The Journal of the American Association of Gynecologic Laparoscopists
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The clinical anesthesia, general surgery, and gynecology literature addressing the pathophysiology and management strategies for perioperative pain were reviewed. There are few prospective, randomized studies from which to draw meaningful conclusions. ⋯ Reducing or eliminating postoperative pain without excessive sedation promotes rapid mobilization and return to self-care. Strategies for pain management can be adopted that reduce postoperative ileus and other adverse reactions to analgesics.
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J Am Assoc Gynecol Laparosc · Aug 1995
Comparative StudyMaternal and fetal effects of laparoscopic insufflation in the gravid baboon.
To test the hypothesis that intraabdominal pressures (IAP) associated with abdominal insufflation for laparoscopic procedures can alter pulmonary and hemodynamic values in the pregnant baboon and hemodynamic values in the fetus. ⋯ The baboon mothers and fetuses had no adverse effects at an IAP of 10 mm Hg, but may have significant cardiovascular and respiratory alterations associated with IAP of 20 mm Hg.
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J Am Assoc Gynecol Laparosc · Aug 1995
Comparative StudyLaparoscopic-assisted vaginal hysterectomy and bilateral salpingo-oophorectomy with suturing technique.
Since December 1992 we have performed laparoscopic-assisted vaginal hysterectomy (LAVH) in 50 women using strict, conventional, basic operative rules, and compared it with open abdominal hysterectomy with respect to operation time, cost, postoperative analgesia requirements, and length of hospital stay. The indications for hysterectomy were uterine myoma in 32 patients, dysfunctional bleeding in 13, and postmenopausal bleeding in 5. ⋯ The complication rate was 15%. The advantages of LAVH include short hospitalization, early recovery, low blood loss, and minimal postoperative discomfort.
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J Am Assoc Gynecol Laparosc · May 1995
Laparoscopic treatment of chronic pelvic pain in 100 adult women.
To evaluate the effectiveness of laparoscopic surgical treatment for women with chronic pelvic pain. ⋯ Extensive laparoscopic surgery to restore normal pelvic anatomy and remove all diseased tissue, including treatment of all endometriosis, resection of ovarian cysts, resection of adhesions, removal of the appendix, and treatment of hernias when indicated, together with laparoscopic uterosacral nerve vaporization or presacral neurectomy, results in significant improvement in reported pain levels.
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J Am Assoc Gynecol Laparosc · May 1995
Comparative StudyLaparoscopic hysterectomy compared with abdominal and vaginal hysterectomy in a community hospital.
To compare costs of laparoscopic hysterectomy with those of abdominal and vaginal hysterectomies in a community hospital. ⋯ Laparoscopic hysterectomy performed with a simple electrosurgical technique and reusable instruments, and without a video monitor was less expensive than abdominal hysterectomy. The video control and disposable instruments were associated with longer operating times and higher charges.