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Laparoscopic management of dermoid ovarian cysts
August 1998, Vol. 5, No. 3 Supplement The JournaJ of the American Association of Gynecologic Laparoscopists
Conclusion. Laparoscopic extraperitoneal infrarenal paraaortic lymph node dissection in a porcine model is feasible, provides excellent exposure to the entire paraaortic lymphatic chain, is safe, and has a remarkably short learning curve. Development of such a technique in humans may have similar advantages.
Measurements and Main Results. Three hundred sixtyeight women (age 22--40 yrs) with distal tubal pathology were operated by laparotomy and 64 (age 23-39 yrs) by laparoscopy. Interventions in both groups were fimbriolysis and salpingoneostomy. In the laparotomy group 53.6% of 190 women undergoing fimbriolysis and 34.2% of 178 undergoing salpingoneostomy achieved normal pregnancy; ectopic pregnancy occurred in 2.1% and 3.3% of women, respectively. In the laparoscopy group, 47.36% of 38 women having fimbriolysis and 31.6% of 26 having salpingoneostomy achieved normal pregnancy; ectopic pregnancies occurred in zero and 3.8%, respectively. Conclusion. Based on comparative analysis of this series, we conclude that laparoscopic distal tubal microsurgery is an effective and safe treatment that can be performed whenever it is indicated.
7. Planning Training Sessionsfor I_aparoscopic Modified Radical Hysterectomy and Pelvic and Paraaortic Lymphadenectomy in the Porcine Model I Atlas. Soroka Medical Center, Ben Gurion University, Beer Sheva, Israel.
Objective. To facilitate planning advanced laparoscopic training sessions in the porcine model based on session time and trainee experience. Measurements and Main Results. Seven advanced laparoscopic training sessions were held for surgeons with at least advanced traditional surgical training after video preparation including porcine anatomy and surgery. Surgical steps increased in difficulty during sessions alloted an estimated 3 hours. Retroperitoneal dissection, ligation, coagulation, cutting, and basic management of complications took less than 2 hours in all sessions. Pelvic lymphadenectomy required 3 hours. Large bowel mobilization, complete ureterolysis, and paraaortic lymphadenectomy were accomplished in 3.5 hours only by surgeons with laparoscopic experience. Modified radical hysterectomy or repair of major vessel, bowel, and ureteral injury was achieved by experienced laparoscopic surgeons in 4.5 hours. Conclusion. Laparoscopic training sessions using the porcine model should be based on time and trainee experience. For trainees with experience in conventional surgery, a 3-hour session can include retroperitoneal dissection and pelvic lymphadenectomy. Complete ureterolysis, paraaortic dissection, or modified radical hysterectomy requires sessions of 4 to 5 hours, and should be restricted to experienced surgeons.
9. Laparoscopic Management of Dermoid Ovarian Cysts C Battista, P Reb6n, F Sarquis, C Yinelli, P Gutierrez, JE Novelli. Gynecology, Mastology and Reproduction Unit, French HospitaI-Mansilla, Buenos Aires, Argentina.
Objective. To describe our experience with laparoscopic diagnosis and treatment of ovarian teratomas. Measurements and Main Results. In 18 patients (age range 20-68 yrs, average 32 yrs) the most significant finding on ultrasound examination was adnexal mass (solid-liquid), occasionally with calcium. In four women the mass was bilateral. Three laparoscopies had to be converted to laparotomy to avoid spilling tissue contents and because of technical difficulties due to tumor size. No postoperative complications occurred. Conclusion. Laparoscopic surgery is a valid procedure in diagnosis and treatment of ovarian teratomas. Safety features must be maintained to avoid postoperative complications.
10. Characterization of the Normal Tube and Validation of Transcervical Falloposcopy in Healthy Fertile Volunteers M Bosnyak, SF Palter. Yale University School of Medicine, New Haven, Connecticut.
8. Laparoscopy versus Laparotomy in Distal Tubal Microsurgery
Objective. To assess the functional lumen of fallopian tube by falloposcopy (prospective surgical study). Measurements and Main Results. Thirty healthy, fertile, multiparous volunteers underwent laparoscopic tubal ligation and scoring of pelvic adhesions and
CA Baistrocchi, CE Croucher, M Horton, AE AIfonsin. Buenos Aires British Hospital, Buenos Aires, Argentina.
Objective. To compare microsurgical techniques performed by laparoscopy.
$3
Conclusion. Laparoscopic extraperitoneal infrarenal paraaortic lymph node dissection in a porcine model is feasible, provides excellent exposure to the entire paraaortic lymphatic chain, is safe, and has a remarkably short learning curve. Development of such a technique in humans may have similar advantages.
Measurements and Main Results. Three hundred sixtyeight women (age 22--40 yrs) with distal tubal pathology were operated by laparotomy and 64 (age 23-39 yrs) by laparoscopy. Interventions in both groups were fimbriolysis and salpingoneostomy. In the laparotomy group 53.6% of 190 women undergoing fimbriolysis and 34.2% of 178 undergoing salpingoneostomy achieved normal pregnancy; ectopic pregnancy occurred in 2.1% and 3.3% of women, respectively. In the laparoscopy group, 47.36% of 38 women having fimbriolysis and 31.6% of 26 having salpingoneostomy achieved normal pregnancy; ectopic pregnancies occurred in zero and 3.8%, respectively. Conclusion. Based on comparative analysis of this series, we conclude that laparoscopic distal tubal microsurgery is an effective and safe treatment that can be performed whenever it is indicated.
7. Planning Training Sessionsfor I_aparoscopic Modified Radical Hysterectomy and Pelvic and Paraaortic Lymphadenectomy in the Porcine Model I Atlas. Soroka Medical Center, Ben Gurion University, Beer Sheva, Israel.
Objective. To facilitate planning advanced laparoscopic training sessions in the porcine model based on session time and trainee experience. Measurements and Main Results. Seven advanced laparoscopic training sessions were held for surgeons with at least advanced traditional surgical training after video preparation including porcine anatomy and surgery. Surgical steps increased in difficulty during sessions alloted an estimated 3 hours. Retroperitoneal dissection, ligation, coagulation, cutting, and basic management of complications took less than 2 hours in all sessions. Pelvic lymphadenectomy required 3 hours. Large bowel mobilization, complete ureterolysis, and paraaortic lymphadenectomy were accomplished in 3.5 hours only by surgeons with laparoscopic experience. Modified radical hysterectomy or repair of major vessel, bowel, and ureteral injury was achieved by experienced laparoscopic surgeons in 4.5 hours. Conclusion. Laparoscopic training sessions using the porcine model should be based on time and trainee experience. For trainees with experience in conventional surgery, a 3-hour session can include retroperitoneal dissection and pelvic lymphadenectomy. Complete ureterolysis, paraaortic dissection, or modified radical hysterectomy requires sessions of 4 to 5 hours, and should be restricted to experienced surgeons.
9. Laparoscopic Management of Dermoid Ovarian Cysts C Battista, P Reb6n, F Sarquis, C Yinelli, P Gutierrez, JE Novelli. Gynecology, Mastology and Reproduction Unit, French HospitaI-Mansilla, Buenos Aires, Argentina.
Objective. To describe our experience with laparoscopic diagnosis and treatment of ovarian teratomas. Measurements and Main Results. In 18 patients (age range 20-68 yrs, average 32 yrs) the most significant finding on ultrasound examination was adnexal mass (solid-liquid), occasionally with calcium. In four women the mass was bilateral. Three laparoscopies had to be converted to laparotomy to avoid spilling tissue contents and because of technical difficulties due to tumor size. No postoperative complications occurred. Conclusion. Laparoscopic surgery is a valid procedure in diagnosis and treatment of ovarian teratomas. Safety features must be maintained to avoid postoperative complications.
10. Characterization of the Normal Tube and Validation of Transcervical Falloposcopy in Healthy Fertile Volunteers M Bosnyak, SF Palter. Yale University School of Medicine, New Haven, Connecticut.
8. Laparoscopy versus Laparotomy in Distal Tubal Microsurgery
Objective. To assess the functional lumen of fallopian tube by falloposcopy (prospective surgical study). Measurements and Main Results. Thirty healthy, fertile, multiparous volunteers underwent laparoscopic tubal ligation and scoring of pelvic adhesions and
CA Baistrocchi, CE Croucher, M Horton, AE AIfonsin. Buenos Aires British Hospital, Buenos Aires, Argentina.
Objective. To compare microsurgical techniques performed by laparoscopy.
$3