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The uncommon diagnosis of abdominal pregnancy is made once per 10,000 births. About 1% of all ectopic pregnancies appear with a primary or secondary peritoneal implantation. To the authors' best kn...

The purpose of this study was to compare the surgical management and pregnancy rates in women with advanced endometriosis and endometriomata who were treated either by endoscopic surgery o...

This article presents the results of a medical legal case presented as an unknown in Volume 11, Number 2, page 113, of this journal. The case was concluded to be an electrosurgical burn delivered to both the ileum and the colon. A description of electrosurgical burns is given and correlated to the medical-legal case. Also discussed are methods to minimize the likelihood of electrosurgical complications. Technology solutions, including actively monitored shielding of monopolar electrodes and bipolar electrodes, also are discussed. The histologic variation of electrosurgical damage is discussed, varying from uniform coagulation necrosis with vacuolization to areas appearing essentially normal but with areas showing pale-staining cellular cytoplasm and small dark nuclei. Areas with both vascular thrombi and hemorrhage also may be seen. The potential causes for electrosurgery damage are insulation failure, direct coupling through instrumentation and tissue, and capacitive coupling. (J GYNECOL SURG 11...

This study was conducted to determine the impact of the addition of the loop ligation (Endoloop) technique on choice of sterilization surgery in our residency teaching program and to investigate significant differences between this technique and other methods performed at our hospital. A retrospective study of all patients undergoing interval tubal sterilization at Tampa General Hospital in 1989 and 1991 was undertaken. Data were analyzed to determine the frequency of sterilization methods and differences between the loop ligation method and the other procedures performed; p values of less than 0.05 were considered significant. Sixty-one patients in 1989 and 75 in 1991 qualified for the study. Five methods of interval sterilization were performed: loop ligation, minilaparotomy, colpotomy, laparoscopic bipolar fulguration, and Silastic ring application. The frequency of the loop ligature technique increased from 0% in 1989 to 40% in 1991. There were no significant differences in operative time and complication rate among the loop method and other procedures. The loop ligature (Endoloop) method of laparoscopic sterilization does not significantly change the length of surgery, blood loss, or complication rate compared to the other laparoscopic techniques used in our residency program. This method provides a definitive tissue diagnosis, eliminates the risk of thermal injury, theoretically provides an opportunity of later tubal reanastomosis, and subjectively helps develop laparoscopic skills.

The objective of this study was to identify factors that may predict patients at risk for unscheduled admission following ambulatory gynecologic laparoscopic surgery and to identify specif...

Operative laparoscopy can be used even for the postmenopausal patient with an adnexal mass if proper patient selection and preoperative evaluation procedures are followed. Outpatient surge...

Omental evisceration remote from the immediate operative period is a rare complication of laparoscopy, with only 3 previous cases reported. Two additional cases of omental evisceration are reported. Previous surgery involving the umbilicus may increase the risk of this complication. Fascial closure following laparoscopy is recommended to reduce the chance of omental evisceration. (J GYNECOL SURG 10:185,1994)

A useful technique to assist the surgeon in the treatment of Asherman's syndrome is described. This technique, using methylene blue to distend the uterine fundus, allows the surgeon to ide...

Laparoscopic salpingo-oophorectomy may be performed using bipolar cautery, endoscopic staplers, or preformed Roeder loops. The last technique violates the principles followed in performing salpingo-oophorectomy at laparotomy and may increase the risk of complications. Following laparoscopic salpingo-oophorectomy with Roeder loops, 1 patient experienced an immediate postoperative bleeding episode when the loops slipped off the pedicle. In another patient, this technique resulted in an ovarian remnant. Laparoscopic salpingo-oophorectomy with Roeder loops may be complicated by postoperative bleeding and ovarian remnants. Bipolar cautery appears to be a safer method for performing this procedure. (J GYNECOL SURG 11:51, 1995)