RESUMO
OBJECTIVE: To describe a technique of performing a partial salpingectomy using a small-diameter (2-mm) laparoscope and bipolar electrocoagulation. STUDY DESIGN: Sixty consecutive women desiring permanent sterilization underwent laparoscopic partial salpingectomy using a 2-mm transumbilical laparoscope and secondary midline sites suprapubically and midway above the pubis. A midportion of the tube was coagulated using Kleppinger forceps, transected with scissors and removed using grasping forceps. RESULTS: Additional time to remove both coagulated tubal segments averaged 4 minutes (range, 3-10). Each segment (mean, 1.5 cm; range, 0.9-2.4 cm) was confirmed in the operating room, then histologically. The transected tubal edges were separated with no thermal injury to nearby structures and with no mesosalpingeal hemorrhage. No cases required conversion from microlaparoscopy to a traditional method, and recovery time was not prolonged. The puncture sites healed well without sutures. CONCLUSION: Successful removal of electrocoagulated tubal segments with histologic confirmation was undertaken microlaparoscopically, with minimal additional operative time.
Assuntos
Eletrocoagulação/métodos , Tubas Uterinas/cirurgia , Laparoscopia/métodos , Esterilização Tubária/métodos , Adulto , Feminino , Humanos , Fatores de Tempo , Resultado do TratamentoRESUMO
Leiomyomata of the vulva are reported rarely. A previously unrecognized leiomyoma in the area of Bartholin's gland grew rapidly during estrogen/progestin replacement therapy. Hormone receptors for both estrogen and progesterone were positive.
Assuntos
Terapia de Reposição de Estrogênios/efeitos adversos , Leiomioma/induzido quimicamente , Neoplasias Vulvares/induzido quimicamente , Adulto , Glândulas Vestibulares Maiores , Etinilestradiol/efeitos adversos , Feminino , Humanos , Acetato de Medroxiprogesterona/efeitos adversosRESUMO
Three cases of colovaginal fistulae were recently diagnosed and treated. Colovaginal fistulae are not commonly reported and their diagnosis may be difficult to make. Our cases presented with a complaint of vaginal discharge, history of hysterectomy, and diagnosis of diverticulosis. The diagnosis and treatment of colovaginal fistulae are discussed.
Assuntos
Divertículo do Colo/complicações , Histerectomia/efeitos adversos , Fístula Intestinal/etiologia , Doenças do Colo Sigmoide/etiologia , Fístula Vaginal/etiologia , Idoso , Idoso de 80 Anos ou mais , Colectomia , Divertículo do Colo/cirurgia , Feminino , Humanos , Fístula Intestinal/cirurgia , Pessoa de Meia-Idade , Doenças do Colo Sigmoide/cirurgia , Fatores de Tempo , Fístula Vaginal/cirurgiaRESUMO
We compared the actual delivery dates of 248 normal pregnant women to the estimated dates of confinement (EDC) calculated from one biparietal diameter measurement (BPD) between 18 and 26 weeks of gestation and to the EDCs corrected by the growth adjusted sonographic age ( GASA ) method. The dating of gestation by those two ultrasound methods also was compared to the calculation of the gestational age from the last menstrual period in a subgroup of 61 women with highly reliable clinical data. The GASA method had no advantage over the dating of gestation using one single BPD measurement obtained before 26 weeks, nor over the dating of gestation using reliable menstrual data.
