Is mesh better than colporrhaphy for pelvic organ prolapse?
July 1st 2011Compared with anterior colporrhaphy, a trocar-guided transvaginal polypropylene mesh repair kit for prolapse of the anterior vaginal wall results in higher short-term success rates, but also higher rates of surgical complications and postoperative events, according to study findings.
Laparoscopic Sterilization Techniques
July 1st 2011At a resident's education conference, Dr. Richard M. Soderstrom, M.D. presented the following handout on today's evidence based evaluation of laparoscopic sterilization methods. Dr. Soderstrom is the author covering this subject in the USA'a first textbook on Laparoscopy, Ed. JM Phillips, Williams & Wilkins, 1977. Since then he has published widely on the subject and continues to act as a consultant to the FDA when new devices for sterilization are entertained.
Pelvic Health in Women: Understanding Chronic Pelvic Pain & Vulvodynia
July 1st 2011The area of pelvic health in women is a growing area of concern for health care providers as well as women with disorders that involve the pelvic area (bladder, pelvic floor muscle, rectum and uterus.) Chronic pelvic pain and vulvodynia, two frustrating pelvic disorders seen in young adult women, is not well understood.
A guide to Women's Health on the Internet Part 2. Gynaecology and Reproductive Medicine
July 1st 2011The problems relating to searching the Internet for medical information are well known; too many sites are identified and there is no easy way to filter out the good from the bad. Consequently, if search engines are not the best place to start your exploration of the Web for information relating to gynaecology and reproductive medicine, where is? In my opinion the best place to start is at the OBGYN.net site .
Meigs' Syndrome: a case presentation and revision of the literature
July 1st 2011Meigs´s syndrome is defined as the presence of ascites and hydrothorax in association with a benign ovarian tumor. It is a rare clinical entity, which is also considered to be an uncommon complication of benign leiomyomas of the female genital tract. The case of a 33 year-old female patient who presented rapid weight loss and a quickly increasing abdominal circumference is described. Clinical and ultrasonographic studies revealed a mobile, semi-solid right adnexal tumor in the lower abdominal quadrants of 15 x 14-cm and ascites as well as hydrothorax of the left lung, confirmed by chest radiography.
Unroofing of the Ureter for Radical Hysterectomy
June 30th 2011Unroofing the ureter in the cardinal ligament is the most important step during radical hysterectomy. At our institution we developed a modified laparoscopic technique to free the ureter from its roof through the cardinal ligament. The technique is based on the advantages of laparoscopic surgery which mainly are: more accurate haemostasis, magnification of the anatomical structures and positioning of the scope parallel to the ureteral course instead of perpendicular like in open surgery.
Performing Laparoscopic Supracervical Hysterectomy
June 30th 2011The forces that drive the development and refinement of surgical technique are multifocal. Physicians value effective procedures that combine safety, simplicity, and reproducibility. Third-party payers seek techniques that are cost effective, require shorter hospital stays, and result in less morbidity. Patients flock to physicians who are able to perform procedures that entail less discomfort, shorter recovery times, better cosmetic results, and also preserve or improve the equality of their lives. Such has been the case with the evolution of laparoscopic hysterectomy.
Early Evaluation Of An Electromechanical Morcellator For Laparoscopic Supracervical Hysterectomy
June 30th 2011The mean uterine weight was 146 g (60-569 g). The mean operating time was 94 minutes (60-225 min.). Actual morcellation time was available in 19 cases by reviewing videotape with an average morcellation time of 11.8 minutes (4-23 min.). Average blood loss was 125 cc (20-600 cc) with one case of late postoperative bleeding requiring operative intervention. The average cost for the procedure was $7,998 ($6,989 - $11,581). Thirty-six patients were discharged within 23 hours from the time of admission and all patients were discharged within 48 hours of the time of admission.
Research methodology in Obstetrics and Gynecology: basic and particular aspects
June 30th 2011Research is the challenging process aiming at the knowledge of truth. It involves our past, is supported by individual aspirations and needs and could be responsible for our own future, for that of other people and for the future of the surrounding environment.
RCT-Laparotomy Vs. Laparoscopic Hysterectomy
June 30th 2011In spite of readily available alternatives to hysterectomy such as endometrial ablation, hysterectomy rates have not fallen. Several comparative trials of hysterectomy have shown shorter hospital stay and convalescence after laparoscopic approach compared to an abdominal approach.
Diagnosing Uterine and Tubal Pathology in Infertility: Which Method is Best?
June 30th 2011The diagnosis of uterine and/or tubal pathology as causes of female infertility represents a fundamental step in the evaluation of the infertile couple. Apart from the invasive diagnostic procedures, several others diagnostic techniques useful to the clinical evaluation of the uterine cavity and tubal anatomy are: transvaginal sonography (TVS), hysterosalpingography (HSG), hysteroscopy and hydrosonography (HDS) and laparoscopy.
What Is the Role of Laparoscopic Surgery in Ovarian Cancer?
June 30th 2011Laparoscopic staging of apparent early ovarian cancer may be accomplished in patients where disease appears limited to the adnexa. For example a completely resected complex adnexal mass with intraoperative frozen-section revealing malignancy and no obvious limitation to complete laparoscopic staging.
When Is Infertility Surgery Indicated?
June 30th 2011The role of reproductive surgery has been questioned in the current environment of improving techniques and success rates with in vitro fertilization (IVF). Another emerging obstacle is the declining number of these types of surgeries being performed in response to the increasing numbers of patients opting for IVF.
The Use Of Microendoscopy For Diagnostic And Therapeutic Office Laparoscopy Under Local Anesthesia
June 30th 2011Since the first laparoscopy was performed in humans by Jacobaeus in 1910, great strides have been made by surgeons in utilizing this valuable tool.1 Unfortunately, the expense of performing even diagnostic laparoscopy has become prohibitive. With the high cost of medical care, measures must be taken to decrease this monumental problem. For years, laparoscopy has been performed under local anesthesia with minimal reported complications.
Laparoscopic Retropubic Colposuspension The Burch Procedure
June 30th 2011Reported in the literature are more than 100 different kinds of surgical treatments for stress urinary incontinence in women, including anterior colporrhaphy (Kelly plication), retropubic urethropexy (Marshall-Marchetti-Krantz procedure, Burch procedure, ), paravaginal suspension, various kinds of needle urethropexy, and suburethral sling procedure.
Endometrial Ablation Rectoscope/Myomectomy Techniques and Complications
June 30th 2011It has been reported that approximately 670,000 hysterectomies are performed each year in the United States. Close to one third (more than 200,000) of these operations are done because of intractable menorrhagia not responsive to medical therapy or to dilation and curettage. The Nd:YAG laser was first used by Goldrath and colleagues showing that this laser can photocoagulate the endometrium and the menstrual flow reduced to little or none.
Prevention and Management of Laparoendoscopic Surgical Complications Laparoscopic Myomectomy
June 30th 2011Uterine myomas are the most common tumors of the female genital tract. = Hysterectomy has been a very common therapy in patients who have completed reproduction. In fact, uterine myomas = account for 20% of the 650,000 hysterectomies performed annually in the United States. Interest in uterine = preservation and organ preserving surgery through techniques of minimally invasive surgery has increased since the first = reports of laparoscopic myomectomy in 1980.
Prevention and Management of Laparoendoscopic Surgical Complications
June 30th 2011Laparoscopic urinary bladder surgery primarily involves retropubic bladder neck suspension procedures. Because variations of the laparoscopic Burch procedure (Tanagho, Hodgkinson) are most frequently performed, this chapter will focus on the complications of the laparoscopic Burch procedure - avoidance, recognition, and treatment.
Endometrial Ablation and Hysteroscopic Surgery
June 30th 2011Over the past decade, a technique has been developed that can reduce or stop your periods without a hysterectomy. This surgery can be done in women who have flooding either with or without fibroid tumors. Dr. Dott was one of the surgeons who introduced this minimally invasive procedure in Atlanta. He has performed this procedure many times and is certified by the Accreditation Council for Gynecological Endoscopy in Advanced Hysteroscopic Surgery. He has taught this procedure in training institutions both in the United States and Russia.