[Laparoscopic burch colposuspensio--our experience].

Stress incontinence is involuntary loss of urine that occurs during periods of increased intraabdominal pressure, such as sneezing, coughing or exercise. Retropubic Burch colposuspension has been considered by many to be the "gold standard" procedure for treatment of female stress urinary incontinence for almost 50 years. The firs reported retropubic surgery performed via the laparoscopic approach was described by Vancaillie and Schuessler in 1991. We present a clinical case of a female patient with stress incontinence who has been operated by laparoscopic approach by our team.

[Laparoscopic myomectomy using bidirectional barbed suture: report of the new technique in 82 cases].

Bidirectional barbed suture introduces a new paradigm in laparoscopic suturing. The aim of our study is to evaluate the efficacy and safety of using bidirectional barbed suture in laparoscopic myomectomy. It included 102 women, requiring a laparoscopic myomectomy for symptomatic uterine fibroids from June 2011 to May 2014. They are divided into two groups according to the thread used for closing the uterine incision. We used bidirectional barbed suture Quill and Vicryl in the control group. The mean operative time was shorter in the Quill group than in control group. Both intraoperative blood loss and drop of hemoglobin were significantly lower in the Quill group. The use of bidirectional barbed suture appears to be safe for closing the hysterotomy site during a laparoscopic myomectomy.

[Our and foreign experience in modern surgical treatment of cervical adenocarcinoma stage T(1A1)].

AIM: The aim of this research work was to evaluate the distant results in patients with cervical adenocarcinoma stage T(1A1) treated conservatively only by conization. MATERIAL AND METHODS: 60 patients were) examined for 10 years period with cervical adenocarcinoma stage T(1A1) (stromal invasion to 3 mm in deapth and 7 mm horizontal spread). RESULTS: 50 patients were surgicaly treated by cold knife conization and 10 patients by LLETZ. In 40 patients a total hysterectomy was additionally performed. 20 patients (age range from 20 to 40 years) were treated only by conization because they desired to preserve fertility. In 12 patients an attempt was made for to get pregnant. In 7 patients there was a successful pregnancy. CONCLUSIONS: The conization of the uterine cervix as the only treatment in patients with cervical cancer T(1A1) adenocarcinoma is effective and safe therapy. It is very important when patients desire to save their reproductive functions. The individualization of this treatment method is not yet obligatory because of the small number of treated patients.

[Our and foreign experience in diagnosis and treatment of preeclampsia].

AIM: Our aim was to evaluate our experience in diagnosis and treatment of preeclampsia in the clinic of Pathological pregnancy--Varna Medical University. We compared our results with the results of prominent western clinics. MATERIAL AND METHODS: We evaluated 140 patients with preeclampsia for the period of 2010 to 2013. A special file was fulfilled. It included: age, parity, gestational age, value of arterial blood pressure, urea, creatinine, common protein in blood, duration of treatment, oedema, urine protein. RESULTS: The mean age of the patients was 30 years. The urea and creatinine were normal. The mean hospital stay was 5,71 days. The blood protein was 61 g/l, only 4.17% of the patients were with protein lower than 58 g/l. In 87.5% of the patients the systolic blood pressure was between 135 and 160 mmHg, in 12.5% the systolic blood pressure was over 160mm Hg. In 58.34% there was a proteinuria. The mean gestational age was 33 gestational weeks. The delivery was performed in the most suitable for the preeclampsia gestational age. CONCLUSIONS: According to our research work the patients with preeclampsia have a very high risk for cardio-vessel diseases and again of preeclampsia in their future pregnancies from 30%-40%. High prenatal care can prevent most of the complications connected with this disease.

[Autofluorescence and endometriosis optical trap or new hope in dianosis of endometriosis?].

Laparoscopic autofluorescence imaging of endometriosis is a new method to properly detect the disease. Autofluorescence in contrast to conventional white light laparoscopy enables us to visualize the entire extent of disease and to recognize extremely small or occult lesions. Autofluorescence imaging in fact reveals a world behind the world, a substantial new representation of endometriosis, which will have much impact on our future therapeutic strategies.

[Laparoscopic hysterectomy -- indications, technic, complications].

In recent decades, interest in laparoscopic gynecological practice increase. This technic applied first as a diagnostic tool in women with infertility. Subsequently starts to be used to perform surgery in small region of the fallopian tubes and ovaries, being increasingly developed and today, it is considered that any gynecological operation can be performed laparoscopically.