The Journal of the American Association of Gynecologic Laparoscopists最新文献

{"title":"Low-energy trauma-induced intercondylar femoral fracture.","authors":"Mathias Aeby, Tobias Wyss, Birgit Mentrup, Erdmute Kunstmann, Franz Jakob, Daniel Aeberli","doi":"10.11138/ccmbm/2016.13.2.151","DOIUrl":"10.11138/ccmbm/2016.13.2.151","url":null,"abstract":"<p><p>We present a 44-year-old female patient with recurrent fragility fractures including an intercondylar femoral fracture and with normal planar bone densitometry. Diagnosis of hypophosphatasia was suggested by low volumetric cortical bone mineral density and laboratory findings. DNA sequencing revealed heterozygous mutations in the exons 5, 6 and 9 of the ALPL gene, thus confirming the suspected diagnosis.</p>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"8 3 1","pages":"151-153"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5119715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78329816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramural Pregnancy","authors":"Keng Wee Tay M.D. ,&nbsp;Wai Cheung M.D. ,&nbsp;Ka-Ming Mok M.D.","doi":"10.1016/S1074-3804(05)60071-0","DOIUrl":"10.1016/S1074-3804(05)60071-0","url":null,"abstract":"","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Page 447"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1074-3804(05)60071-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24948759","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 Fundamental Manipulations of Surgery: A Structured Vocabulary for Designing Surgical Curricula and Simulators","authors":"Dr. William LeRoy Heinrichs M.D., Ph.D. ,&nbsp;Sakti Srivastava M.B., B.S., M.S. ,&nbsp;Dr. Kevin Montgomery Ph.D. ,&nbsp;Parvati Dev Ph.D.","doi":"10.1016/S1074-3804(05)60073-4","DOIUrl":"10.1016/S1074-3804(05)60073-4","url":null,"abstract":"<div><p>A structured vocabulary is proposed for supporting the design and development of advanced surgical simulators. Nine fundamental surgical instrument-tissue actions or manipulations are defined and common synonyms provided. The vocabulary focuses on “target skills” that are familiar to surgeons, in comparison with “enabling skills” from the lexicon of instructional designers and psychometricians. The adoption of this vocabulary can facilitate communication among surgeons and bioengineers developing “high-fidelity” surgical simulators.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Pages 450-456"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1074-3804(05)60073-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24948761","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":"Effect of Humidified and Heated CO2 During Gynecologic Laparoscopic Surgery on Analgesic Requirements and Postoperative Pain","authors":"Dr. Stefan Kissler M.D. ,&nbsp;Dr. Marianne Haas M.D. ,&nbsp;Dr. Renate Strohmeier Ph.D. ,&nbsp;Dr. Hubert Schmitt M.D. ,&nbsp;Dr. Achim Rody M.D. ,&nbsp;Dr. Manfred Kaufmann M.D. ,&nbsp;Dr. Ernst Siebzehnruebl M.D.","doi":"10.1016/S1074-3804(05)60078-3","DOIUrl":"10.1016/S1074-3804(05)60078-3","url":null,"abstract":"<div><h3>Study Objective</h3><p>To determine the effect of humidified and heated CO₂ for pneumoperitoneum during laparoscopic surgery on analgesic requirements, postoperative pain, and patient satisfaction.</p></div><div><h3>Design</h3><p>Prospective, randomized, double-blind, controlled study (Canadian Task Force classification I).</p></div><div><h3>Setting</h3><p>University hospital.</p></div><div><h3>Patients</h3><p>Ninety consecutive women scheduled for gynecologic laparoscopic surgery.</p></div><div><h3>Intervention</h3><p>Operative laparoscopic management of adnexa surgery or adhesiolysis.</p></div><div><h3>Measurements and Main Results</h3><p>Thirty consecutive patients were randomized into each study group. Group I received humidified, heated gas; group II dry, heated gas; and group III (control group) standard dry, cold gas. No significant difference in intraoperative and postoperative analgesic requirements or postoperative pain score between group I and group II was found. There was even a tendency (not significant) toward less pain and higher postoperative satisfaction in patients in the control group. Therefore, the evaluation was stopped after 53 patients.</p></div><div><h3>Conclusion</h3><p>The use of humidified, heated gas did not reduce postoperative pain or intraoperative analgesic requirements and is thus not preferable to standard dry, cold gas in gynecologic laparoscopic surgery.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Pages 473-477"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1074-3804(05)60078-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24948765","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 Treatment of Ovarian Dermoid Cysts: Eleven Years' Experience","authors":"Spiros Milingos M.D. ,&nbsp;Athanasios Protopapas M.D. ,&nbsp;Petros Drakakis M.D. ,&nbsp;Anthoula Liapi M.D. ,&nbsp;Dimitris Loutradis M.D. ,&nbsp;Alexandros Rodolakis M.D. ,&nbsp;Dimitrios Milingos M.D. ,&nbsp;Stylianos Michalas M.D.","doi":"10.1016/S1074-3804(05)60079-5","DOIUrl":"10.1016/S1074-3804(05)60079-5","url":null,"abstract":"<div><h3>Study Objective</h3><p>To compare laparoscopic and open approaches in the management of benign ovarian teratomas (dermoid cysts) with regard to operative outcome, complications, and postoperative follow-up. Factors that predispose to rupture of dermoid cysts during laparoscopic removal and rates of adhesion formation in women with and without cyst rupture during laparoscopic surgery also were considered.</p></div><div><h3>Design</h3><p>Review of cases of women with dermoid cysts who underwent cystectomy either by laparoscopy or laparotomy in our department from 1992 through 2002 (Canadian Task Force classification III).</p></div><div><h3>Setting</h3><p>The Infertility and Operative Laparoscopy units of the First Department of Obstetrics and Gynecology of the University of Athens, Alexandra Maternity Hospital, Athens, Greece.</p></div><div><h3>Patients</h3><p>Two hundred twenty-two women with an ovarian mass requiring surgical management. Of these, 187 women with benign cystic teratomas underwent laparoscopic cystectomy, and 35 underwent cystectomy by laparotomy.</p></div><div><h3>Intervention</h3><p>Cystectomy either by laparoscopy or laparotomy.</p></div><div><h3>Measurements and Main Results</h3><p>Potential benefits of operative laparoscopy include reduced blood loss, less postoperative pain, shorter hospital stay, fast recovery, and an excellent cosmetic result.</p></div><div><h3>Conclusion</h3><p>Laparoscopy should be considered the method of choice for the removal of benign ovarian cystic teratomas as it offers the advantages of fewer postoperative adhesions, reduced pain, shorter hospital stay, and better cosmetic result. It should be performed by surgeons with considerable experience in advanced laparoscopic surgery.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Pages 478-485"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1074-3804(05)60079-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24949322","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":"Outpatient Hysteroscopic Polypectomy in 237 Patients: Feasibility of a One-Stop “See-and-Treat” Procedure","authors":"Giancarlo Garuti M.D. ,&nbsp;Fulvia Cellani M.D. ,&nbsp;Monica Colonnelli M.D. ,&nbsp;Francesco Grossi M.D. ,&nbsp;Massimo Luerti M.D.","doi":"10.1016/S1074-3804(05)60083-7","DOIUrl":"10.1016/S1074-3804(05)60083-7","url":null,"abstract":"<div><h3>Study Objective</h3><p>To evaluate the feasibility of a “see-and-treat” office polyp resection, using a 5-mm sheathed operative hysteroscope.</p></div><div><h3>Design</h3><p>Retrospective study (Canadian Task Force classification II-2).</p></div><div><h3>Setting</h3><p>Public hospital.</p></div><div><h3>Patients</h3><p>Two hundred thirty-seven patients suffering from endometrial polyps who underwent outpatient hysteroscopy.</p></div><div><h3>Interventions</h3><p>Office polypectomy with anesthetic paracervical block (120 patients) or without (117 patients) using either mechanical (104 patients) or bipolar coaxial electrosurgical (107 patients) instrumentation. In 26 patients, we stopped the procedure before surgery because of intervening adverse events or polyps judged unresectable with an office-based procedure. A 10-cm visual analog scale (VAS) was used to rate patients' pelvic pain perception.</p></div><div><h3>Measurements and Main Results</h3><p>Overall effective polyp resection rate was 81.2% (191 of 235 evaluable patients). An inverse, although not significant (r = -.44) correlation was found between accomplished polypectomies and polyp size, ranging from 96.0% to 18.7% when the diameter of polyps was below 1 cm and above 4 cm, respectively (50 of 52 and 3 of 16 successfully accomplished procedures, respectively). No significant differences were found between successful resection rates (83.3% and 80.2%, respectively; p = .10) and VAS scores (2.2 ± 2.6 and 3.6 ± 2.9, respectively; p = .30) obtained in 79 premenopausal and 156 postmenopausal patients. Paracervical block administration (118 evaluable patients) matched with no anesthetic support (117 patients) was not associated either with an improved rate of resection (85.5% and 76.9%, respectively; p = .10) or with pelvic pain perception (VAS scores 3.3 ± 2.9 and 3.0 ± 2.8, respectively; p = .94). Visual analog scale scores were significantly lower (2.8 ± 2.5 and 4.7 ± 3.6, respectively; p = .001) and polyp resection rates were significantly higher (84.3% and 67.4%, respectively; p = .01) in 192 parous versus 43 nulliparous patients. Polypectomy failed in 44 of 235 patients (18.7%); the leading causes of failure were intolerable pelvic pain in 18 patients (7.6%) and polyp size in 17 patients (7.2%). Other than pelvic pain, the only adverse event we observed was clinical vasovagal reaction in four patients (1.7%).</p></div><div><h3>Conclusion</h3><p>One-stop outpatient hysteroscopic polypectomy is effective in about 80% of patients. With proper preoperative selection, it can be offered as a reliable option to avoid general anesthesia and resectoscopic surgery.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Pages 500-504"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1074-3804(05)60083-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24949326","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":"Preliminary Experience with Robot-Assisted Laparoscopic Myomectomy","authors":"Arnold P. Advincula M.D. ,&nbsp;Arleen Song M.D., M.P.H. ,&nbsp;William Burke M.D. ,&nbsp;R. Kevin Reynolds M.D.","doi":"10.1016/S1074-3804(05)60085-0","DOIUrl":"10.1016/S1074-3804(05)60085-0","url":null,"abstract":"<div><p>The following retrospective case series evaluated the technique and feasibility of integrating robot-assisted technology in the performance of a laparoscopic myomectomy in order to overcome the limitations of conventional laparoscopy. We attempted 35 robot-assisted laparoscopic myomectomies in a university hospital setting with a conversion rate of 8.6%. There were a total of 48 myomas removed in 31 patients with completed robot-assisted laparoscopy. The mean number of myomas removed/patient was 1.6 (range 1–5). The mean diameter of myomas removed was 7.9 ± 3.5 cm (95% CI 6.63–9.13), with the majority greater than 5 cm. The mean myoma weight was 223.2 ± 244.1 g (95% CI 135.8–310.6). Mean operating time was 230.8 ± 83 minutes (95% CI 201.6–260). The average estimated blood loss was 169 ± 198.7 mL (95% CI 99.1–238.4). One patient experienced cardiogenic shock from vasopressin, two developed postoperative infections, and one was found to have adenomatous adenomyosis instead of a leiomyoma. The median length of hospital stay was 1 day. Overall, robot-assisted laparoscopic myomectomy is a promising new technique that may overcome many of the surgical limitations of conventional laparoscopy.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Pages 511-518"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1074-3804(05)60085-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24949328","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":"Systematic Review of Mifepristone for the Treatment of Uterine Myoma","authors":"","doi":"10.1016/S1074-3804(05)60091-6","DOIUrl":"https://doi.org/10.1016/S1074-3804(05)60091-6","url":null,"abstract":"","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Page 544"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1074-3804(05)60091-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137403450","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":"Intraperitoneal Ropivacaine and a Gas Drain: Effects on Postoperative Pain in Laparoscopic Surgery","authors":"Dr. Emma Readman M.B., B.S. ,&nbsp;Dr. Peter J. Maher M.B., B.S., FRANZCOG ,&nbsp;Antony M. Ugoni B. Sci. (hons), M. Sci. ,&nbsp;Dr. Simon Gordon M.B., B.S., FRANZCOG","doi":"10.1016/S1074-3804(05)60080-1","DOIUrl":"10.1016/S1074-3804(05)60080-1","url":null,"abstract":"<div><h3>Study Objective</h3><p>To assess the benefits of the combination of a gas drain and the instillation of local anesthetic on the incidence of pain after operative gynecologic laparoscopy.</p></div><div><h3>Design</h3><p>Randomized control trial (Canadian Task Force classification I).</p></div><div><h3>Setting</h3><p>Tertiary referral center.</p></div><div><h3>Patients</h3><p>One hundred twenty-eight patients undergoing operative gynecologic laparoscopy procedures lasting less than 105 minutes.</p></div><div><h3>Interventions</h3><p>Postoperatively, one group received a blocked drain and saline placed intraperitoneally; a second group was given a blocked drain and ropivacaine; a third group received a patent drain and saline; and a fourth was given a patent drain and ropivacaine.</p></div><div><h3>Measurements and Main Results</h3><p>Visual analogue pain scores (VAS) were measured at 1, 2, 4, and 12 hours and day 1 to day 7. Also measured was opioid consumption at 4 hours, nausea, and activity scores. We found a statistically significant improvement in pain scores at 2 and 4 hours in the group allocated to receive a patent drain and ropivacaine.</p></div><div><h3>Conclusion</h3><p>We recommend the use of a gas drain and ropivacaine to reduce postoperative pain.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Pages 486-491"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1074-3804(05)60080-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24949323","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 Incidence of Endometrial Cancer after Endometrial Ablation in a Low-Risk Population","authors":"Dr. Robert S. Neuwirth M.D. ,&nbsp;Dr. Franklin D. Loffer M.D. ,&nbsp;Dr. Therese Trenhaile M.D. ,&nbsp;Dr. Bruce Levin Ph.D.","doi":"10.1016/S1074-3804(05)60081-3","DOIUrl":"10.1016/S1074-3804(05)60081-3","url":null,"abstract":"<div><h3>Study Objective</h3><p>To assess the incidence of endometrial cancer in 509 women who had undergone hysteroscopic endometrial ablation in two centers between 1978 and 1994. All patients had normal endometrial histology before ablation.</p></div><div><h3>Design</h3><p>Retrospective cohort study (Canadian Task Force classification II-2).</p></div><div><h3>Setting</h3><p>Teaching hospital-affiliated private practices.</p></div><div><h3>Patients</h3><p>Five hundred nine women with perimenopausal bleeding.</p></div><div><h3>Intervention</h3><p>The patients were contacted directly, by mail or phone, and asked if they had had a diagnosis or treatment for cancer or precancer of the endometrium. The list of unreachable patients was submitted to the National Death Index. After this, names and other pertinent data of the remaining patients were submitted to the Cancer Registries of the 50 states and Washington, DC. Forty-two patients were omitted from these searches due to insufficient information or because they were unreachable, and one excluded because of a diagnosis of Bloom's syndrome. The comparative incidence was obtained from the U.S. SEER data of age-specific rates of endometrial cancer published by the National Cancer Institute.</p></div><div><h3>Measurements and Main Results</h3><p>Fifty-one percent of the patients were contacted directly yielding one case of endometrial cancer. Eight patients had died, but none from endometrial cancer. One patient was located in the New Jersey Cancer Registry. A total of 5063 woman-years was identified with two cases of endometrial cancer. The expected incidence was 1.66 cases in an age-matched group with known length of follow-up from the U.S. SEER data. There is no significant difference between the two groups.</p></div><div><h3>Conclusion</h3><p>The flaws in the databases include the lack of data on subsequent hysterectomy for benign disease in both the treated group and the SEER database. Low risk for endometrial cancer is narrowly defined to normal endometrium pre-ablation. Nevertheless, the data give an approximation of the incidence for endometrial cancer, and should serve as a benchmark for prospective studies in patients undergoing endometrial ablation as well as a resource to counsel patients in the choice between ablation and hysterectomy.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Pages 492-494"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1074-3804(05)60081-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24949324","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}