[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.

[Pregnancy after a partial dearterialization of the uterus. A case report]. / Embarazo post-desarterialización parcial del útero. Informe de un caso.

A case of a 27-year-old woman with a previous partial uterine dearterialization for uterine atony in its first gestation, is presented. This woman asked advise for secondary infertility and after a laparoscopic adhesiolysis she achieved pregnancy. With the exception of tubo-peritoneal factor all other infertility studied factors were normal. Partial uterine dearterialization must be taken in account in patients with obstetric bleeding and posterior fertility expectatives.

[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.

[Considerations on 200 cases of vaginal burns by potassium permanganate]. / Consideraciones sobre 200 casos de quemaduras vaginales con permanganato de potasio.

PIP: Potassium permanganate in tablets is still used in Mexico under the wrong belief that it will induce abortion. What it does, instead, is to provoke deep burns and ulcers in the vaginal walls, and to cause serious hemorrhage. This study investigates 200 women who used potassium permanganate as an abortifacient agent, and who needed hospitalization. Average age was 28; 58.5% had 4 or more children; 88.5% were married, and 11.5% were not; all patients belonged to the lowest socioeconomic class. Many had antecedents of induced abortion, and most had been amenorrheic for only 4-5 weeks. 23.5% of patients was not pregnant. Acute anemia was the most common complication, followed by hypovolemic shock. In this series there was 21.5% of diagnostic error, which shows the importance of suspecting this pathologic entity in women bleeding profusely and for whom induced abortion is suspected.^ieng