[Laparoscopic surgery in gynecology. Experience at the Luis Castelazo Ayala Hospital]. / Cirugía ginecológica laparoscópica. Experiencia en el Hospital Luis Castelazo Ayala.

The purpose of the present study was to demonstrate the various applications of the laparoscopic surgery in the field of gynecology. 40 patients who were submitted to laparoscopic surgery were studied and divided into 5 groups accordingly to the surgical procedure: adhesiolysis, surgery of ovarian tumors, hysterectomy, surgery of the Fallopian tube and myomectomy. All the patients had a preoperative study and once completed they were selected for laparoscopic surgery. The laparoscopic procedure was able to solve the gynecologic pathology. The mean overall surgical time was of 66.8 min with a maximum time of 180 and a minimum of 30 min, accordingly to the groups the surgical mean times were as follows: 1) adhesiolysis 111 min 2) ovarian surgery 69 min 3) hysterectomy 113 min 4) tubal surgery 60 min and 5) myomectomy 58 min. There were no surgical complications and they all had a brief hospitalization period and a fast return to active life. All procedures were done with a bipolar cautery. We conclude that laparoscopic surgery is a useful resource for the resolution of the majority of the benign gynecologic pathology and when indicated in the proper way there is no rise in the morbid-mortality, and offers a short hospitalization period and a quick return to active life.

[Modified factors in the study of the infertile couple in women with papilloma virus cervical infection, descriptive analysis]. / Factores alterados en el estudio de la pareja estéril en mujeres con infección cervical por virus del papiloma humano, análisis descriptivo.

The cervical infection by human papilloma virus (HPV) is considered one of the most common sexual transmitted diseases. Fifty couples were studied which consulted for sterility, in all women a cervical HPV infection was detected. Colposcopy, cervical biopsy, vaginal secretions culture, hysterosalpingography, laparoscopy and semen analysis were performed, in all of them. Age, obstetrical history, age at which patients began sexual relations, number of sexual partners, usage and time of usage of intrauterine device were analyzed. We can conclude that patients HPV cervical infection have risk factors for tuboperitoneal sterility, and are also in risk for other sexual transmitted diseases.

[Seven-year experience with microsurgery]. / Experiencia de siete años de microcirugía.

From 700 laparoscopies performed, in 600 of them (85.7%) the tuboperitoneal factor was altered. Surgery included: termino-terminal plastia 70 cases (36%), (3 patients had previous plastia); adhensiolysis 62 (31%), salpingostomy 48 (24%), neoimplantation 10 (5%), and mixed surgery 9 (4%). After surgery, desertion was present in 78 patients. Of the 121 remaining, 34 (28.1%) had primary sterility and 87 (71.9%) secondary sterility. 74 patients (61.2%) obtained pregnancy, 62 (83.8%) reached term, seven were abortions of first trimester (9.5%) and were five ectopic pregnancies (6.7%). The interval between surgery and pregnancy achievement was 1 to 48 months, 12.8 months average. We emphasize the 47 patients analysis who didn't has pregnancy, through: remark time after surgery, histerosalpingography, new laparoscopy and reevaluation of sterility factors; the results were: 19 cases (40.5%) have a 5 to 60 months time after surgery, 19.5 months average, 18 (38.3%) had new tubary obstruction, three (6.4%) with endometriosis treatment, three (6.4%) have tuberculosis genital treatment, two (4.2%) with falling again endocrine-ovarian factor, and two (4.2%) with masculine relapse. A decease was present because anesthetic complication. We underline selection surgery criterion and a strictly evaluation, such as an antiadhesion pre, trans and postoperative regime, ligamentopexya of rounds ligaments and a conscious education of the patients in their strictly pursuit.