The Journal of the American Association of Gynecologic Laparoscopists
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J Am Assoc Gynecol Laparosc · May 1998
Comparative Study Clinical TrialLaparoscopic appraisal of the anatomic relationship of the umbilicus to the aortic bifurcation.
To determine the cephalocaudal relationship among the umbilicus, aortic bifurcation, and iliac vessels by direct measurement during laparoscopy. ⋯ The cephalocaudal relationship between the aortic bifurcation and umbilicus varies widely and is not related to body mass index in anesthetized patients. Regardless of body mass index, the aortic bifurcation is more likely to be located caudal to the umbilicus in the Trendelenburg compared with the supine position. Its presumed location can be misleading during Veress needle or primary cannula insertion, and a more reliable guide is necessary for this procedure to avoid major retroperitoneal vascular injury.
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J Am Assoc Gynecol Laparosc · May 1998
Clinical TrialMeasurement of intraocular pressure during laparoscopy and its relationship to central venous pressure.
STUDY OBJECTIVE. To determine the effect of different positional degrees on hemodynamics, especially central venous pressure and intraocular pressure, and a possible interrelationship, during laparoscopic surgery. SETTING. University teaching hospital (Canadian Task Force classification II-1). ⋯ Continuous monitoring of intraocular pressure may help detect alterations in central venous pressure during general anesthesia for laparoscopic surgery. Undesirable alterations caused by degree of Trendelenburg position may negatively affect patients with high cardiac or ophthalmic risk.
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J Am Assoc Gynecol Laparosc · Nov 1997
Comparative Study Clinical TrialPreventing hyponatremic encephalopathy: comparison of serum sodium and osmolality during operative hysteroscopy with 5.0% mannitol and 1.5% glycine distention media.
To determine whether isotonic 5.0% mannitol is superior to 1.5% glycine in preventing development of hyponatremic encephalopathy. ⋯ We found that 5.0% mannitol distention fluid produces greater postoperative dilutional hyponatremia than 1.5% glycine, but hypo-osmolality does not occur with mannitol. Its use should lessen the risk of hyponatremic encephalopathy.
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J Am Assoc Gynecol Laparosc · Aug 1997
Transvaginal ultrasonography and hysteroscopy in the diagnosis of endometrial abnormalities.
To investigate the value of transvaginal ultrasonography, aspiration biopsy, and hysteroscopy combined with curettage or directed biopsy in detecting endometrial pathology in women with abnormal uterine bleeding. ⋯ Transvaginal ultrasound seems to be an excellent initial diagnostic method, with high sensitivity in diagnosing endometrial abnormalities. Its combination with aspiration biopsy seems to be safe in women with a thin endometrium. Hysteroscopy is necessary in postmenopausal women with an endometrium of 4 mm or more, as well as in premenopausal patients with endometrial thickness more than 5 mm (preovulatory phase of the cycle) and in those with suspected polyps or myomas.
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J Am Assoc Gynecol Laparosc · May 1997
Comparative StudyTransvaginal sonographic and hysteroscopic findings in postmenopausal women receiving tamoxifen.
To evaluate the effect of tamoxifen on the endometrium. ⋯ Women receiving tamoxifen, especially those who are asymptomatic, should be closely monitored by transvaginal sonography and hysteroscopy to detect endometrial pathologies.