Abstract:

Leiomyomas, the most common solid pelvic tumors, occur in 25% to 30% of women during their reproductive years. Approximately 20%to 50%of these women experience symptoms that require treatment, with the most common complaints being menorrhagia, metrorrhagia, pelvic pressure, and the appreciation of a pelvic mass.

Authors:

Douglas R. Phillips, M.D., F.A.C.O.G., F.A.C.S., F.I.C.S., Herbert A. Goldfarb, M.D., F.A.C.O.G., F.A.C.S.

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Abstract:

Endometriosis is one of the most enigmatic and common diseases encountered by the gynecologist in the reproductive-age female. An estimated 10%of reproductive-age women and 25-35% of infertile women have this progressive disease which may result in significant morbidity.

Authors:

G. David Adamson, M.D., F.R.C.S.C., F.A.C.O.G., F.A.C.S., Alexis Kim, M.D., Anna Sapugay M.D.

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Abstract:

Although the development of continuous-flow resectoscopes has revolutionized hysteroscopic surgery, the necessity of using electrolyte-free irrigating solutions to distend the uterus has also introduced a risk of serious or fatal clinical complications should a patient absorb an excessive volume of fluid during the operation.

Authors:

Arnold J. Kresch, M.D., F.A.C.O.G., Andrea Hutchinson, M.D., F.A.C.O.G.

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Abstract:

Diagnosis and treatment of endometriosis is the most frequent reason for gynecologic operative laparoscopy in the United States.' It is therefore important for the laparoscopist to be thoroughly familiar with the current standards of diagnosis and management of this complex disease. The most common presentations where endometriosis is found are pelvic pain, infertility, and adnexal mass. The ovaries, the posterior leaf of the broad ligament, and the cul-de-sac are the most frequent locations, and the left side is more frequently affected than the right.

Authors:

Harry Reich, M.D.

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Abstract:

Laparoscopic surgery has been at the forefront of gynecologic surgical innovation in the past decade. Significant benefits which have been realized by the utilization of laparoscopy include: 1) a reduced size of surgical incisions 2) reduced length of hospital stays 3) increased utilization of outpatient surgery 4) a more rapid postoperative recovery period 5) reduced morbidity and 6) reduced total costs of treatment. Recent refinements in surgical technique and instrumentation have allowed for the development of a new incarnation of laparoscopy which has the potential to further realize each of these goals. Office microlaparoscopy under local anesthesia is the most recent advance in gynecologic minimally invasive surgery.

Authors:

Steven F. Palter, M.D., David L. Olive, M.D.

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Abstract:

The revolution in laparoscopic surgery demands implementation of adequate training programs preferably in an academic setting. The most dramatic progress over the last decade in the field of gynecology was undoubtedly the development of advanced operative laparoscopy,"" This has been initiated by an unprecedented technological revolution.

Authors:

Daniel S. Seidman, M.D., Farr Nezhat, M.D, Camran Nezhat, M.D.

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Abstract:

Endometriosis is prevalent: its incidence has been estimated to range from 5-10% in normal women, and up to 60%of women who present with infertility or chron.ic pelvic pain. 1 Chronic pelvic pain is the reason for 10% of all office visits to a gynecologist,z and 40% of all laparoscopies performed are done for chronic pelvic pain," Further, it is reported that one in seven or 15%of the gynecological patients seen have pelvic endometriosis, and it is the second most frequent indication for which the American female undergoes a hysterectomy," It has also been noted that the infertility associated with pelvic endometriosis increases with the stage of the disease.

Authors:

Steven D. McCarus, M.D., F.A.C.O.G

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Abstract:

Laparoscopic assisted vaginal hysterectomy (LAVH)is a procedure gaining in popularity over abdominal hysterectomy, for a number of different indications. According to a recent study by Wilcox, et al., over 1.7 million women underwent a hysterectomy procedure in the U.S. from 1988through 1990,and twothirds of the procedures for benign disease were performed for leiomyomata or endometriosis, indications typically afflicting women of child-bearing age. I Seventy-five percent of the procedures included in the Wilcox study were abdominal hysterectomies, the remainder being vaginal hysterectomies. National Hospital Discharge Summary data reveal that 562,000hysterectomies were performed in 1993,rendering hysterectomy second only to cesarean section in volume of annual Ob/ Gyn surgical procedures performed.

Authors:

Charles Miller, M.D., F.A.C.O.G., Mary Johnston, R.N.

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Abstract:

Hysteroscopy is gaining increasing acceptance among surgeons as the initial surgical treatment of choice for managing abnormal uterine bleeding and submucous fibroids. With refinements in electrosurgery and laser ablation instruments, and the development of continuous-flow resectoscopes, hysteroscopic treatment indications.

Authors:

Arnold J. Kresch, M.D., F.A.C.O.G., Andrea Hutchinson, M.D., F.A.C.O.G.

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