsp;S. Tanahatoe md,&nbsp;M. Veselic md,&nbsp;J. B. Trimbos md phd","doi":"10.1111/j.1365-2508.1997.137-gy0547.x","DOIUrl":"10.1111/j.1365-2508.1997.137-gy0547.x","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the value and limitations of aspiration cytology in the diagnosis of cystic lesions of the ovary which were predicted sonographically as benign.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A prospective study. All patients, pre- and postmenopausal, who were going to have a laparoscopic cystectomy or oöphorectomy had a laparoscopic aspiration of the cyst. Without knowledge of the patient's clinical history or the histology of the lesion, cytological evaluation was performed. Cytomorphological evaluation and prediction of the subsequent histological diagnosis was made.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between July 1994 and August 1996 60 aspirates were evaluated. Of the aspirates, 16 (27%) were not evaluable, according to our cytological criteria. The predictive value for discrimination between functional or neoplastic cysts was 65% (95% CI, 52–77%). Sensitivity and specificity were 91% (95% CI, 80–97%) and 67% (95% CI, 22–96%), respectively. The predictive value for the correct histological diagnosis was 42% (95% CI, 29–55%). The size of the cyst had no significant predictive value for the histological diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Cytological evaluation of aspirates of ultrasonographically benign ovarian cysts gives no additional information regarding the histology of the lesion. Because the therapeutic significance of this method is also low, aspiration of ovarian cysts should be abandoned.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"6 6","pages":"363-367"},"PeriodicalIF":0.0,"publicationDate":"2003-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-2508.1997.137-gy0547.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78814250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hysteroscopic findings in postmenopausal patients using tibolone","authors":"Hugo Maia,&nbsp;Simone Machado,&nbsp;Silvana Borges,&nbsp;Ariane Chagas,&nbsp;Amélia Maltez,&nbsp; Elsimar M. Coutinho","doi":"10.1046/j.1365-2508.2002.00495.x","DOIUrl":"10.1046/j.1365-2508.2002.00495.x","url":null,"abstract":"<div>\u0000 \u0000 <p><b>Objective</b> To investigate the cause of uterine bleeding in tibolone users who were referred to an endoscopy unit.</p>\u0000 <p><b>Design</b> Hysteroscopy followed by endometrial biopsy was carried out in all patients. The endometrial echo was measured by transvaginal sonography prior to hysteroscopy and compared with hysteroscopic findings.</p>\u0000 <p><b>Results</b> Endometrial polyps were the pathological lesions most frequently diagnosed by hysteroscopy in tibolone users. However, their diagnosis was missed by blind endometrial biopsy in all cases. The surrounding endometrium was always atrophic even when a polyp was present in the uterine cavity. There was one case of endometrial carcinoma which occurred in association with a polyp.</p>\u0000 <p><b>Conclusion</b> Tibolone does not exert any stimulatory effect on the normal endometrium. However, intrauterine lesions such as polyps can grow in response to this treatment. The presence of polyps is associated with abnormal uterine bleeding in these patients.</p>\u0000 </div>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"11 2-3","pages":"131-135"},"PeriodicalIF":0.0,"publicationDate":"2003-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.2002.00495.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84291582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hysteroscopic septal resection, the treatment of choice in patients with subseptate uterus: postoperative pregnancy rates","authors":"Peter Oppelt,&nbsp;Julia Siebold,&nbsp;Jan Stähler,&nbsp;Daniela Plathow,&nbsp;Manfred Kaufmann,&nbsp;Rudolf Baumann","doi":"10.1046/j.1365-2508.2002.00503.x","DOIUrl":"10.1046/j.1365-2508.2002.00503.x","url":null,"abstract":"<div>\u0000 \u0000 <p><b>Objective</b> Hysteroscopic septal resection for subseptate uterus is a modern alternative to the classic procedures of Tompkins and Jones. We therefore investigated whether this new operation, which is less stressful for the patient, and can usually be carried out on an outpatient basis, can produce results similar to those of the classic laparotomy methods in patients receiving treatment for infertility.</p>\u0000 <p><b>Design</b> Questionnaires were sent to 14 women who had undergone hysteroscopic surgery for infertility and known subseptate uterus at the University Department of Gynaecology in Frankfurt-am-Main.</p>\u0000 <p><b>Results</b> Nine patients responded, six of whom had become pregnant after hysteroscopic resection of the septum. This corresponds to the results achieved with laparotomy methods.</p>\u0000 <p><b>Conclusion</b> These results, like those of the few other studies on the topic in the literature, show that hysteroscopic septal resection in infertile patients offers a low-stress, fast and outpatient alternative to the elaborate classic techniques of Tompkins and Jones.</p>\u0000 </div>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"11 2-3","pages":"123-126"},"PeriodicalIF":0.0,"publicationDate":"2003-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.2002.00503.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85488597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The route for hysterectomy: is it time to change?","authors":"Salim K. Najia,&nbsp;Kalsang Bhatia,&nbsp;Vince Hall","doi":"10.1046/j.1365-2508.2002.00504.x","DOIUrl":"10.1046/j.1365-2508.2002.00504.x","url":null,"abstract":"<div>\u0000 \u0000 <p><b>Objective</b> To determine the proportion of hysterectomies done by the vaginal route for all benign gynaecological indications, at our centre, and to assess our performance with respect to the feasibility of bilateral salpingo-oöphorectomy, and also to identify any major complications.</p>\u0000 <p><b>Design</b> A retrospective analysis of case notes on 99 consecutive hysterectomies done for benign gynaecological indications.</p>\u0000 <p><b>Setting</b> A district general hospital.</p>\u0000 <p><b>Results</b> Out of 99 hysterectomies, 92 were done by the vaginal route, (excluding four laparoscopy-assisted vaginal hysterectomies), with no significant major complications except for one conversion to laparotomy. Bilateral salpingo-oöphorectomy was successfully performed in 98.3% of patients in whom it was planned. There was no significant uterine prolapse in 78% of patients undergoing vaginal hysterectomy, and the largest uterus removed vaginally weighed 1146 g.</p>\u0000 <p><b>Conclusions</b> Vaginal hysterectomy is feasible in most patients with benign gynaecological indications. Where possible contraindications exist, the use of preliminary laparoscopy should be encouraged, to help in the proper selection of patients and perhaps to remedy any relative contraindications. Gynaecologists need to appraise the vaginal route, and there is a strong need to address training issues as far as vaginal surgery is concerned.</p>\u0000 </div>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"11 2-3","pages":"71-74"},"PeriodicalIF":0.0,"publicationDate":"2003-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.2002.00504.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84690820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microwave endometrial ablation: does endometrial thickness or the medium for preoperative hysteroscopy affect the depth of ablation?","authors":"Sarah Wallage,&nbsp;Kevin G. Cooper,&nbsp;Ian Miller","doi":"10.1046/j.1365-2508.2002.00514.x","DOIUrl":"10.1046/j.1365-2508.2002.00514.x","url":null,"abstract":"<div>\u0000 \u0000 <p><b>Objectives</b> To determine the depth of tissue necrosis following microwave endometrial ablation (MEA) after perioperative saline hysteroscopy, and to determine the effects of varying endometrial thickness on depth and regularity of necrosis after gas hysteroscopy.</p>\u0000 <p><b>Subjects</b> 15 premenopausal women undergoing hysterectomy for dysfunctional uterine bleeding at Aberdeen Royal Infirmary.</p>\u0000 <p><b>Methods</b> Endometrial thickness was measured by transvaginal ultrasound scanning. After cervical dilation a hysteroscopy was performed with carbon dioxide or saline before proceeding to MEA and then hysterectomy. A vital stain was used to assess the depth and regularity of endomyometrial necrosis in the excised uterus.</p>\u0000 <p><b>Results</b> The nitroblue tetrazolium stain was a simple and effective way of demonstrating the depth of necrosis. In this small study, saline hysteroscopy led to cornual sparing in some cases. There was no clear effect of endometrial thickness up to 8 mm with gas hysteroscopy.</p>\u0000 <p><b>Conclusions</b> Saline hysteroscopy may affect the clinical outcome of MEA. Aspiration of residual saline may minimize any negative effect. The depth and regularity of necrosis did not seem to be affected by endometrial thicknesses of up to 8 mm after gas hysteroscopy. It seems reasonable to proceed to a clinical trial to assess the outcome of postmenstrual MEA without hormonal endometrial preparation.</p>\u0000 </div>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"11 2-3","pages":"107-110"},"PeriodicalIF":0.0,"publicationDate":"2003-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2508.2002.00514.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80240753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized prospective trial of rigid and flexible hysteroscopy in an outpatient setting","authors":"Andrew J. Baxter,&nbsp;Barbara Beck,&nbsp;Kevin Phillips","doi":"10.1111/j.1365-2508.2002.00562.x","DOIUrl":"10.1111/j.1365-2508.2002.00562.x","url":null,"abstract":"<div>\u0000 \u0000 <p><b>Objective </b> To compare flexible and rigid hysteroscopy in an outpatient hysteroscopy clinic.</p>\u0000 <p><b>Design </b> A randomized, single-blinded prospective study.</p>\u0000 <p><b>Setting </b> A one-stop, outpatient hysteroscopy clinic in a district general hospital.</p>\u0000 <p><b>Subjects </b> 96 women referred to the clinic with abnormal uterine bleeding.</p>\u0000 <p><b>Main outcome measures </b> Patient pain scores, local anaesthetic usage, need for cervical dilation, quality of view, correlation of clinical and histological findings, duration of procedure, operator's assessment of the ease of the procedure.</p>\u0000 <p><b>Results </b> Data from 83 women were analysed; three declined to enter the study, one failed to complete the pain scores and nine also had an operative hysteroscopy. Immediate median pain scores were statistically lower in the flexible hysteroscopy group, 1.2 vs. 3.6 (<i>P</i> = 0.001). The difference persisted 30 min after the procedure (0.4 vs. 1.1, <i>P</i> = 0.031). Pain experienced with endometrial biopsy was similar in the two groups (2.5 vs. 3.0, <i>P</i> = 0.16). There were no statistical differences between the two study arms with regard to procedure duration, quality of view, need for cervical dilation, anaesthetic usage or operator assessment of the ease of the procedure. There was agreement in clinical and histological diagnoses in all cases. The operators’ assessment of patients’ pain level correlated highly with patient pain scores. There were no statistically significant differences in any end-point between the two operators.</p>\u0000 <p><b>Conclusion </b> Flexible hysteroscopy is associated with lower levels of patient discomfort than rigid hysteroscopy. Other study variables were comparable for the two types of hysteroscopy.</p>\u0000 </div>","PeriodicalId":100599,"journal":{"name":"Gynaecological Endoscopy","volume":"11 6","pages":"357-364"},"PeriodicalIF":0.0,"publicationDate":"2003-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1365-2508.2002.00562.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85749325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}