摘要:

Our knowledge relating implantation and the endometrium is largely descriptive at present. In the absence of a unifying hypothesis, I describe endometrial receptivity for implantation. Tissue component data are described, first relating to whole tissue, then isolated glands and stroma, vessels, the luminal epithelium, and infiltrating leukocytes. Finally, I consider trophoblast-endometrial interaction. Stimulatory and inhibitory factors impinging on a proteolytic cascade must be related to the process of invasion of the trophoblast. Only early data are available, as the description of this fascinating process unfolds.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The power sources used in endoscopic surgery are varied and numerous, and will continue to improve as technology progresses. Early attempts at operative laparoscopy were crude, limited by the available instrumentation, and tended to be frustrating: scissors that had to be frequently sharpened and endocoagulators that took a seemingly interminable time to achieve their tissue effect. New developements in ultrasonic energy and different wavelengths of laser energy are used alongside increasingly sophisticated electrosurgical tools, employing both monopolar and bipolar systems, and innovative delivery systems such as the argon beam coagulator and the Helica Thermal Coagulator. All of these systems have their advocates and their detractors, but in the end the choice of power source is determined by the type of equipment that the operator feels most comfortable with. The surgeon must have a detailed knowledge of the physical concepts required to generate the power source, and be able to understand the complications that can be created by the energy, how to avoid them, how and to deal with them if they occur. Although there are subtle differences in the reaction of the different energy sources with human tissue, the clinical outcome appears to be much the same, and depends more on the skill of the individual surgeon than the power source employed

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The growing impact of laparoscopic surgery must not make us underestimate the existence of complications, some of them severe, with medical-legal implications. Several surveys and case reports of complications following modern gynecologic laparoscopic surgery, some reporting laparoscopic management of visceral injuries, have been published recently. The complication rate depends on the complexity of the surgical procedure; serious complications still arise during performance of laparoscopy. Patients must be informed of the hazards of so-called 'minimally' invasive surgery.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Because of the extension of laparoscopic surgery to older patients with more complicated medical histories, anaesthetists increasingly have to face the problem of haemodynamic and respiratory tolerance of the technique. The management of such problems requires the understanding of the mechanisms involved, and their implications in terms of patient selection. Protocols where the maintenance of anaesthesia is provided using halogenated agents like isoflurane or desflurane have been shown to blunt the increase in systemic vascular resistances induced by CO2insufflation and therefore enhance the haemodynamic tolerance of this procedure.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

As newer technologies are incorporated into the field of gynecologic surgery, we must know their limitations, and be able to ascertain their true efficacy with certainty. This is especially important when we make decisions with and for our patients, which may affect their future fertility. This review was written with this important goal in mind.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Laparoscopic treatment of polycystic ovary syndrome has its roots in bilateral wedge resection. Although it is still unclear why surgery is effective in treating this syndrome, more than 600 cases of patients treated laparoscopically have been reported in the literature. Recent publications enhance our understanding of appropriate patient selection as well as the effectiveness of, and the complications associated with, this prodedure.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Management of ectopic pregnancy includes a high index of suspicion coupled with established algorithms of diagnosis using serum P-human chorionic gonadotropin and transvaginal ultrasound. Early diagnosis and intervention usually leads to conservation of the involved tube. Careful follow up for persistent ectopic pregnancy leads to appropriate medical or surgical management. The use of methotrexate, either systemically or by local injection, may provide an alternative to surgery in selected patients with ectopic pregnancy.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

We describe the use of laparoscopic techniques in hysterectomy, and the epidemiology of hysterectomy. We review the advantages and complications of total laparoscopic hysterectomy and subtotal laparoscopic hysterectomy. Finally, we discuss long-term outcomes and the cost of these techniques.

ISSN:1040-872X    

出版商:OVID    

年代:1995

数据来源: OVID