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Pneumoperitoneum in laparoscopy and its relationship to patient size
August 2002, Vol. 9, No. 3 Supplement TheJournal of the American Association of Gynecologic Laparoscopists
fragments, a current would be completed thus stopping the morcellator. Conclusion. Industry has already developed such devices and they should be made available to and be used by endoscopic surgeons.
and intraabdominal pressure of 20 mm Hg. was set by an automatic insufflator. Patient height, weight, BMI, surgical procedure, and CO2 requirements were recorded. A positive correlation between both height and CO2 and weight and CO2 was seen, with height and weight having a stronger relationship. Correlation between BMI and CO2 was not statistically significant. A linear regression model using height and weight to predict requirements was statistically significa_nt (r2 = 0.58). Interpretation of the model showed a marginal increase in height to have a much larger effect on CO2 requirements than a marginal increase in weight. Conclusion. In establishing pneumoperitoneum, it is imperative to consider the patient's height in conjunction with weight, to determine the amount of CO2 to be used.
139. Improved Patient Compliance at Office Hysteroscopy Using Pediatric Cystoscope 1M Pansky, 20 Asiag, 2R Bahar, 3M Feingold, 10 Neeman, 1R. Sagiv, 1M Yaron. 1Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel;2Maccabi Women's Health Center; 3TeI-Hashomer and Sackler School of Medicine, Tel Aviv, Israel.
Objective. To assess the efficacy of the 2.3-mm pediatric cystoscope for office diagnostic hysteroscopy. Measurements and Main Results. Subjects were 1335 women in whom a continuous-flow 2.3-mm pediatric cystoscope was used for hysteroscopy. Complete diagnosis of the uterine cavity was achieved in 87.4%. The leading cause of failure (80% of unsuccessful procedures) was cervical stenosis, followed by active uterine bleeding and obstructive myomas (6% each). Only two women (0.2%) required local anesthesia. Only six (0.5%) required dilatation of the cervix. Mean procedure time was 120 seconds, followed by a mean observation period of 10 minutes. No uterine perforation or other complication occurred. Vasovagal reaction occurred in 10 women and was treated by bedrest and observation. There was almost no need for postprocedure analgesia. Conclusion. It would seem that this instrument decreases the failure rate of office hysteroscopy to a minimum, and helps increase compliance of both patients and surgeons in favor of office hysteroscopy.
141. Comparison of Different Techniques of Fundal Detachment in Supracervical Hysterectomy R Pasic, AM Abdeh'nonern, RL Levine. Department of Obstetrics and Gynecology, University of Louisville, Louisville, Kentucky.
Objective. To evaluate the effectiveness of a new electrosurgical method to detach the uterine corpus from the cervix during supracervical hysterectomy, and compare the time required for different methods of fundal detachment. Measurements and Main Results. Supracervical hysterectomy was performed with different techniques in 12 women. The new monopolar electrosurgical instrument called the Lap Loop appears to be efficient and safe for rapid detachment of the uterine corpus from the cervix and with minimal blood loss. The time required for cervical cutting is significantly shorter than the time required for unipolar scissors. Conclusion. The Lap Loop appears superior to unipolar scissors in detaching the ftmdus during supracervical hysterectomy.
140. Pneumoperitoneum in Laparoscopy and Its Relationship to Patient Size 1C Papasakelariou, 2L Revere. 1Christus St. Joseph Hospital; 2University of Houston Clear Lake, Houston, Texas.
142. Laparoscopic Assessment of the Sparc Sling System for Treatment of Stress Urinary Incontinence MA Pelosi III, MA Pelosi II. Pelosi Women's Medical Center, Bayonne, New Jersey.
Objective. To determine the effect of individual patient variables (height, weight, BMI) on the amount of CO2 required to establish pneumoperitoneum at laparoscopy. Measurements and Main Results. Sixty-eight women without history of abdominal surgery underwent operative laparoscopy. Pneumoperitoneum was established
Objective. To evaluate the mechanism, safety, and precision of this new tra_nsvaginal tension-free sling.
$43
fragments, a current would be completed thus stopping the morcellator. Conclusion. Industry has already developed such devices and they should be made available to and be used by endoscopic surgeons.
and intraabdominal pressure of 20 mm Hg. was set by an automatic insufflator. Patient height, weight, BMI, surgical procedure, and CO2 requirements were recorded. A positive correlation between both height and CO2 and weight and CO2 was seen, with height and weight having a stronger relationship. Correlation between BMI and CO2 was not statistically significant. A linear regression model using height and weight to predict requirements was statistically significa_nt (r2 = 0.58). Interpretation of the model showed a marginal increase in height to have a much larger effect on CO2 requirements than a marginal increase in weight. Conclusion. In establishing pneumoperitoneum, it is imperative to consider the patient's height in conjunction with weight, to determine the amount of CO2 to be used.
139. Improved Patient Compliance at Office Hysteroscopy Using Pediatric Cystoscope 1M Pansky, 20 Asiag, 2R Bahar, 3M Feingold, 10 Neeman, 1R. Sagiv, 1M Yaron. 1Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel;2Maccabi Women's Health Center; 3TeI-Hashomer and Sackler School of Medicine, Tel Aviv, Israel.
Objective. To assess the efficacy of the 2.3-mm pediatric cystoscope for office diagnostic hysteroscopy. Measurements and Main Results. Subjects were 1335 women in whom a continuous-flow 2.3-mm pediatric cystoscope was used for hysteroscopy. Complete diagnosis of the uterine cavity was achieved in 87.4%. The leading cause of failure (80% of unsuccessful procedures) was cervical stenosis, followed by active uterine bleeding and obstructive myomas (6% each). Only two women (0.2%) required local anesthesia. Only six (0.5%) required dilatation of the cervix. Mean procedure time was 120 seconds, followed by a mean observation period of 10 minutes. No uterine perforation or other complication occurred. Vasovagal reaction occurred in 10 women and was treated by bedrest and observation. There was almost no need for postprocedure analgesia. Conclusion. It would seem that this instrument decreases the failure rate of office hysteroscopy to a minimum, and helps increase compliance of both patients and surgeons in favor of office hysteroscopy.
141. Comparison of Different Techniques of Fundal Detachment in Supracervical Hysterectomy R Pasic, AM Abdeh'nonern, RL Levine. Department of Obstetrics and Gynecology, University of Louisville, Louisville, Kentucky.
Objective. To evaluate the effectiveness of a new electrosurgical method to detach the uterine corpus from the cervix during supracervical hysterectomy, and compare the time required for different methods of fundal detachment. Measurements and Main Results. Supracervical hysterectomy was performed with different techniques in 12 women. The new monopolar electrosurgical instrument called the Lap Loop appears to be efficient and safe for rapid detachment of the uterine corpus from the cervix and with minimal blood loss. The time required for cervical cutting is significantly shorter than the time required for unipolar scissors. Conclusion. The Lap Loop appears superior to unipolar scissors in detaching the ftmdus during supracervical hysterectomy.
140. Pneumoperitoneum in Laparoscopy and Its Relationship to Patient Size 1C Papasakelariou, 2L Revere. 1Christus St. Joseph Hospital; 2University of Houston Clear Lake, Houston, Texas.
142. Laparoscopic Assessment of the Sparc Sling System for Treatment of Stress Urinary Incontinence MA Pelosi III, MA Pelosi II. Pelosi Women's Medical Center, Bayonne, New Jersey.
Objective. To determine the effect of individual patient variables (height, weight, BMI) on the amount of CO2 required to establish pneumoperitoneum at laparoscopy. Measurements and Main Results. Sixty-eight women without history of abdominal surgery underwent operative laparoscopy. Pneumoperitoneum was established
Objective. To evaluate the mechanism, safety, and precision of this new tra_nsvaginal tension-free sling.
$43