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Prolene tape of TVT in the space of the retzius
August 2001, Vol. 8, No. 3 Supplement
TheJournal of the American Association of Gynecologic Laparoscopists
This is in contrast to significant correlation reported between intraoperative description and histologic confirmation of infarction. Surgeons must be careful when deciding whether or not to remove what appear to be necrotic adnexa, as looks can be deceiving.
Conclusion. Abdominal wall thickness at the umbilical and left upper quadrant entry sites correlates well with both weight and BMI. Even in obese women, the distance to the gas pocket after insufflation at either entry site is remarkably small.
291. Prolene Tape of TVT in the Space of the Retzius H Shimizu, A Kabayashi. Social Insurance Funabashi Central Hospital, Chiba, Japan.
293. OvaOffice Flexible Hysteroscopy to Diagnose Endometrial Cancer M Tilli, AJ Aldini. Hospital Dr. Carlos Bocalandro, Buenos Aires Argentina.
Objective. To report our experience with prolene tape in the space of Retzius (SOR). Measurements and Main Results. A patient with left ovarian tumor and SUI underwent laparoscopic left salpingo-oophorectomy and observation of SOR after TVT. Findings of SOR were the right end of prolene tape in the white line and left end through the lower part of the fascia of intemal obturator muscle. The woman was continent 1 year after surgery. Conclusion. Prolene tape is expected to penetrate periurethral endopelvic fasica and act as a_neffective subsling. This case shows TVT is effective as long as tape is beneath the urethra and through SOR.
Objective. To assess the efficacy of ambulatory flexible hysteroscopy in diagnosing uterine endocavitary malignancies. Measurements and Main Results. One hundred ten postmenopausal women (age range 41-78 yrs) not treated by HRT had the diagnosis of postmenopausal bleeding (30%), endocavitary ultrasound image (63.6%), or both (6.4%). They underwent flexible hysteroscopy and endometrial sampling using Cornier's pipelle or directed biopsy. Six patients (5.4%) required general anesthesia due to cervical stenosis. Hysteroscopic findings were slender endometrium in 50 women (45.4%), thickened endometrium in 18 (16.3%), suspected neoplasm in 15 (13.6%), and endocavitary formation resembling polyp or myoma in 27 (24.5%). Specimens were unsuitable for diagnosis in 6.3%. Signs suspicious of malignancy were found in 15 women, in 14 of whom (93.3%) the diagnosis was confirmed by histopathology. Conclusion. High diagnostic efficiency, acceptance by patients, and good cost:benefit ratio make ambulatory flexible hysteroscopy a first choice for women suspected of having uterine cavity carcinoma.
292. Use of a Spinal Needle Test to Estimate Abdominal Wall Thickness at Laparoscopy MF Terkildsen, MP Milad. Prentice Women's Hospital, Northwestern University, Chicago, Illinois.
Objective. To correlate abdominal wall thickness at two initial entry sites for laparoscopy with BMI. Measurements and Main Results. Subjects were 123 consecutive women undergoing diagnostic and operative laparoscopy. Mean BMI was 24.7 kg/m2 (range 17.243.0 kg/m2), with 19 patients (15%) considered clinically obese (BMI =30 kg/m2). After CO2 insufflation, a spinal needle attached to a saline-filled syringe was inserted and advanced perpendicular to the skin until the gas pocket was reached. To improve precision, this distance was successively measured 3 times at the umbilicus and 3 times at Palmer's point (left upper quadrant). A significant correlation was noted between abdominal wall thickness and BMI at the umbilicus (r = 0.72) and at Palmer's point (r = 0.78). Mean thickness at the umbilicus differed significantly between obese (2.8 _+1.2 cm) and nonobese patients (1.4 _+ 0.5 cm, p <0.01), as did mean thickness at the left upper quadrant (4.1 _+ 1.1 vs 1.9 _+ 0.6 cm, p <0.01).
$87
294. Normal versus Abnormal Findings in Fallopian Tube Investigation AL Valentini, L Muzii, R Marana, GF Catalano, C Desito, P Marano. University Cattolica del Sacro Cuore, Rome, Italy.
Objective. To show normal versus abnormal findings at HSG to improve radiographic assessment of tubal morphology. Measurements and Main Results. Tubal morphology is correctly assessed by HSG in most patients. Ampullary diverticula and endolumenal ampullary adhesions in patent tubes cannot be correctly investigated by HSG, as shown by laparoscopy or salpingoscopy.
TheJournal of the American Association of Gynecologic Laparoscopists
This is in contrast to significant correlation reported between intraoperative description and histologic confirmation of infarction. Surgeons must be careful when deciding whether or not to remove what appear to be necrotic adnexa, as looks can be deceiving.
Conclusion. Abdominal wall thickness at the umbilical and left upper quadrant entry sites correlates well with both weight and BMI. Even in obese women, the distance to the gas pocket after insufflation at either entry site is remarkably small.
291. Prolene Tape of TVT in the Space of the Retzius H Shimizu, A Kabayashi. Social Insurance Funabashi Central Hospital, Chiba, Japan.
293. OvaOffice Flexible Hysteroscopy to Diagnose Endometrial Cancer M Tilli, AJ Aldini. Hospital Dr. Carlos Bocalandro, Buenos Aires Argentina.
Objective. To report our experience with prolene tape in the space of Retzius (SOR). Measurements and Main Results. A patient with left ovarian tumor and SUI underwent laparoscopic left salpingo-oophorectomy and observation of SOR after TVT. Findings of SOR were the right end of prolene tape in the white line and left end through the lower part of the fascia of intemal obturator muscle. The woman was continent 1 year after surgery. Conclusion. Prolene tape is expected to penetrate periurethral endopelvic fasica and act as a_neffective subsling. This case shows TVT is effective as long as tape is beneath the urethra and through SOR.
Objective. To assess the efficacy of ambulatory flexible hysteroscopy in diagnosing uterine endocavitary malignancies. Measurements and Main Results. One hundred ten postmenopausal women (age range 41-78 yrs) not treated by HRT had the diagnosis of postmenopausal bleeding (30%), endocavitary ultrasound image (63.6%), or both (6.4%). They underwent flexible hysteroscopy and endometrial sampling using Cornier's pipelle or directed biopsy. Six patients (5.4%) required general anesthesia due to cervical stenosis. Hysteroscopic findings were slender endometrium in 50 women (45.4%), thickened endometrium in 18 (16.3%), suspected neoplasm in 15 (13.6%), and endocavitary formation resembling polyp or myoma in 27 (24.5%). Specimens were unsuitable for diagnosis in 6.3%. Signs suspicious of malignancy were found in 15 women, in 14 of whom (93.3%) the diagnosis was confirmed by histopathology. Conclusion. High diagnostic efficiency, acceptance by patients, and good cost:benefit ratio make ambulatory flexible hysteroscopy a first choice for women suspected of having uterine cavity carcinoma.
292. Use of a Spinal Needle Test to Estimate Abdominal Wall Thickness at Laparoscopy MF Terkildsen, MP Milad. Prentice Women's Hospital, Northwestern University, Chicago, Illinois.
Objective. To correlate abdominal wall thickness at two initial entry sites for laparoscopy with BMI. Measurements and Main Results. Subjects were 123 consecutive women undergoing diagnostic and operative laparoscopy. Mean BMI was 24.7 kg/m2 (range 17.243.0 kg/m2), with 19 patients (15%) considered clinically obese (BMI =30 kg/m2). After CO2 insufflation, a spinal needle attached to a saline-filled syringe was inserted and advanced perpendicular to the skin until the gas pocket was reached. To improve precision, this distance was successively measured 3 times at the umbilicus and 3 times at Palmer's point (left upper quadrant). A significant correlation was noted between abdominal wall thickness and BMI at the umbilicus (r = 0.72) and at Palmer's point (r = 0.78). Mean thickness at the umbilicus differed significantly between obese (2.8 _+1.2 cm) and nonobese patients (1.4 _+ 0.5 cm, p <0.01), as did mean thickness at the left upper quadrant (4.1 _+ 1.1 vs 1.9 _+ 0.6 cm, p <0.01).
$87
294. Normal versus Abnormal Findings in Fallopian Tube Investigation AL Valentini, L Muzii, R Marana, GF Catalano, C Desito, P Marano. University Cattolica del Sacro Cuore, Rome, Italy.
Objective. To show normal versus abnormal findings at HSG to improve radiographic assessment of tubal morphology. Measurements and Main Results. Tubal morphology is correctly assessed by HSG in most patients. Ampullary diverticula and endolumenal ampullary adhesions in patent tubes cannot be correctly investigated by HSG, as shown by laparoscopy or salpingoscopy.