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42. Bipolar vessel-sealing devices in laparoscopic hysterectomies: a multicenter randomized controlled clinical trial.

Author

Hasanov, M., Denschlag, D., Seemann, E., Gitsch, G., Woll, J., and Klar, Maximilian

Subjects
BLOOD loss estimation, HYSTERECTOMY, METRORRHAGIA, RANDOMIZED controlled trials, VAGINAL surgery, UTERINE surgery, COMPARATIVE studies, ENDOMETRIOSIS, LAPAROSCOPY, RESEARCH methodology, MEDICAL cooperation, RESEARCH, UTERINE fibroids, EVALUATION research, SURGICAL blood loss
Abstract

Objective: To compare operating time and blood loss in patients undergoing total laparoscopic hysterectomies (TLH) for benign conditions with either the Marseal™ IQ 5 mm (MS) or the Ligasure™ 5 mm (LS) vessel-sealing device.Design and Setting: A randomized controlled clinical trial (RCT) in two German gynecology departments.Patients: 74 patients scheduled to undergo TLH for a symptomatic fibroid uterus, adenomyosis or severe meno-metrorrhagia.Interventions: Patients were randomized to receive a TLH with either the MS or the LS device. 27 variables were prospectively collected to address potential confounding issues.Measurement and Main Results: Operating time, defined as the time period between the first (round ligament dissection) and the last (uterine vessels sealing) use of the device, estimated and calculated intraoperative blood loss. The mean operating time (95% confidence interval, CI) was 22.7 min (95% CI 17.6-27.7) for LS and 26.4 min (95% CI 20-32.8) for the MS device (p = .89). The estimated intraoperative blood loss was 164 ml (95% CI 110-217) for LS and 160 ml (95% CI 116-203) for the MS device (p = .36). The multivariate analyses accounting for BMI, endometriosis, uterine weight and appearance of fibroids did not reveal any significant effect of the type of device used on operating time and estimated blood loss.Conclusion: In this RCT, both devices provided reliable and effective sealing and dissection. The reusable MS showed non-inferiority against the disposable LS device with regard to operating time and estimated intraoperative blood loss. [ABSTRACT FROM AUTHOR]

Published
2018
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43. Die Therapie des Vulvakarzinoms in den Frühstadien

Author

Gitsch G

Subjects
medicine.medical_specialty, Groin, business.industry, medicine.medical_treatment, Obstetrics and Gynecology, Vulvar cancer, medicine.disease, Surgery, Vulva, medicine.anatomical_structure, Labia minora, Maternity and Midwifery, Radical Vulvectomy, medicine, Lymphadenectomy, Radical Local Excision, business, Vulvar Diseases
Abstract

In the past, and still in some centres, patients with clinical stage I and II squamous cell vulvar cancer were treated by radical vulvectomy and bilateral inguinal-femoral lymphadenectomy. Modern management of vulvar cancer during the last 20 years has developed towards more conservative procedures in the therapy of early stage disease. At the Royal Hospital for Women, Sydney, women with invasive tumours 1 mm may undergo unilateral inguinal-femoral lymphadenectomy. Midline lesions and those involving the labia minora require bilateral groin dissection. In selected cases radical local excision of the primary lesion may also be performed in T2 lesions > 20 mm but should always be combined with a bilateral inguino-femoral lymphadenectomy. Adjuvant pelvic and groin irradiation should be given if at least one large node has undergone a tumorous change of if there are multiple nodes containing micrometastases. Careful patient selection is necessary to successfully achieve high cure rates, acceptable cosmetic results and psychosexual wellbeing.

Published
1996
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44. Gynäkologische Onkologie am Royal Hospital for Women, Sydney

Author

Gitsch G

Subjects
Gynecology, medicine.medical_specialty, business.industry, General surgery, medicine, Obstetrics and Gynecology, General Medicine, Gynecologic oncology, business
Abstract

Die gynakologische Onkologie in Australien ist zentralisiert. Im Royal Hospital for Women in Sydney werden pro Jahr mehr als 300 gynakologischonkologische Eingriffe durchgefuhrt. Die Etablierung des Z

Published
1995
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