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Journal of Minimally Invasive Gynecology, Vol 12, No 5, September/October Supplement 2005

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Setting: Department of Obstetrics and Gynecology, the Gachon Gil Hospital, College of Medicine, Incheon, Korea. Patients: Eighty two incontinent women (ages 34 –70 yrs) with benign gynecologic disease. Intervention: After TVT procedure, 65 patients underwent laparoscopic-assisted vaginal hysterectomy (LAVH) and 6 patients underwent vaginal total hysterectomy (VTH) and 5 patients underwent total abdominal hysterectomy (TAH). Measurements and Main Results: Mean duration of operation time was 136 minutes (range 60 –300); mean duration of hospitalization was 7.6 days (range 6 –15); mean duration of catheterization was 2.2 days (range 2–5) and mean follow-up interval was 13 months (range 6 –18). There were six patients lost to follow-up for several reasons. The subjective success rate was 97.4% and the objective success rate was 97.4%. The rates of complications of bladder perforation, postoperative voiding difficulty and postoperative overactive bladder syndrome were 6.6%, 7.9% and 7.9% respectively; neither pelvic hematoma requiring blood transfusion nor failure of TVT procedure occurred. Conclusion: The results of our study prove that TVT procedure combined with hysterectomy is safe and effective in incontinent patients with benign gynecologic disease.

Conservative Laparoscopic Surgery of Interstitial Pregnancy Yamamoto K. Gifu Municipal Hospital, Gifu, Japan Study Objective: To assess the safety and efficacy of conservative laparoscopic surgery of interstitial pregnancy. Design: Case report. Setting: Urban hospital. Patients: Two. Intervention: Laparoscopic linear incision and suture of interstitium. Local injection of vasopressin (0.2IU/ml) and methotrexate (50mg) was used (off label uses). Measurements and Main Results: First patient: A 26-yearold, gravida 1 para 1 woman with left unruptured interstitial pregnancy at 9 weeks, 3 days gestational age. Urine hCG was 4,800 IU/L. Gestational sac 10mm in diameter was found near the left interstitium, but no fetus was found. The mass was 2.5 cm in diameter. There was no hemoperitoneum. Operating time was 124 minutes. Blood loss was 120ml. No severe complications occurred. Postoperative hospital stay was 3 days. Persistent ectopic pregnancy didn’t occur. Postoperative hysterosalpingography revealed patency of bilateral oviducts although there was a pooling image in the diseased side. She suffered from ipsilateral isthmic pregnancy afterwards. Second patient: A 29-yearold, nulligravida woman with right unruptured interstitial pregnancy at 6 weeks, 5 days gestational age. Urine hCG was 8,000 IU/L. Gestational sac 15mm in diameter and fetus, with a heartbeat, 8mm in size was shown near right interstitium. The mass was 2.3 cm in diameter. There was no hemoperitoneum. Operating time was 90 minutes. Blood loss was negligible. No severe complications occurred. Postoperative hospital stay was 4 days. Persistent ectopic pregnancy didn’t occur. Postoperative hysterosalpingography revealed patency of bilateral oviducts. She became pregnant and achieved normal delivery afterwards. Conclusion: Conservative laparoscopic surgery of interstitial pregnancy is safer and more effective than previously believed. It appears that a fetal heartbeat in a mass of small diameter isn’t a contraindication. In addition, it seems that this operation should be limited to cases in which hemostatic control of the operative field is good. 291 A Clinical Analysis of Tension-Free Vaginal Tape (TVT) Combined with Hysterectomy Yoon SJ. Gachon Medical School, Gil Medical Center, Incheon, Korea Study Objective: To evaluate the clinical efficacy of TVT combined with hysterectomy in incontinent patient with benign gynecologic disease. Design: Retrospective analysis of 82 patients was performed TVT combined with hysterectomy under general anesthesia.

292 Retrospective Analysis of the Clinical Results Observed in 223 Patients Using Five Endometrial Ablation Techniques Young-Hawkins D. Logan, Utah Study Objective: Assess the efficacy of the five endometrial ablation modalities in women suffering from DUB. Design: A retrospective long-term data analysis (Canadian Task-Force Classification III). Setting: Cache Valley Specialty Hospital/Logan Regional Hospital. Patients: Two hundred twenty-three pre and post-menopausal women suffering from menorrhagia due to benign causes. Intervention: Endometrial ablation using rollerball, ThermaChoice, HTA, Her Option and NovaSure endometrial ablation systems. Measurements and Main Results: Five endometrial ablation techniques were used to treat 223 patients. Position of the uterus was not a factor in patient selection. All patients received the treatment under intravenous sedation except for HerOption. Populations were comparable between groups by age and BMI. Patients treated with NovaSure had no endometrial pre-treatment. For other techniques, some form of endometrial thinning was used. 2-D/3-D/SIS in conjunction with endometrial biopsy were used to exclude endometrial pathology and pre- and/or neoplasia of the endometrium. Rollerball ablation was considered a bench-mark (gold-standard) and the results observed with respect of amenorrhea, success, reduction in dysmenorrheal, PMS and hysterectomy rate were comparable to those reported in the