Laparoscopic laser tubal sterilization

Abstracts

174. Thermal Balloon Endometrial Ablation for Menorrhagia

diagnostic laparoscopy. No changes in menstrual cycle patterns, no pregnancies, and no cases of abdominal pain have been reported since the procedure. Conclusion. Laparoscopic laser ablation of the fallopian tube is a safe method of sterilization which is easy to perform and has a low postoperative morbidity. In units with laser facilities this method may also be more cost effective than the use of rings or clips.

CP Spencer, l Erain. Farnborough Hospital, Kent, England.

Objective. To determine the effects of thermal balloon endometrial ablation in women with menorrhagia that does not respond to antifibrinolytic therapy. Measurements and Main Results. Thirty-eight women (age range 39-54 yrs) with menorrhagia without an identifiable organic cause underwent day surgery thermal balloon endometrial ablation under general anesthesia and were followed for 6 and 12 months. The Cavaterm intrauterine balloon was filled with glycine and at an average temperature of 85 ~ C for 15 minutes. In 13 women who were seen for up to 12 months after treatment, amenorrhea was achieved in 9, oligomenorrhea in 3, and normal menstruation in 1. In 25 women who were followed for 6 months, anaenorrhea was reported in 16, oligomenorrhea in 7, and normal menstruation in 1. One woman required hysterectomy for persistent bleeding after pelvic infection. Conclusion. Thermal balloon endometrial ablation is a safe procedure. Longer follow-up is necessary to determine its effectiveness.

176. Surgical Treatment of Bilateral Hydrosalpinges before IVF 1L Stadtmauer, 2DB Goldstein, 2C Acosta. 1South Bay OB/GYN, West Islip, New York;2Central Park West Fertility Center, New York, New York.

Objective. To compare pregnancy rates in patients with hydrosalpinges undergoing IVF after two laparoscopic surgical procedures (prospective, controlled study). Measurements and Main Results. Subjects were 60 women (age range 22-38 yrs) with bilateral hydrosalpinges, and normal ovulation and partners' semen analyses. Before IVF, 20 women in group 1 did not have surgery, 15 in group 2 had cornual resection and linear salpingostomy of distal hydrosalpinx, and 15 in group 3 had lysis of adhesions and bilateral neosalpingostomy. Clinical pregnancy rates differed among the groups (p <0.05): group 1, four pregnancies, one clinical, three biochemcial; group 2, five pregnancies, four clinical, one biochemical; group 3, four pregnancies, all clinical. Age and FSH level on day 3 did not differ statistically. Conclusion. Surgical treatment either by disconnecting the tubes and draining the hydrosalpinx or neosalpingostomy followed by IVF appears to be beneficial. A randomized study with additional patients is necessary to support this conclusion.

175. Laparoscopic Laser Tubal Sterilization CP Spencer, T Theodoridis, ] Erian. Farnborough Hospital, Kent, England.

Objective. To determine the effects of laparoscopic laser tubal sterilization on postoperative pain, menstrual function, and pregnancy rates in women undergoing sterilization with this technique. Measurements and Main Results. One hundred thirteen healthy women (age range 28-45 yrs) with normal gynecologic organs underwent day surgery laparoscopic tubal ablation under general anesthesia and were followed for 24 months. The procedures were completed using laparoscopic laser ablation of each fallopian tube with a Nd:YAG laser to vaporize and separate the isthmic portion of each fallopian tube. Women were followed for 24 months to determine changes in menstrual cycle, abdominal pain, dyspareunia, and pregnancy rates. There were no intraopoerative complications and analgesia requirements were similar to those in women undergoing

177. Thermachoice for Fndometrial Ablation in a

Clinical Practice R syed. Staten Island University Hospital, New York, New York.

Objective. To evaluate safety and efficacy of a newly approved uterine thermal balloon therapy in a clinical practice (prospective, observational study).

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