- Email: [email protected]
A retrosective analysis of 15,000 laparoscopic cases with regard to visually controlled cannula and veress needle insertion
August 1999, Vd. 6, No. 3 Supplement The Journal of the American Association of Gynecologic Laparoscopists
179. Lin's Outer Sheath for Continuous-Flow System of Flexible Hysteroscopy K Seki, BL Lin, Y lwata. Kawasaki Municipal Hospital, Kawasaki, Japan.
Conclusion. This method is safe, inexpensive, and fast. The instrument is reusable and may be used as an analog to numerous other intraabdominal surgical procedures such as appendectomy, omentum resection, and cholecystectomy.
Objective. To describe Lin's outer sheath, which was developed for continuous-flow flexible hysteroscopes. Measurements and Main Results. A diagnostic flexible hysteroscope (outer diameter 3.1 ram) equipped with Lin's outer sheath was used for intrauterine examinations in 1114 women. No cervical dilatation, anesthesia, or analgesia was required. In most cases a tenaculum was not required. Even with bleeding, a clear visual field can be obtained. Conclusion. Lin's outer sheath allows for continuous flow of flexible hysteroscopy, making intrauterine examinations possible even during intrauterine bleeding.
182. A Review of 500 LAVHs JH Seo. DS Eun Eun Hospital, Gynecologic Endoscopic Surgery Center, Eun Hospital, Kwangju, Korea. Objective. To evaluate the effectiveness and value of LAVH. Measurements and Main Results. All 500 patients required hysterectomy for uterine diseases. Average operating time was 56.4 +_11.8 minutes, and mean estimated postoperative hemoglobin loss was 0.62 _+ 1.0 g/dl. No serious complications occurred. Conclusion. LAVH may be valuable for gynecologic uterine diseases, but it should be performed only by experienced laparoscopists to obtain maximum value and advantages.
180. A Retrospective Analysis of 15,000 Laparoscopic Cases with Regard to Visually Controlled Cannula and Veress Needle Insertion I Semm, K Semrn. University of Kiel, Kie], Germany.
183. Minilaparoscopy Under Local Anesthesia A Sharon, A Lissak, O Brandes-Klein, O Fruchter, O Kogan, H Abramovici. Carmel Medical Center, Haifa, Israel.
Objective. To review the success of visually controlled technique of cannula insertion. Measurements and Main Results. In 15,000 laparoscopies the complication rate was less than 0.012%. Conclusion. With increasing numbers of cannula injuries, a review of these techniques is of utmost importance.
Objective. To compare the efficacy, tolerance, and safety of local and general anesthesia during minilaparoscopy. Measurements and Main Results. Fourteen women underwent minilaparoscopy under local and 58 underwent similar procedures under general anesthesia. A diagnostic or therapeutic procedure was performed using 2.0-ram cannulas and a 1.98-mm fiberoptic laparoscope. Local anesthesia consisted of lidocaine and a mixture of bupivacaine plus adrenalin infiltrated subcutaneously at sites of cannula insertion and into the peritoneal cavity. Mean operating time for procedures performed under local anesthesia was significantly shorter (15 min) than for those under general anesthesia. Visualization was satisfactory in all procedures, and no complications occurred. Patients were questioned at days 1 and 14 postoperatively about anxiety, pain, and satisfaction regarding the procedure and anesthesia. Anxiety regarding anticipated pain was similar in both groups, as was the amount of pain reported.
181. The Dual Applicator, a New Ligation Device K Semm, DH Kim. University of Kiel, Kiel, Germany. Objective. To describe a new ligation device for hemostasis during laparoscopic surgery. Measurements and Main Results. The dual applicator combines the cost and simplicity of the Roeder loop, so that the surgeon clamps the vessels and cuts and sets the ligature. The dual applicator is particularly effective when separating adnexa from the uterus at hysterectomy. It is 10 mm in diameter and carries a 5-mm forceps through one channel and a 5-ram Roeder loop through the other. Two applicators are introduced suprapubicatly, left and right. Once tissue to be separated is grasped and scissors transected, it and the remaining pedicles are ligated with the Roeder loops.
$51
179. Lin's Outer Sheath for Continuous-Flow System of Flexible Hysteroscopy K Seki, BL Lin, Y lwata. Kawasaki Municipal Hospital, Kawasaki, Japan.
Conclusion. This method is safe, inexpensive, and fast. The instrument is reusable and may be used as an analog to numerous other intraabdominal surgical procedures such as appendectomy, omentum resection, and cholecystectomy.
Objective. To describe Lin's outer sheath, which was developed for continuous-flow flexible hysteroscopes. Measurements and Main Results. A diagnostic flexible hysteroscope (outer diameter 3.1 ram) equipped with Lin's outer sheath was used for intrauterine examinations in 1114 women. No cervical dilatation, anesthesia, or analgesia was required. In most cases a tenaculum was not required. Even with bleeding, a clear visual field can be obtained. Conclusion. Lin's outer sheath allows for continuous flow of flexible hysteroscopy, making intrauterine examinations possible even during intrauterine bleeding.
182. A Review of 500 LAVHs JH Seo. DS Eun Eun Hospital, Gynecologic Endoscopic Surgery Center, Eun Hospital, Kwangju, Korea. Objective. To evaluate the effectiveness and value of LAVH. Measurements and Main Results. All 500 patients required hysterectomy for uterine diseases. Average operating time was 56.4 +_11.8 minutes, and mean estimated postoperative hemoglobin loss was 0.62 _+ 1.0 g/dl. No serious complications occurred. Conclusion. LAVH may be valuable for gynecologic uterine diseases, but it should be performed only by experienced laparoscopists to obtain maximum value and advantages.
180. A Retrospective Analysis of 15,000 Laparoscopic Cases with Regard to Visually Controlled Cannula and Veress Needle Insertion I Semm, K Semrn. University of Kiel, Kie], Germany.
183. Minilaparoscopy Under Local Anesthesia A Sharon, A Lissak, O Brandes-Klein, O Fruchter, O Kogan, H Abramovici. Carmel Medical Center, Haifa, Israel.
Objective. To review the success of visually controlled technique of cannula insertion. Measurements and Main Results. In 15,000 laparoscopies the complication rate was less than 0.012%. Conclusion. With increasing numbers of cannula injuries, a review of these techniques is of utmost importance.
Objective. To compare the efficacy, tolerance, and safety of local and general anesthesia during minilaparoscopy. Measurements and Main Results. Fourteen women underwent minilaparoscopy under local and 58 underwent similar procedures under general anesthesia. A diagnostic or therapeutic procedure was performed using 2.0-ram cannulas and a 1.98-mm fiberoptic laparoscope. Local anesthesia consisted of lidocaine and a mixture of bupivacaine plus adrenalin infiltrated subcutaneously at sites of cannula insertion and into the peritoneal cavity. Mean operating time for procedures performed under local anesthesia was significantly shorter (15 min) than for those under general anesthesia. Visualization was satisfactory in all procedures, and no complications occurred. Patients were questioned at days 1 and 14 postoperatively about anxiety, pain, and satisfaction regarding the procedure and anesthesia. Anxiety regarding anticipated pain was similar in both groups, as was the amount of pain reported.
181. The Dual Applicator, a New Ligation Device K Semm, DH Kim. University of Kiel, Kiel, Germany. Objective. To describe a new ligation device for hemostasis during laparoscopic surgery. Measurements and Main Results. The dual applicator combines the cost and simplicity of the Roeder loop, so that the surgeon clamps the vessels and cuts and sets the ligature. The dual applicator is particularly effective when separating adnexa from the uterus at hysterectomy. It is 10 mm in diameter and carries a 5-mm forceps through one channel and a 5-ram Roeder loop through the other. Two applicators are introduced suprapubicatly, left and right. Once tissue to be separated is grasped and scissors transected, it and the remaining pedicles are ligated with the Roeder loops.
$51