Minilaparoscopy-assisted natural orifice surgery.

Background And Objectives: New technology has allowed us to perform major abdominal and pelvic surgeries with increasingly smaller instruments. The ultimate goal is surgery with no visible scars. Until current technical limitations are overcome, minilaparoscopy-assisted natural orifice surgery (MANOS) provides a solution.

Does ICSI require acrosomal disruption? An ultrastructural study.

Background: Aggressive immobilization of sperm prior to ICSI significantly improves fertilization rates, but the mechanism of this effect is not yet clear. This study was performed in order to assess the characteristics of mechanically immobilized human sperm by transmission electron microscope (TEM).

Methods: Sperm obtained from ejaculated semen samples from three different donors were immobilized in a standard manner for ICSI.

Culdolaparoscopic oophorectomy with vaginal hysterectomy: an optional minimal-access surgical technique.

Background And Purpose: Oophorectomy during vaginal hysterectomy may be difficult or impossible when the ovaries lie high in the pelvis or when adhesions are present. A new technique of culdolaparoscopic oophorectomy during vaginal hysterectomy is described.

Patients And Methods: After the uterus is removed, a 12-mm cannula is introduced into the culde-sac, and a pneumoperitoneum is created.

Chromosome analysis of epididymal and testicular sperm in azoospermic patients undergoing ICSI.

Background: Although ICSI provides a way of treating azoospermic men, concern has been raised about the potential risk for transmission of genetic abnormalities to the offspring. We quantified the incidence of chromosomal abnormalities in epididymal and testicular sperm retrieved from azoospermic patients undergoing ICSI.

Methods: Individual testicular sperm were collected from testicular biopsies with an ICSI pipette, and epididymal sperm were retrieved by microsurgical epididymal sperm aspiration.

Operative culdolaparoscopy: a new approach combining operative culdoscopy and minilaparoscopy.

The tendency is to use small cannulas for operative laparoscopy; however, working with these cannulas may have technical limitations. We developed a technique for performing appendectomy combining culdoscopy and minilaparoscopy. It uses 3- or 5-mm abdominal cannulas, and the large 10- or 12-mm cannula is inserted into the posterior vaginal fornix under laparoscopic surveillance.