ISSN:1052-3901    

DOI:10.1089/lps.1991.1.69

年代:1991

数据来源: MAL

摘要:

We report the effective clinical use of endoscopic laser in Japan using the results of a nationwide survey and our own experience with more than 100 cases. The Nd:YAG laser and argon dye laser with hematoporphyrin derivative (photodynamic therapy) were most commonly used in digestive endoscopy and were investigated as new modalities of cancer therapy. Photodynamic therapy was fairly effective, especially in superficial esophageal cancer and the ill-defined lesions of early gastric cancer. Endoscopic laser treatment was carried out on 80 patients with 86 lesions of early gastric cancer at our hospital, and the following tumor types were proven highly curable by this means: focal cancer, IIa and so-called "gastritis-like" tumors less than 2 cm in size. The Nd:YAG laser provides a new approach to palliative treatment, such as recanalization of neoplastic obstruction in the advanced stage of gastrointestinal cancers.

ISSN:1052-3901    

DOI:10.1089/lps.1991.1.71

年代:1991

数据来源: MAL

摘要:

Common duct stones present a special problem to the surgeon when he performs a laparoscopic cholecystectomy. We describe a method of exploring the common duct and extracting stones. The procedures for opening of the common duct, removal of stones, and the placement of a T-tube are carefully outlined.

ISSN:1052-3901    

DOI:10.1089/lps.1991.1.79

年代:1991

数据来源: MAL

摘要:

Since abdominal wall herniae derive from the abdominal cavity, they are accessible to laparoscopic diagnosis and treatment. This may be more appropriate than the conventional external approach.In five gynecological patients, scheduled for pelviscopic surgery, a coexisting inguinal hernia was endoscopically repaired. Transcutaneous aquadissection of the musculofascial defect using physiological saline solution in a syringe was easy to perform and very helpful in the endoscopic dissection of the peritoneal space. The method is described in specific detail, and recommended for application.

ISSN:1052-3901    

DOI:10.1089/lps.1991.1.83

年代:1991

数据来源: MAL

摘要:

This study presents 100 consecutive cases of total salpingectomy performed via laparoseopy for indications of ruptured or recurrent ectopic pregnancy, hydrosalpinges, torsion of the fallopian tube, hematosalpinges, or extensive adhesions. A multiple abdominal puncture approach was used, and salpingectomy was accomplished by electrosurgical coagulation and laser transection of the isthmus, mesosalpinx, and tubo-ovarian ligaments using the CO2laser. The fallopian tubes were removed from the pelvic cavity through one of the suprapubic punctures. The mean duration of the procedure was 22 minutes, and the mean duration of hospitalisation after surgery 7.4 hours. No major intraoperative or postoperative complications were encountered. Laparoscopic salpingectomy appears to be a safe and relatively simple procedure associated with the advantages of outpatient surgery.

ISSN:1052-3901    

DOI:10.1089/lps.1991.1.91

年代:1991

数据来源: MAL

摘要:

Falloposcopy combined with laparoscopy was performed in 11 women during the late follicular phase of spontaneous menstrual cycles, and a preovular follicle was confirmed to be present in each case. The fimbrial end of the tube and the ipsilateral ovary containing the preovular follicle were suspended in a fluid environment of 200 ml of lactated Ringer's solution which acted as a support medium for visualization of tubal mucus and facilitated the endoscopy procedure. As the falloposcope was passed through the fimbrial opening, it was observed to carry clear, elastic and filamentous strands of mucus material from within the distal tubal lumen in 4 of 11 procedures. As these mucus strands were carried on the tip of the falloposcope to touch the surface of the ovary containing the preovular follicle, they attached, on contact, in all cases. The fimbrio-ovarian mucus bridge created was quite strong and could be stretched for up to 7 mm before it detached from the ovarian surface. The mucus attachment appeared to be equally secure over the preovular follicle and adjacent ovarian surfaces. These fimbrio-ovarian mucus connections, which have a high affinity for ovarian surface attachment about the time of ovulation, may play an important role in securing tubal oocyte capture in humans.

ISSN:1052-3901    

DOI:10.1089/lps.1991.1.97

年代:1991

数据来源: MAL

摘要:

Eighty falloposcopies were performed in fallopian tubes of women with suspected tubal disease. In three falloposcopies (4%), isthmic plugs were observed occluding the entire isthmic lumen. In all cases these plugs were mobilized by falloposcopic-directed, selected tubal cannulation and aquadissection techniques. Restoration of tubal patency, verified by concurrent chromopertubation under laparoscopic monitoring was achieved in all cases. On one occasion, the isthmic plug was mobilized and identified on the fimbria, and tubal patency was confirmed. When this plug was retrieved and examined histologically, it was found to consist of a cast of debris containing aggregates of histiocyticlike cells of endometrial stromal or mesothelial origin. The genesis of these plugs is unknown. In another subgroup, white to yellow mucus like fragments were observed within the intramural and isthmic lumen during a further 8 of 80 falloposcopies (10%). Whether these mucus like fragments are of physiological or pathophysiological significance remains to be determined. Objective demonstration that isthmic plugs can cause reversible proximal tubal obstruction (PTO) has been achieved using falloposcopy. Falloposcopy offers the diagnostician the ability to objectively classify the cause of PTO. A useful falloposcopic classification and scoring system of tubal lumen lesions has been utilized and is described.

ISSN:1052-3901    

DOI:10.1089/lps.1991.1.103

年代:1991

数据来源: MAL

ISSN:1052-3901    

DOI:10.1089/lps.1991.1.111

年代:1991

数据来源: MAL

ISSN:1052-3901    

DOI:10.1089/lps.1991.1.115

年代:1991

数据来源: MAL

摘要:

Laparoscopic resection of full-thickness lesions of the anterior rectum followed by repair using a two-layer suture technique is described. Anterior rectal laceration occurred in two bowel-prepped women during excision of deep fibrotic endometriosis. Neither patient required subsequent surgery nor suffered any postoperative sequela. While not all rectal injuries are suitable for laparoscopic suture repair, in selected cases, bowel injury can be effectively managed laparoscopically without resorting to major abdominal surgery.

ISSN:1052-3901    

DOI:10.1089/lps.1991.1.119

年代:1991

数据来源: MAL