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Oral Presentations more ectopic surgeries were approached through the laparoscope compared to 1995 (P⬍0.01). In addition, significantly more laparoscopies were successfully completed from a baseline rate of 33.3% in 1995 to 64.8% in 2000 (P⫽0.03). By 2000 significantly less conversions occurred compared to the baseline year of 1995 (4.0 vs. 18.5%; P⫽0.01). Conclusion: Laparoscopy became the primary approach for the management of ectopic pregnancy in part secondary to experienced laparoscopic surgeons and resident participation in an ongoing laparoscopy training program.

S37 significantly increased size cavity at postoperative SHG. Less than 10% of cases required a second hysteroscopy for residual adhesions. Days of menstrual flow increased significantly postoperatively. Data on endometrial thickness and pregnancy rates will be presented. Conclusion: This systematic approach yielded significantly better outcomes for AS than standard methods. We were able to successfully restore partial or full patency to despite the severity of disease without intraoperative or postoperative complications. FRIDAY, NOVEMBER 11, 2005 (10:30 AM–10:40 AM)

THURSDAY, NOVEMBER 10, 2005 (4:51 PM– 4:57 PM) Open Communications 4 —Uterine Abnormalities 89 Development of a Highly Successful Novel Comprehensive Diagnostic, Intraoperative, & Postoperative Treatment for Asherman’s Syndrome Palter SF. Gold Coast IVF, Syosset, New York Study Objective: We previously reported clinical features and treatment results from an international registry of patients with Asherman’s Syndrome - AS and documented 1) no consensus exists regarding optimal treatment regimens 2) worldwide treatment outcomes are very poor with standard treatment methods. This study presents results of a novel comprehensive diagnostic, intraoperative, and postoperative management plan designed to address limitations revealed in our previous study and yield patent uteri with low complications. Design: Retrospective analysis of patients treated with identical diagnostic, operative and postoperative management algorithm. Setting: Private infertility practice with large referral base of severe Asherman’s Syndrome. Patients: Forty patients with intrauterine synechiae, hypo/ amenorrhea, and infertility. Intervention: Patients underwent preoperative 2D⫹3D coronal plane sonohysterographic mapping of intrauterine adhesions. Under ultrasound adhesions were partially lysed with saline and SHG balloon followed by short-interval hysteroscopy. LOA was performed under ultrasound guidance (with full bladder) in the midcoronal-midsaggital plane using semiflexible scissors without intrauterine energy. An 8 –12 French Foley catheter with distal tip cut flush to balloon was inflated in cavity under ultrasound to 2 cm average diameter. Patients received broad spectrum antibiotics, estradiol, and activity restriction for 2 weeks with serial exams/balloon adjustment until removal. Treatment results were assessed by SHG 6 weeks postoperatively. Measurements and Main Results: The majority of patients had severe intrauterine scarring (ESH stage III/IV). All had involvement of uterine cavity/fundus beyond cervix. This approach prevented perforations, vessel injuries, and infections despite aggressive LOA. All patients had a patent

Plenary 9 —Operative Laparoscopy 90 Does the Use of Vicryl Plus Antibacterial Suture Decrease the Incidence of Umbilical Infection when Compared to Vicryl Suture? DeFazio A, Datta MS, Nezhat C. Atlanta Center for Specialty Minimally Invasive Pelvic Surgery, Atlanta, Georgia; Atlanta Center for Specialty Minimally Invasive Pelvic Surgery, Atlanta, Georgia; Johns Hopkins Hospital Obstetrics and Gynecology, Baltimore, Maryland Study Objective: Compare rates of wound infection following laparoscopy and costs when Vicryl Plus Antibacterial suture (coated polyglactin 910 with triclosan) is used versus regular Vicryl to reapproximate umbilical fascia. Design: Prospective, randomized, double blinded, controlled trial of umbilical wound infection rates of patients undergoing laparoscopic surgery using standard Vicryl or antibacterial Vicryl Plus suture. Follow up was performed one and six weeks postoperatively. Setting: Tertiary care laparoscopic pelvic surgery center in Atlanta, Georgia. Patients: Ninety-three women controlled for age, body mass index (BMI), diabetic status, American Society of Anesthesia (ASA) class, preoperative and postoperative antibiotic use, length of procedure, intraoperative core body temperature, corticosteroid administration, and preoperative and postoperative hematocrit values. Intervention: Two groups were analyzed: patients with umbilical incision closure with Vicryl Plus Antibacterial suture or standard coated Vicryl suture, randomized by coin flip. Umbilical surgical sites were assessed postoperatively for clinical signs of infection or inflammation by an independent surgeon blinded to the suture type used. Measurements and Main Results: Postoperatively, 4 patients in the Vicryl group (8.7%) showed signs of infection or inflammation compared to 4 patients in the Vicryl Plus group (10.3%). Cases of umbilical incision infection or inflammation were treated with outpatient wound care and/or antibiotics. Cost of the suture types was $55.47 for a box of three dozen Standard 3-0 Vicryl coated suture, while a box of three dozen Vicryl Plus Antibacterial Suture was $348.