[SPIC: a training simulator for coelioscopic interventions with gynecologic purpose]. / SPIC: simulateur pédagogique d'interventions coelioscopiques à visée gynécologique.

There is much demand for laparoscopy training. We have developed a training simulator for initial training in gynecological laparoscopy. The simulator includes a mannequin with 3 located trocars, a PC and software for managing the graphical part of the training protocol. The objective is to learn how to achieve spatial localization and handle tools within the abdominal cavity. A series of exercises are proposed with increasing degree of difficulty. The simulator can be customized to simulate many different scenarios. The trainer must be present to provide an ultimate assessment of the trainee's experience. This new training tool cannot replace traditional surgical training but can help make it more efficient. The simulator is now being used by residents. Further technical developments are in progress to add further indispensable mechanical interactions (force feed back) to visualize the organ deformations and organ dissections within the abdominal cavity.

[Value and limits of complementary investigations in cases of toxoplasmosis seroconversion during pregnancy. A case report and review of the literature]. / Intérêt et limites des investigations complémentaires en cas de séroconversion toxoplasmique en cours de grossesse. A propos d'un cas et revue de la littérature.

We report a case of acute toxoplasmosis during the first trimester of pregnancy in which antenatal diagnosis was negative. Except for non-specific signs of liver failure, assessment by repeated ultrasound scans, testing of fetal blood for toxoplasmic specific antibodies and competitive PCR to isolate the parasite, had ruled out fetal infection. In spite of early treatment with spiramycin, and although the infant was assumed to be non-contaminated, severe hydrocephalus was noted at 3 and half months of life, arising soon after therapy had been stopped. This case focuses attention on the problem of the shortcomings of the diagnostic techniques currently used, and leads us to question our practical course of action. Several questions are thus raised: how reliable are indirect signs of fetal compromise, what is the real sensitivity of the PCR test and how useful are repeated amniocentesis and inoculation of the amniotic fluid to mice.

[Vaginal delivery of monochorionic, monoamniotic twins. Clinical case]. / Accouchement par voie basse d'une grossesse monochoriale monoamniotique. Cas clinique.

Monochorial-monoamniotic female twins were delivered by the vaginal route with no particular problem after 37 week gestation. Cephalic presentation for both infants was not hindered by a tangled cord with a knot.