[Single-port surgery and adnexal procedures: which indications in oncological surgery?]. / Cœlioscopie par mono-trocart et chirurgie annexielle : quelles applications en chirurgie oncologique ?

OBJECTIVE: To show the interest of single trocar in order to perform uni- or bilateral salpingo-oophorectomies. PATIENTS AND METHODS: A descriptive study monocentric. RESULTS: A total of 79 unilateral or bilateral salpingo-oophorectomies were performed by single-port laparoscopy between January 2010 and September 2012 at the Institut Paoli-Calmettes (Marseille). There are three surgical indications: diagnostic, therapeutic and prophylactic. The median age was 50 years (22-78 years). The median BMI was 22.4 kg/m(2) (17.5 to 37.7 kg/m(2)). The median blood loss was 0cc (0cc-50cc). The median hospital stay of patient was one day (0-6 days). The conversion rate in this study was 8.8%. DISCUSSION AND CONCLUSION: The single-port laparoscopic approach to perform uni- or bilateral salpingo-oophorectomies is a natural evolution of the conventional laparoscopy. If the cosmetic role seems obvious, its therapeutic value compared to traditional technique must be demonstrated by prospective studies with larger numbers.

Health policy in France: a major issue in the 1978 legislative elections.

For the 1978 legislative elections, all French political parties have, for the first time, a relatively detailed health policy. The right-wing parties of the present government concentrate on the reduction of medical expenditure and the maintenance of the free enterprise tradition of French medicine. The left-wing parties concentrate more on the development of public health institutions and suggest nationalization of the pharmaceutical industry. Within the Left, there is, however, a difference of emphasis: the Socialists propose the setting up of medicosocial centers and abolition of the fee-for-service system; the Communists concentrate rather on industrial health and believe that an improved health service can only come from changes in overall social economic policy. None of these policies is particularly adventurous but their mere existence shows that health is now a major political preoccupation in France. Some of these policies are mainly concerned with individual and public welfare and others with the necessity of maintaining a certain social order. The debate surrounding health policy usually turns around these two issues.