Incidence of cyclical bleeding after laparoscopic supracervical hysterectomy.

Study Objective: The aim of the study was to estimate the incidence of cyclical bleeding after laparoscopic supracervical hysterectomy (LSH) when the uterus is amputated at or below the level of internal cervical os.

Design: Prospective series of consecutive patients (Canadian Task Force classification II-3).

Setting: Single surgery team, independent surgery center.

Clinical experience with the (OPERA)StarSL using saline irrigation fluid for OPERA.

Objective: To present clinical results using a new hysteroscopic resectoscope, the (OPERA)Star(SL) with PEARL technology, which cuts and coagulates uterine tissue in a physiologic, conductive fluid environment in order to perform OPERA, Out-Patient Endometrial Resection/Ablation. Use of physiologic normal saline in resectoscopy has not previously been feasible. Use of normal saline prevents complications such as hyponatremia and cerebral edema due to excessive absorption of traditional nonphysiologic fluids.

Initial experience with a physiologic morcellating resectoscope.

A new physiologic morcellating resectoscope allows operative hysteroscopy to be performed with a physiologic distention medium, thus reducing the risk of dilutional hyponatremia and cerebral edema secondary to excessive absorption of nonphysiologic fluid. To study this new technology, we gathered in vitro data with the SL resectoscope with dual-function electrode (FemRx, Sunnyvale, CA). Coupled to a standard monopolar electrosurgery unit and operating in normal saline or Ringer's lactate solution, extirpated uteri showed equivalent depth of tissue necrosis with this new physiologic morcellating resectoscope as with a conventional monopolar resectoscope used in an electrically nonconductive fluid.

Prevention of adhesion formation/reformation with the Gore-Tex Surgical Membrane.

Eighteen patients with extensive adhesions and 10 undergoing myomectomy had GORE-TEX Surgical Membranes placed in order to prevent adhesion formation/reformation. At the time of second-look laparoscopy the membranes were removed easily and the extent of adhesion was minimal. Preliminary data from 10 additional patients undergoing adhesiolysis demonstrated that the GSM resulted in significantly fewer adhesions than did oxidized regenerated cellulose.

Surgical treatment of symptomatic colorectal endometriosis.

The approach to the treatment of bowel endometriosis has varied greatly. In this paper we present 77 consecutive patients with deep colorectal endometriosis treated with a full-thickness resection. Gynecologic procedures included conservative laparotomies for preserving fertility (39 patients); hysterectomy with bilateral salpingo-oophorectomy (29 patients); bilateral salpingo-oophorectomy (2 patients); left salpingo-oophorectomy (1 patient) and resection of pelvic endometriosis in patients with previous ablative surgery (6 patients).