ABSTRACT
OBJECTIVE: To optimize methods of surgery in patients with malformations of the genitalia. METHODS: Comparative evaluation of effectiveness of reconstructive plastic operations for malformations of uterus and vagina, performed by conventional methods or via laparoscopy. RESULTS: Laparoscopy permits identification of the pelvic peritoneum plus opening it and using the most mobile portion to create the vaginal fornix. In patients with vaginal and cervical aplasia and non-communicating functional rudimentary uterus, laparoscopy assists hysterectomy performed by the vaginal approach, as well as the last step of colpopoiesis. CONCLUSIONS: Laparoscopy significantly facilitates the procedure, reduces operating time and risks, and makes the operation available to the wide range of surgeons skilled in laparoscopy.
Subject(s)
Hysterectomy, Vaginal/standards , Hysterectomy/standards , Laparoscopy/standards , Peritoneum/surgery , Surgery, Plastic/methods , Vagina/abnormalities , Vagina/surgery , Female , Humans , Hysterectomy/methods , Hysterectomy, Vaginal/methods , Laparoscopy/methodsABSTRACT
A total of 253 patients were examined and operated on for ectopic pregnancy. Eight-six patients were operated on through a laparoscopic access (group 1) and 167 through a laparotomic access (group 2). The authors assess the diagnostic value of echography, measurement of b-subunit of chorionic gonadotrophin, puncture of the abdominal cavity through the posterior vaginal vault, and of histologic examination of scrapings off the endometrium in a complex of examinations of patients with ectopic pregnancy. The results demonstrated the advantages of the laparoscopic access over laparotomy as involving lesser bleeding to the abdominal cavity and no evident adhesions.
Subject(s)
Laparoscopy , Pregnancy, Tubal/diagnosis , Pregnancy, Tubal/surgery , Adult , Emergencies , Fallopian Tubes/surgery , Female , Follow-Up Studies , Humans , Laparotomy , PregnancyABSTRACT
This study was aimed at assessment of the efficacy of surgical treatment of bulky formations in the ovaries. Surgical laparoscopy for benign tumors and tumor-like processes in the ovaries was carried out in 548 patients. The operations were performed for benign tumors (17%), tumor-like formations (23%), endometrioid cysts (16%), polycystic ovaries (14%), gonadal dyskinesia (2%), and stable menstrual dysfunction (24%). The size of ovarian formations varied from 2 to 8 cm. Partial or clinoid resection of the ovaries, adnexectomy, oophorectomy, removal of the parovarian cyst, or extended biopsy of the ovaries were carried out. The results were good. No relapses were recorded. Blood loss was virtually null. The mean duration of an operation was 67.34 +/- 10.5 min. Follow-up of 6 months to 3 years revealed no adhesions in 34.2% cases and first-degree adhesions in 65.8%.
