ABSTRACT
Objective@#Transvaginal removal of large specimens during laparoscopic hysterectomy can be a complex surgical procedure that poses a risk of organ injury and tissue spillage into the abdominal cavity and is associated with extraction of the specimen and manual morcellation. Our objective was to demonstrate a technique for transvaginal removal of large specimens using the Alexis Contained Extraction System (CES) in laparoscopic hysterectomy. @*Methods@#The technique used for transvaginal removal of large specimens using the Alexis CES was presented in this video. Surgery was performed at a tertiary hospital. @*Results@#Following resection of the specimen during laparoscopic hysterectomy, the Alexis CES was inserted into the abdominal cavity through the umbilical trocar wound. The specimen was placed in a bag to prevent tissue spillage. The ring retractor was guided to the vagina and pulled out transvaginally. By repeatedly turning the ring retractor, tension was applied to the specimen bag, and the vaginal wall was unfolded all around to enable a secure surgical field. During manual morcellation of the specimen in the bag, the retractor was pulled and additionally turned to roll and re-tension the specimen bag when the bag was loosened. The specimen was pushed out of the vagina and safely and effectively extracted without concerns about tissue spillage in the abdominal cavity or related organ injuries. @*Conclusion@#The technique for transvaginal removal of large specimens using the Alexis CES enables simple, effective, and safe tissue extraction with contained manual morcellation during laparoscopic hysterectomy.
ABSTRACT
In order to examine the attitudes of medical students toward oriental medicine before and after lecture course, self-administered questionnaires were given the medical students of Kyoto Prefectural University of Medicine. Eighteen percent of the students had some experience with the prescription of Kampo medicine by doctors; 53% had used Kampo medicine purchased in pharmacies, and 13% had been treated with acupuncture and moxibustion. Eighty-four percent of the students were interested in oriental medicine; 82% thought that oriental medicine was worth learning; 76% thought that oriental medicine was essential in contemporary medicine and 54% wanted to introduce oriental medicine into their clinical practice in the future. These percentages increased after the lecture course to 92%, 85%, 87% and 62%, respectively.
ABSTRACT
This is a report of the 16th Annual Conference on Student Selection held on August 30, 1997 in Tokyo. The main topic of discussion was the subject whether bachelor's degree must be required to medical school applicants. Advantages, disadvantages and expected future problems concerning the proposal by the advisory committee of the Ministry of Education and Culture are widely discussed.