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

{"title":"Ureteral Endometriosis: The Role of Magnetic Resonance Imaging","authors":"Dr. Corinne Balleyguier M.D. ,&nbsp;Dr. Morgan Roupret M.D. ,&nbsp;Dr. Thuy Nguyen M.D. ,&nbsp;Dr. Karen Kinkel M.D. ,&nbsp;Dr. Olivier Helenon M.D. ,&nbsp;Dr. Charles Chapron M.D.","doi":"10.1016/S1074-3804(05)60088-6","DOIUrl":"10.1016/S1074-3804(05)60088-6","url":null,"abstract":"<div><p>In six women out of 792 who underwent magnetic resonance imaging (MRI) for management of deep infiltrating endometriosis (DIE), ureteral involvement was suspected. Ureteral endometriosis was identified as a hypointense nodule on T2- weighted images and hyperintense foci on T1-weighted images. Magnetic resonance urography detected obstruction and hydronephrosis in half the women. Detection with MRI of periureteral involvement (extrinsic endometriosis) in four women rather than ureteral wall lesions (intrinsic endometriosis) in two women is an original finding from this series. Magnetic resonance imaging features were correlated and matched with intraoperative and pathologic findings. Magnetic resonance imaging is a useful preoperative tool for the diagnosis and assessment of ureteral endometriosis in rare cases when such lesions have been suspected.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Pages 530-536"},"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)60088-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24949270","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":"Body Piercing Affecting Laparoscopy: Perioperative Precautions","authors":"Dr. Volker R. Jacobs M.D. ,&nbsp;Dr. John E. Morrison Jr. M.D. ,&nbsp;Dr. Stefan Paepke M.D. ,&nbsp;Dr. Marion Kiechle M.D.","doi":"10.1016/S1074-3804(05)60089-8","DOIUrl":"10.1016/S1074-3804(05)60089-8","url":null,"abstract":"<div><p>Piercing is an increasingly popular fashion trend mainly among adolescents. Umbilical piercing in particular can cause perioperative problems during laparoscopic procedures. We describe how to deal with this fashion trend in our institutions. First, any piercing needs to be documented during preoperative physical examination. During preoperative informed consent, patients are told that all pierced jewelry needs to be removed, preferably by the patient before the procedure. For the operation, patients may be offered the use of sterile “sleepers,” which are substitutes made of plastic to avoid closure of the wound canal perioperatively. Postoperatively, most pierced jewelry can be put back into position after anesthesia has completely worn off. Only jewelry for piercings close to wounds (e.g., navel piercings) should not be reinserted until the skin is closed. Careful observation and increased hygienic effort to prevent local infection is necessary. To date, we have not seen any severe umbilical infection after laparoscopy. However, in several patients the umbilical pierced jewelry was back in the navel on the same day of surgery, sometimes immediately after waking from anesthesia. Hospital staff should know how to remove and substitute piercing jewelry as well as how to optimize hygienic care perioperatively to prevent umbilical wound infections. Time and effort for patient teaching and hygienic care are slightly increased.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Pages 537-541"},"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)60089-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24949271","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 Salpingotomy for Tubal Pregnancy: Comparison of Linear Salpingotomy With and Without Suturing","authors":"","doi":"10.1016/S1074-3804(05)60092-8","DOIUrl":"https://doi.org/10.1016/S1074-3804(05)60092-8","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)60092-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137403452","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":"Ultrasonographic Evaluation of Postoperative Ovarian Cyst Formation after Laparoscopic Excision of Endometriomas","authors":"Ludovico Muzii M.D. ,&nbsp;Filippo Bellati M.D. ,&nbsp;Francesco Plotti M.D. ,&nbsp;Natalina Manci M.D. ,&nbsp;Innocenza Palaia M.D. ,&nbsp;Marzio A. Zullo M.D. ,&nbsp;Roberto Angioli M.D. ,&nbsp;Pierluigi Benedetti Panici M.D.","doi":"10.1016/S1074-3804(05)60074-6","DOIUrl":"10.1016/S1074-3804(05)60074-6","url":null,"abstract":"<div><h3>Study Objective</h3><p>To evaluate, by means of serial transvaginal ultrasound (US) examinations, the ovary after laparoscopic excision of endometriomas with the stripping technique.</p></div><div><h3>Design</h3><p>Prospective, controlled, single-blind clinical trial (Canadian Task Force classification II-1).</p></div><div><h3>Setting</h3><p>Tertiary care university hospital.</p></div><div><h3>Patients</h3><p>Forty-seven patients, from 21- to 35-years old, undergoing laparoscopic excision of a monolateral ovarian endometrioma.</p></div><div><h3>Intervention</h3><p>The patients underwent serial US scans performed by a blinded observer during the first, third, and sixth menstrual cycle after surgery.</p></div><div><h3>Measurements and Main Results</h3><p>At the first follow-up US examination, an abnormal finding, namely the presence of an ovarian cyst on the operated ovary, was diagnosed in five of 47 patients (10.6%; p = .03 when compared with the nonoperated ovary). In the remaining 42 patients (89.4%), no gross abnormalities were evident. No differences were present between the two ovaries as to ovarian volume or follicular development pattern. During the third follow-up US, in 47 patients (100%) no gross abnormalities were present.</p></div><div><h3>Conclusion</h3><p>The US follow-up of ovaries operated on for endometriomas by laparoscopy demonstrates that the evidence of an ovarian cyst in the early postoperative period is not an uncommon event. This finding, occurring in approximately 10% of cases, seems to be a transient one occurring during ovarian healing after surgery, since no evidence of such anomaly was present on subsequent US scans. Therefore, treatment for US evidence of recurrence of an ovarian endometrioma should be deferred for at least 3 to 6 months if the diagnosis of recurrence is made in the early postoperative period. Apart from this finding, the operated ovary is indistinguishable from the contralateral one, even 1 month after surgery.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Pages 457-461"},"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)60074-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24948762","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":"Effects of Transfusion with Red Cells Filtered to Remove Leucocytes: Randomised Controlled Trial in Patients Undergoing Major Surgery","authors":"","doi":"10.1016/S1074-3804(05)60093-X","DOIUrl":"https://doi.org/10.1016/S1074-3804(05)60093-X","url":null,"abstract":"","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Pages 544-545"},"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)60093-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137403451","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":"Tissue Trauma in Abdominal and Laparoscopic-Assisted Vaginal Hysterectomy","authors":"Cem Atabekoglu M.D. ,&nbsp;Murat Sönmezer M.D. ,&nbsp;Mete Güngör M.D. ,&nbsp;Ruşen Aytaç M.D. ,&nbsp;Firat Ortaç M.D. ,&nbsp;Cihat Ünlü M.D.","doi":"10.1016/S1074-3804(05)60077-1","DOIUrl":"10.1016/S1074-3804(05)60077-1","url":null,"abstract":"<div><h3>Study Objective</h3><p>To compare the degree of tissue damage between abdominal and laparoscopic-assisted hysterectomy.</p></div><div><h3>Design</h3><p>Prospective, randomized, controlled study (Canadian Task Force classification I).</p></div><div><h3>Setting</h3><p>University hospital.</p></div><div><h3>Patients</h3><p>Forty-six women.</p></div><div><h3>Intervention</h3><p>Laparoscopic-assisted and abdominal hysterectomy.</p></div><div><h3>Measurements and Main Results</h3><p>The degree of tissue injury caused by surgical trauma was assessed by measuring plasma levels of creatine phosphokinase (CPK), C-reactive protein (CRP), lactic dehydrogenase (LDH), and CA 125 in patients undergoing laparoscopic-assisted (n = 23) and abdominal hysterectomy (n = 23). Plasma levels of CPK-MB isoenzyme were measured in order to exclude the possibility of myocardial injury. Blood samples were taken preoperatively, and on the first and second postoperative days. There was no difference in demographic characteristics between the groups. One patient in the laparotomy group and two patients in the laparoscopy group were excluded from analysis due to bladder injury, postoperative thrombophlebitis, and conversion to laparotomy because of severe adhesions. The mean operation time was longer (105.5 ± 23.1 minutes vs 77.3 ± 18.7 minutes, p &lt;.001), but the duration of hospital stay was shorter (2.7 ± 0.8 days vs 4.3 ± 1.4 days, p &lt;.001) and analgesic requirement was lower in the laparoscopy group compared with the abdominal group. We observed significant postoperative increases in CRP and CPK in both groups on postoperative days 1 and 2, whereas the increase in LDH was significant only in the laparotomy group on postoperative day 2. There were no significant changes in CPK-MB and CA 125. Moreover, mean plasma levels of CRP and CPK were significantly higher in the laparotomy group on postoperative days 1 and 2 than in the laparoscopy group (p &lt;.05).</p></div><div><h3>Conclusion</h3><p>Surgery is a significant cause of tissue injury that can be assessed by specific enzymes and proteins. We suggest that laparoscopic surgery causes less tissue damage as assessed by lower postoperative CRP and CPK values, and that less tissue trauma related with laparoscopic surgery may account for early mobilization and reduced analgesic requirement in these patients.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 4","pages":"Pages 467-472"},"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)60077-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24948764","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":"Use of TachoComb in laparoscopic myomectomy","authors":"Y. Asakawa, M. Morita, T. Maemura, M. Nakakuma, H. Kubo","doi":"10.1016/S1074-3804(04)80435-3","DOIUrl":"https://doi.org/10.1016/S1074-3804(04)80435-3","url":null,"abstract":"","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2004-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73608481","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":"Fertility after Ovarian Drilling by Transvaginal Fertiloscopy for Treatment of Polycystic Ovary Syndrome","authors":"Dr. Hervé Fernandez M.D. ,&nbsp;Dr. Antoine Watrelot M.D. ,&nbsp;Dr. Jean-Dominique Alby M.D. ,&nbsp;Dr. Jacques Kadoch M.D. ,&nbsp;Dr. Amélie Gervaise M.D. ,&nbsp;Dr. Renaud deTayrac M.D. ,&nbsp;Dr. René Frydman M.D.","doi":"10.1016/S1074-3804(05)60054-0","DOIUrl":"10.1016/S1074-3804(05)60054-0","url":null,"abstract":"<div><h3>Study Objective</h3><p>To evaluate fertiloscopy ovarian drilling with bipolar energy in women with clomiphene citrate-resistant polycystic ovary syndrome (PCOS).</p></div><div><h3>Design</h3><p>Prospective study (Canadian Task Force classification II).</p></div><div><h3>Setting</h3><p>University teaching hospital and private clinic.</p></div><div><h3>Patients</h3><p>Eighty women with clomiphene citrate-resistant PCOS.</p></div><div><h3>Intervention</h3><p>Operative transvaginal fertiloscopy with a coaxial bipolar electrode.</p></div><div><h3>Measurements and Main Results</h3><p>During a mean follow-up of 18.1 months (± 6.4), 73 women (91%) recovered regular and ovulatory cycles. The cumulative pregnancy rate was 60% (44/73) for spontaneous and stimulated cycles, with 39.7% (29/73) imputed to drilling alone. The mean time to conceive was 3.9 months (range 1–11.8). There were eight miscarriages (18%), and no ectopic pregnancies or multiple pregnancy. No complications occurred.</p></div><div><h3>Conclusion</h3><p>Ovarian drilling by transvaginal fertiloscopy with bipolar electrosurgery appears to be an effective minimally invasive procedure in patients with PCOS resistant to clomiphene citrate.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 3","pages":"Pages 374-378"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1074-3804(05)60054-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24825410","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":"Essure Hysteroscopic Sterilization: Results Based on Utilizing a New Coil Catheter Delivery System","authors":"Dr. John F. Kerin M.D. ,&nbsp;Dr. David N. Munday M.D. ,&nbsp;Dr. Martin G. Ritossa M.D. ,&nbsp;Dr. Andrew Pesce M.D. ,&nbsp;Dr. David Rosen M.D.","doi":"10.1016/S1074-3804(05)60056-4","DOIUrl":"10.1016/S1074-3804(05)60056-4","url":null,"abstract":"<div><h3>Study Objective</h3><p>To assess the safety and placement effectiveness of a new delivery catheter for the Essure micro-insert hysteroscopic sterilization system.</p></div><div><h3>Design</h3><p>Prospective, multicenter, single-arm clinical study. (Canadian Task Force classification II-3).</p></div><div><h3>Setting</h3><p>Hospital-based clinical research centers.</p></div><div><h3>Patients</h3><p>One hundred two women of reproductive age and proven fertility.</p></div><div><h3>Intervention</h3><p>A new coil catheter delivery system was used for micro-insert placement.</p></div><div><h3>Measurements and Main Results</h3><p>The bilateral placement of micro-inserts using the coil catheter delivery system occurred in 100 women out of 102 attempts (98%). The two women who did not have successful micro-insert placement were subsequently shown to have proximal tubal stenotic disease.</p></div><div><h3>Conclusion</h3><p>These findings indicate that the introduction of the coil catheter delivery system for Essure hysteroscopic sterilization improves the micro-insert bilateral placement rate when compared with previous studies. It is hypothesized that the coil catheter has superior navigational properties, particularly within tortuous or narrowed tubal lumens.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 3","pages":"Pages 388-393"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1074-3804(05)60056-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24826628","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 vs. Rollerball Electroablation for Menorrhagia: A Multicenter Randomized Trial","authors":"Dr. Jay M. Cooper M.D. ,&nbsp;Dr. Ted L. Anderson M.D., Ph.D. ,&nbsp;Dr. Claude A. Fortin M.D. ,&nbsp;Dr. Stuart A. Jack M.D. ,&nbsp;Ms Maria B. Plentl M.S.N., W.H.N.P.","doi":"10.1016/S1074-3804(05)60057-6","DOIUrl":"10.1016/S1074-3804(05)60057-6","url":null,"abstract":"<div><h3>Study Objective</h3><p>To compare the effectiveness, safety, and acceptability of microwave endometrial ablation (MEA) with those of rollerball electroablation (REA) for the treatment of menorrhagia.</p></div><div><h3>Design</h3><p>Randomized clinical trial (Canadian Task Force classification I).</p></div><div><h3>Setting</h3><p>Eight academic medical centers and private medical practices.</p></div><div><h3>Patients</h3><p>Three hundred twenty-two women with documented menorrhagia due to benign causes.</p></div><div><h3>Intervention</h3><p>MEA or REA.</p></div><div><h3>Measurements and Main Results</h3><p>By intent-to-treat analysis, the success rate of MEA at 12 months (87.0%; CI 81.7%–91.2%) did not differ significantly (p = .40) from that of REA (83.2%; CI 74.7%–89.7%). Among evaluable patients, success rate was also similar (p = .24) in the MEA (96.4%; CI 92.7%–98.5%) and REA (92.7%; CI 85.6%–97%) groups. The amenorrhea rate in evaluable patients after MEA was 61.3% (CI 54.1%–68.2%). In patients with myomas, the success and amenorrhea rates in evaluable patients after MEA were 90.3% (CI 74.2%–98%) and 61.3% (CI 42.2%–78.2%), respectively. In evaluable patients with body mass index of 30 kg/m² or greater, MEA success rate was 96.7% (CI 88.5%–99.6%) compared with 81.8% (CI 59.7%–94.8%) for REA (p = .042). The ablation procedure was performed under IV sedation in 62% of patients in the MEA group versus 18% of patients in the REA group (p &lt;.001); whereas, general anesthesia was employed more often in patients undergoing REA (37% vs. 76%, p &lt;.001). No major complications were encountered. Patient satisfaction with results of treatment was high (98.5% of the MEA and 99.0% of the REA group).</p></div><div><h3>Conclusion</h3><p>Microwave endometrial ablation is an efficacious and safe procedure for the treatment of menorrhagia. Over half of patients treated with MEA achieve amenorrhea, and the procedure is suitable for women with myomas and irregular uterine cavities. The procedure is easily learned and can be performed rapidly, under IV sedation in most cases.</p></div>","PeriodicalId":79466,"journal":{"name":"The Journal of the American Association of Gynecologic Laparoscopists","volume":"11 3","pages":"Pages 394-403"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1074-3804(05)60057-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24826629","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}