[Assessment of the sound level in the operating room during urological surgery]. / Évaluation du niveau sonore dans un bloc opératoire d'urologie.

OBJECTIVES: In the operating room, a high sound level is associated with a higher risk of complications and affects the communication between the various workers. The objective of this study was to assess the sound level at the operating room during urological procedures. MATERIAL AND METHODS: A monocentric cross-sectional study was carried out in 100 procedures in urology. They were divided into four groups: open surgical procedures, endoscopic procedures, pure laparoscopic procedures, and robotic-assisted laparoscopic procedures. The sound level was measured with the Sound Metter by Examobile application (Bielsko-Biala, Poland) for i-phone®. RESULTS: For all procedures, mean sound level, mean minimum sound level and mean maximum sound level were 60.31±3.3 db, 52.42±2.6 db and 81.73±2.8 db, respectively. For endourological procedures, they were 61.6±4.1 db, 53.4±4.1 db and 81.3±3.1 db, respectively. For open surgery, they were 59.0±1.0 db, 51.6±1.8 db and 81.4±1.5 db, respectively. For laparoscopic surgery, they were 58.33±0.6 db, 50.66±1.2 db and 83.33±1.5 db, respectively. Robotic-assisted laparoscopic surgery, they were 60.0±2.4 db, 52.5±2.3 db and 83.56±1.8 db, respectively. No difference was found according to the type of surgical approach. However, the sound level in the operating room was increased for endourological procedures using the laser technology as compared to endourological procedures without laser used (58.7±1.1 vs. 66.3±0.1 db, P=0.01, respectively). CONCLUSION: The sound level in the operating room during urological procedures was high. For the endourological procedures, the sound level was the highest when the laser technology was used. LEVEL OF EVIDENCE: 3.

Recurrence rate of ovarian endometriosis in patients treated with laparoscopic surgery and postoperative suppressive therapy.

INTRODUCTION: The testing represented a prospective study that was performed at the Gynaecology and Obstetrics Clinic "Narodni Front" in Belgrade during a two-year period. The study encompassed female patients with ovarian endometrioma operated with laparoscopic surgery. The research objective was to determine the percentage of occurrence of relapses in patients operated for endometriosis of the ovary in relation to the stage of the disease and the type of performed operation, and which were receiving suppressive therapy with gonadotropin-releasing hormone (GnRH) analogues after the surgery compared to those who were not receiving suppressive therapy after the operation. MATERIALS AND METHODS: The recurrence of endometriosis on the ovary of the test and control groups was monitored during the first year after surgery. In all patients ultrasound checks were done every month during the first six months after surgery, and then every three months for the next six months. In all patients in whom the recurrence, i.e. endometrioma on the ovary larger than three cm was revealed postoperatively by ultrasound, the laparoscopic removal of the endometrioma was performed again as well as the histopathological examination of the material. RESULTS AND CONCLUSION: There was no statistically significant difference in the distribution of recurrence of endometriosis between the groups formed according to the type of surgical technique (cystectomy or cystotomy). The recurrence of endometriosis occurred later in the group of patients in which the treatment GnRH analogues was applied after the surgical treatment. The recurrence of endometriosis in more severe stages (Stage III and IV) occurs later in the group of patients in which the treatment GnRH analogues is applied after the surgical treatment.