Energy sources for gynecologic laparoscopic surgery: a review of the literature.

Importance: A range of energy sources are used in gynecologic laparoscopy. These energy sources include monopolar electrosurgery, bipolar electrosurgery (including "advanced bipolar" devices that incorporate tissue feedback monitoring), and various types of laser and ultrasonic technologies. Gynecologists using these tools should be aware of the potential benefits and potential dangers of these instruments.

Comparative studies of energy sources in gynecologic laparoscopy.

Energy sources incorporating "vessel sealing" capabilities are being increasingly used in gynecologic laparoscopic surgery although conventional monopolar and bipolar electrosurgery remain popular. The preference for one device over another is based on a combination of factors, including the surgeon's subjective experience, availability, and cost. Although comparative clinical studies and meta-analyses of laparoscopic energy sources have reported small but statistically significant differences in volumes of blood loss, the clinical significance of such small volumes is questionable.

Laparoscopic vessel sealing technologies.

Laparoscopic vessel sealing devices have revolutionized modern laparoscopy. These devices fall into 2 major categories: advanced bipolar and ultrasonic instruments. The range of tissue effects available with these technologies is more limited than with conventional monopolar electrosurgery; however, both advanced bipolar and ultrasonic devices efficiently seal vessels (≤7-mm and ≤5-mm diameter, respectively), and most also have built-in tissue transection capabilities.

A comparative study assessing the efficacy and acceptability of anorectal swabs for antenatal GBS screening.

Objectives: To assess women's perception of pain and acceptability of low vaginal swab (LVS) and anorectal swab (ARS) for antenatal screening for Group B Streptococcus (GBS), and to compare the detection rate between these tests.

Methods: Separate LVS and ARS were collected at the 36-week antenatal visit, either by the patient herself or by her clinician. Acceptability and pain were evaluated on a Likert scale using a standardised questionnaire.

Laparoscopic subtotal hysterectomy: evidence and techniques.

Laparoscopic subtotal/supracervical hysterectomy (LSH) is a surgical option when hysterectomy is indicated. Proponents of LSH suggest possible advantages including reduced recovery time, decreased risk of pelvic organ prolapse, and decreased risk of organ damage, in particular to the urinary tract. Opponents of LSH have suggested that the future risk of cervical malignancy, the possibility of ongoing cyclical bleeding, limited morbidity due to total laparoscopic hysterectomy, and similar clinical outcomes render this approach unnecessary.