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.

Randomized trial comparing a radially expandable needle system with cutting trocars.

Sharp trocar insertion for laparoscopic procedures carries with it increased risk for vascular and visceral complications and incisional hernia. In a trial, which randomized 87 patients to treatment with either sharp trocars or a radially expanding needle system with blunt dilator, results showed that with the latter system there was statistically improved patient assessment of pain, a lower complications rate, and shorter procedure time. In the group of patients randomized to treatment with conventional trocars, there were a total of six instrument-related adverse events (6/42): four cases (five incidences) of abdominal wall injuries and one small bowel perforation caused by a Veress needle.

Is the standard of care what we think it is?

For the most part, gynecologists are actually unaware of the issues involving surrogate versus quality of life outcomes, the "deceptive practice of medicine" and the true incidence of complications as they relate to the standard of care. An anonymous survey of 1958 practicing gynecologists attending seven national symposia revealed a significant number of unreported complications. Clearly, the standard of care (at least with regard to complication risk) is markedly different than has been suggested by the medical literature.

Endometriosis ascites: a case report.

This is a case presentation of an usual nature, a 43-year-old Hispanic female, multigravida presenting with physical findings of massive ascites. In most instances, the presence of massive ascites is associated with malignancies, tuberculosis or perforated visous. In this case, the diagnosis of extensive endometriosis with ascites is reported as a very rare complication of the disease.