Search

Myomectomy is appropriate for many women with uterine fibroids whether or not they wish to preserve their childbearing potential. An expert provides guidance on abdominal myomectomy, including intraoperative technique, controlling [...]

* Hysterectomy is increasingly the first--and only--treatment option recommended for fibroids, but evidence shows that myomectomy is efficacious, safe, and associated with improved quality of life for many women. It [...]

Parker is an ob-gyn specializing in the evaluation and treatment of women with uterine fibroids. He is an expert in surgery for myomectomy using minimally invasive surgery or through open [...]

During hysterectomy for benign indications, many surgeons routinely remove the ovaries to prevent cancer. Here's what we know about this practice. [CASE] Patient opts for hysterectomy, asks about oophorectomy Your [...]

Gynecologists have long suggested that prophylactic oophorectomy is the best way to decrease the rate of ovarian cancer. (1) In fact, calculations suggest that routine oophorectomy for women over 40 [...]

Women who have undergone menopause and develop masses on the ovaries or fallopian tubes usually undergo exploratory laparotomy (surgical opening of the abdomen), with the aim of removal of ovarian cancer, if found. This is done in spite of the fact that most such masses are benign; thus, a screening approach that allows selection of only those masses likely to be malignant is needed. To evaluate the accuracy of a diagnostic approach that uses ultrasonography and determination of levels of a tumor marker known as CA 125 in the blood (high levels of which indicate malignancy), results from laparoscopic visualization and treatment of 25 postmenopausal patients are presented. The patients were considered likely to have benign masses, according to results from the preoperative tests. Results confirmed this prediction, in all cases. The operations were of short duration (average, 73 minutes), patients remained in the hospital an average of 12 hours after surgery, and they returned to normal activity a few days later. Two surgical complications occurred (a perforated bladder and an injury to the large bowel), and one patient required laparotomy. Thus, 22 patients were successfully treated with minimal surgical intervention. These diagnostic and surgical approaches are recommended for certain carefully selected postmenopausal women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Benign cystic teratomas of the ovary may be safely removed via laparoscopy during pregnancy. Benign cystic teratomas of the ovary may complicate pregnancies after the first trimester by twisting or rupturing, obstructing delivery, or harboring malignancy. Researchers performed laparoscopy on 12 women with benign cystic teratomas between nine and 17 weeks of pregnancy. Cysts ruptured during surgery in 10 women, but no one experienced abdominal infection postoperatively. Thorough irrigation of the abdomen during surgery seemed to prevent infection from developing. Ultrasonography can be used to diagnose benign cystic teratomas before surgery. To reduce the risk of miscarriage, surgery should be done at the beginning of the second trimester while the uterus is still small.

Byline: William H. Parker, Joel M. Childers, Michel Canis, Douglas R. Phillips, Howard Topel Keywords: Laparoscopy; pregnancy Abstract: OBJECTIVE: Our purpose was to evaluate the surgical management and outcome of laparoscopic removal of benign cystic teratomas during pregnancy. STUDY DESIGN: The records of women with benign cystic teratomas who were managed with operative laparoscopy during pregnancy were reviewed. RESULTS: Twelve women had laparoscopic removal of a benign cystic teratoma during pregnancy. Gestational ages at surgery ranged from 9 to 17 weeks, with a mean of 14 weeks. Cyst size ranged from 5 to 13 cm, with a mean of 8.5 cm. Intraoperative rupture of the cyst occurred in 10 of 12 (93%) women. No patient had evidence of chemical peritonitis. The mean operating time was 87 minutes and the mean postoperative hospital stay was 44 hours. No intraoperative or postoperative maternal or fetal complications occurred. CONCLUSIONS: Laparoscopic removal of a benign cystic teratoma of the ovary may be safely accomplished during pregnancy. In spite of a significant risk of cyst rupture, careful operative technique followed by copious irrigation of the pelvis may avoid chemical peritonitis and potential adverse sequelae. (AM J OBSTET GYNECOL 1996;174:1499-501.) Author Affiliation: Los Angeles, California, Tucson, Arizona, Stony Brook, New York, Park Ridge, Illinois, and Clermont-Ferrand, France Article History: Received 5 September 1995; Revised 5 October 1995; Accepted 10 October 1995 Article Note: (footnote) [star] From the Departments of Obstetrics and Gynecology, University of California, Los Angeles, School of Medicine,a University of Arizona, b Polyclinique de l'Hotel Dieu, c State University of New York, d and Lutheran General Hospital. e , [star][star] Reprint requests: William H. Parker, MD, 1450 Tenth St., Santa Monica, CA 90401., a 0002-9378/96 $5.00 + 0 6/1/69805

Watch these, and more, expert surgical technique and commentary videos in the EXPLORE: Multimedia section [...]

Yes, but the model needs to be validated in other populations and data sets before it can be set to clinical use. For this case-control study of 2,461 women in [...]

'THE FDA'S REVIEW OF THE DATA ON OPEN POWER MORCELLATION WAS 'INADEQUATE, IRRESPONSIBLE' AND A 'DISSERVICE TO WOMEN'' WILLIAM H. PARKER, MD (AUDIO COMMENTARY; NOVEMBER 2014) In the February issue [...]