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.

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).

Relationship between the results of sperm analysis and GIFT.

In vitro fertilization (IVF) and GIFT have been proposed as therapeutic approaches in infertile couples where a significant male factor is present. To date, few published data are available relating the success rate of GIFT to the severity of the male factor. In this report the results of the first 172 GIFT cases were analyzed.

Endometriosis then and now. Evolution of surgical techniques and treatment.

Surgical techniques and practices for conservative endometriosis surgery began developing in the U.S. They led naturally to contemporary concepts and to the rationale for use of the techniques.

The residual ovary syndrome.

Previous reports have demonstrated a significant incidence of pelvic symptomatology involving ovaries preserved following hysterectomy, to be called "the residual ovary syndrome." This report, in an 11-year retrospective analysis of all oophorectomies at The Methodist Hospital in Houston, Texas, identified 202 cases in which a previous hysterectomy had been performed. The majority of these patients presented with varying degrees of chronic pelvic pain (77.