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Peritoneal adhesion formation in a rat cecum model
August 1998, Vol. 5, No. 3 Supplement TheJournal of the American Association of Gynecologic Laparoscopists
than resection. Improvements in operating technique and equipment achieve better results with fewer complications.
there were focal adhesion sites on mesothelial surfaces. Significant cell proliferation was observed after 24 hours. At 1 week there was considerable angiogenesis and tissue modeling. [31-Integrin was highly expressed at very early stages of adhesion development and was quickly reduced, suggesting a role in initiation of the lesions. In contrast, cellular fibronectin was not detectable until 1 week after injury. Conclusion. Rat cecum adhesion model is an excellent in vivo system to study adhesion formation. Adhesions may occur as early as 2 hours after tissue injury; and ~31-integrin is involved in their early development.
206. Analysis of One-Stage Transcervical Resection
of Endometrium 1EL Xia, 2LM Feng, 2H Ouan, 2HL Duan. ~Capital University of Medical Sciences, Beijing, China; 2Beijing Fuxing Hospital, Beijing, China.
Objective. To assess the feasibility and efficacy of one-stage TCRE in treating menorrhagia. Measurements and Main Results. One hundred twentyfive women (average age 43.23 yrs, range 17-72 yrs) suffered from AUB with or without small submucous fibroids or polyps. Hysteroscopic examination was performed first. If there was suspicion of malignancy, biopsy tissue was obtained and the procedure stopped. Otherwise D&C was performed and endometrium ablated by electroresectoscope or rollerball. Results were satisfactory in 96% of women, with total amenorrhea in 63.16%, slight spotting in 19.74%, hypomenorrhea in 13.16%, and normal menstruation in 2.74%. Two patients underwent a second procedure. The one failure (0.08%) was due to enlarged fibroids, which required hysterectomy. Conclusion. One-stage transcervical resection of the endometrium without hormone pretreatment, hysteroscopic examination, or D&C is feasible, efficient, and safe therapy for AUB.
208. Preliminary Report of 2-Year Experience with Extraperitoneoscopic Burch's Colposuspension for Genuine Stress Incontinence CF Yen, CL Lee, CJ Wang, YK Soong. Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Objective. To describe a new, purely extraperitoneal approach for laparoscopic Burch colposuspension to eliminate opening and repairing peritoneum. Measurements and Main Results. Between October 1995 and March 1997 we performed 124 extraperitoneal Burch colposuspensions in women with GUSI with bladder neck hypermobility based on urodynamic study and pad test, with suggestion of bladder neck suspension. Among these women, 38 were followed for more than 2 years and 86 for more than 1 year. Based on subjective incontinence scoring, more than 90% reported more than 81% improvement and were satisfied with the outcome. Conclusion. Results of extraperitoneoscopic Burch's colposuspension were as good as those with traditional transperitoneal laparoscopic Burch colposuspension, but operating time and recovery were shorter. Unexpected benefits were clearer view of anatomy of the deep pelvic floor and wider working field.
207. Peritoneal Adhesion Formation in a Rat Cecum
Model FD Yelian, R Khalifa, K Oomen, MP Diamond. Wayne State University, Detroit, Michigan.
Objective. To define temporal and spatial events, and cellular and molecular involvement during adhesion development. Measurements and Main Results. Cecum of 30 rats were abraded with a standard electrical abrasion apparatus. After surgical injury, two to three rats from each time point were sacrificed at 0, 2, 4, 8, 16, 24, 48, 72, 96, 168, 336, and 504 hours. Adhesion status was observed and recorded, and tissue collected for histologic analysis. Among 26 animals sacrificed after 2 hours of surgery, 25 (96%) formed visible adhesion; histologically, we found significant local edema and vessel dilatation. Cecum-cecum adhesions were observed as early as 2 hours after injury. After 8 hours
209. Comparison of Radially Expanding Cannulas with Conventional Cutting Tip Cannulas PM Yuen, SF Yim. Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
Objective. To compare safety and postoperative pain associated with radially expanding access (REA) system (Step; InnerDyne, Sunnyvale, CA) and disposable conventional cutting tip cannula (prospective, randomized, double-blind, self-controlled study).
$59
than resection. Improvements in operating technique and equipment achieve better results with fewer complications.
there were focal adhesion sites on mesothelial surfaces. Significant cell proliferation was observed after 24 hours. At 1 week there was considerable angiogenesis and tissue modeling. [31-Integrin was highly expressed at very early stages of adhesion development and was quickly reduced, suggesting a role in initiation of the lesions. In contrast, cellular fibronectin was not detectable until 1 week after injury. Conclusion. Rat cecum adhesion model is an excellent in vivo system to study adhesion formation. Adhesions may occur as early as 2 hours after tissue injury; and ~31-integrin is involved in their early development.
206. Analysis of One-Stage Transcervical Resection
of Endometrium 1EL Xia, 2LM Feng, 2H Ouan, 2HL Duan. ~Capital University of Medical Sciences, Beijing, China; 2Beijing Fuxing Hospital, Beijing, China.
Objective. To assess the feasibility and efficacy of one-stage TCRE in treating menorrhagia. Measurements and Main Results. One hundred twentyfive women (average age 43.23 yrs, range 17-72 yrs) suffered from AUB with or without small submucous fibroids or polyps. Hysteroscopic examination was performed first. If there was suspicion of malignancy, biopsy tissue was obtained and the procedure stopped. Otherwise D&C was performed and endometrium ablated by electroresectoscope or rollerball. Results were satisfactory in 96% of women, with total amenorrhea in 63.16%, slight spotting in 19.74%, hypomenorrhea in 13.16%, and normal menstruation in 2.74%. Two patients underwent a second procedure. The one failure (0.08%) was due to enlarged fibroids, which required hysterectomy. Conclusion. One-stage transcervical resection of the endometrium without hormone pretreatment, hysteroscopic examination, or D&C is feasible, efficient, and safe therapy for AUB.
208. Preliminary Report of 2-Year Experience with Extraperitoneoscopic Burch's Colposuspension for Genuine Stress Incontinence CF Yen, CL Lee, CJ Wang, YK Soong. Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Objective. To describe a new, purely extraperitoneal approach for laparoscopic Burch colposuspension to eliminate opening and repairing peritoneum. Measurements and Main Results. Between October 1995 and March 1997 we performed 124 extraperitoneal Burch colposuspensions in women with GUSI with bladder neck hypermobility based on urodynamic study and pad test, with suggestion of bladder neck suspension. Among these women, 38 were followed for more than 2 years and 86 for more than 1 year. Based on subjective incontinence scoring, more than 90% reported more than 81% improvement and were satisfied with the outcome. Conclusion. Results of extraperitoneoscopic Burch's colposuspension were as good as those with traditional transperitoneal laparoscopic Burch colposuspension, but operating time and recovery were shorter. Unexpected benefits were clearer view of anatomy of the deep pelvic floor and wider working field.
207. Peritoneal Adhesion Formation in a Rat Cecum
Model FD Yelian, R Khalifa, K Oomen, MP Diamond. Wayne State University, Detroit, Michigan.
Objective. To define temporal and spatial events, and cellular and molecular involvement during adhesion development. Measurements and Main Results. Cecum of 30 rats were abraded with a standard electrical abrasion apparatus. After surgical injury, two to three rats from each time point were sacrificed at 0, 2, 4, 8, 16, 24, 48, 72, 96, 168, 336, and 504 hours. Adhesion status was observed and recorded, and tissue collected for histologic analysis. Among 26 animals sacrificed after 2 hours of surgery, 25 (96%) formed visible adhesion; histologically, we found significant local edema and vessel dilatation. Cecum-cecum adhesions were observed as early as 2 hours after injury. After 8 hours
209. Comparison of Radially Expanding Cannulas with Conventional Cutting Tip Cannulas PM Yuen, SF Yim. Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
Objective. To compare safety and postoperative pain associated with radially expanding access (REA) system (Step; InnerDyne, Sunnyvale, CA) and disposable conventional cutting tip cannula (prospective, randomized, double-blind, self-controlled study).
$59