The Almodin-Moron trocar for uterine entry during fetal surgery.

OBJECTIVE: Compare the use of a newly designed and reusable metal trocar for initial uterine entry with the disposable Tulipan-Bruner trocar in creation of a hysterotomy for fetal surgery. METHODS: Six consecutive patients undergoing hysterotomy for intrauterine repair of myelomeningocele were randomized to uterine entry either with the Tulipan-Bruner trocar or with the Almodin-Moron trocar. Blood loss was estimated by the primary surgeon. RESULTS: There was no statistically significant difference in the uterine entry times between the trocars. Blood loss was estimated to be approximately the same. The Almodin-Moron trocar was judged to provide easy handling with good safety. CONCLUSIONS: The Almodin-Moron trocar provides a uterine entry during creation of a hysterotomy that is as quick and causes as little trauma as the Tulipan-Bruner trocar.

Recovery of fertility after grafting of cryopreserved germinative tissue in female rabbits following radiotherapy.

BACKGROUND: Many cancer survivors face infertility as a consequence of the aggressive treatment they must undergo. Cryopreservation of ovarian tissue before chemotherapy or radiotherapy may allow for tissue transplantation after the treatment, and restoration of fertility. We tested the potential of an orthotopic autografting of cryopreserved germinative tissue in female rabbits with ovarian failure following radiotherapy. METHODS: Ten adult multiparous female rabbits were randomly allocated into two groups, five in group I (control) and five in group II (transplant). All rabbits underwent right oophorectomy with cryopreservation of the germinative tissue, followed by sterilization of the remaining left ovary by radiotherapy. Later, group II rabbits received in the irradiated left ovary an implant of the frozen germinative tissue from the right ovary, whose small pieces were freely spread intracortically in a procedure we named 'intracortical sowing of germinative tissue' (ISGT). RESULTS: All group II rabbits conceived following spontaneous mating within 6 months of the transplant, whereas none of the remaining rabbits in group I had conceived up to 11 months after transplant. CONCLUSIONS: This study suggests that fertility can be restored in rabbits by sowing cortical tissue in a previously irradiated ovary. The clinical feasibility of this technique remains to be determined.

Controle ecografico do desenvolvimento folicular e colheita de oocito pre-ovulatorio. / Echographic control of follicular development and preovulatory oocyte recovery

Foram estudados 21 ciclos, entre espontaneos e induzidos com citrato de clomifene e HCG, ou UMG e HCG, acompanhando o desenvolvimento folicular com ecografia e confirmando-o laparoscopicamente, objetivando-se a colheita de oocito pre-ovulatorio.De 21 ciclos estudados houve correlacao entre imagem ecografica e laparoscopia em 71%. De 47 foliculos puncionados, obtiveram-se 14 oocitos