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Canadian Medical Association Journal Jul 1974In the last five years, laparoscopy has become increasingly popular in North America. The procedure has been mainly embraced by the gynecologist and its use in this... (Review)
Review
In the last five years, laparoscopy has become increasingly popular in North America. The procedure has been mainly embraced by the gynecologist and its use in this field has largely supplanted culdoscopy. Other specialties, nevertheless, have been slower in recognizing its value.The procedure has wide applications in gynecology. In pediatrics, laparoscopy proves useful in elucidation of amenorrhea, intersex and precocious puberty. In general surgery, laparoscopy has been recognized as a useful tool in the patient with multiple trauma, and in establishing the diagnosis of many intra-abdominal conditions.Numerous perlaparoscopic operative procedures which include biopsies and tubal sterilizations may be carried out by an experienced operator. Complications associated with the procedure are few, but may be severe. These can be avoided by careful adherence to proper technique.
Topics: Amenorrhea; Disorders of Sex Development; Endometriosis; Female; General Surgery; Gynecology; Humans; Hysterosalpingography; Infertility, Female; Intestinal Obstruction; Intrauterine Devices; Laparoscopy; Liver Diseases; Liver Neoplasms; Methods; Ovarian Neoplasms; Pediatrics; Pelvic Inflammatory Disease; Pelvic Neoplasms; Peritoneal Neoplasms; Pregnancy; Pregnancy, Tubal; Puberty, Precocious; Sterilization, Tubal; Turner Syndrome
PubMed: 4276392
DOI: No ID Found -
California Medicine Apr 1952Cul-de-sac puncture for introduction of a culdoscope is easily made with the patient in the knee-chest position. With the use of the instrument, the pelvic organs can be...
Cul-de-sac puncture for introduction of a culdoscope is easily made with the patient in the knee-chest position. With the use of the instrument, the pelvic organs can be viewed clearly. Culdoscopic examination of 45 patients was carried out. In all cases in which laparotomy was done after the examination, the culdoscopic observations and diagnosis were confirmed. In no case in which tubal pregnancy was present, was the diagnosis missed in culdoscopic examination. Patients were only slightly uncomfortable after the examination. There was no evidence of pelvic peritonitis in any patient, and no pregnant patient aborted as a result of the procedure.
Topics: Culdoscopes; Culdoscopy; Douglas' Pouch; Female; Genital Diseases, Female; Humans; Laparotomy; Pelvis; Pregnancy
PubMed: 14925833
DOI: No ID Found -
Annals of the New York Academy of... May 1967
Topics: Adolescent; Adult; Amenorrhea; Chromosome Aberrations; Chromosome Disorders; Culdoscopy; Cysts; Female; Fertility; Humans; Karyotyping; Laparotomy; Obesity; Ovarian Diseases; Ovarian Neoplasms; Pituitary Diseases; Pituitary Neoplasms; Psychotic Disorders; Sex Chromatin; Thyroid Gland; Turner Syndrome; Uterus; Vagina
PubMed: 5231264
DOI: 10.1111/j.1749-6632.1967.tb14694.x -
Proceedings of the Royal Society of... Jul 1958
Topics: Culdoscopy; Endoscopy; Female; Humans; Pregnancy
PubMed: 13567716
DOI: No ID Found -
British Medical Journal May 1953
Topics: Colpotomy; Culdoscopy; Female; Humans; Pelvis; Pregnancy
PubMed: 13042175
DOI: No ID Found -
Fertility and Sterility Feb 1970
Topics: Culdoscopy; Female; Genital Diseases, Female; Humans; Laparoscopy; Methods; Pain
PubMed: 4244335
DOI: No ID Found -
The Cochrane Database of Systematic... 2004Worldwide, the most commonly used method of fertility regulation is tubal sterilisation. In developed countries sterilisation is generally performed by laparoscopy... (Review)
Review
BACKGROUND
Worldwide, the most commonly used method of fertility regulation is tubal sterilisation. In developed countries sterilisation is generally performed by laparoscopy rather than by minilaparotomy, based on the belief that this approach is both safe and effective. In developing countries, where the resources are limited for the purchase and maintenance of the more sophisticated laparoscopic equipment, minilaparotomy may still be the most common approach. In both resource poor and industrialised countries using the technique with the greatest effectiveness and safety, together with the least costs, is extremely important. Though both methods are widely used, the advantages and disadvantages of laparoscopic sterilisation compared to mini-laparotomy have not been systematically evaluated. The ideal method would be one which is highly effective, economical, able to be performed on an outpatient basis, allowing rapid resumption of normal activity, producing a minimal or invisible scar and having a potential for reversibility. This review considers the methods to enter the abdominal cavity through the abdominal wall, either by minilaparotomy, laparoscopy or culdoscopy regardless of the technique used for tubal sterilisation.
OBJECTIVES
To evaluate laparoscopic tubal sterilisation, as compared to minilaparotomy in terms of operative morbidity and mortality. Trials comparing laparoscopy or minilaparotomy with culdoscopy were also included in the review. Different methods used to interrupt tubal patency (excision, occlusion and coagulation) and comparison of different forms of anaesthesia will be considered in different reviews.
SEARCH STRATEGY
Randomised controlled trials (RCTs) have been identified by using the search strategy of the Cochrane Collaboration. The Cochrane Controlled Trials Register was last searched in 1999 (Cochrane Library Issue 4, 1999). Reference lists of identified trials have been searched.
SELECTION CRITERIA
All randomised controlled trials comparing laparoscopy, minilaparotomy and/or culdoscopy for tubal sterilisation. Except in one trial [Taner 1994] where 4 women underwent curettage at the same time, all women requested tubal sterilisation as an interval procedure.
DATA COLLECTION AND ANALYSIS
Trials under consideration were evaluated for methodological quality and appropriateness for inclusion. Data were extracted independently by the reviewers. Results are reported as odds ratio for dichotomous outcomes and weighted mean differences for continuous outcomes.
MAIN RESULTS
Minilaparotomy vs laparoscopy: There was no difference in major morbidity between the 2 groups. Minor morbidity was significantly less in the laparoscopy group (Peto OR 1.89; 95% CI 1.38, 2.59). Duration of operation was about 5 minutes shorter in the laparoscopy group (WMD 5.34; 95% CI 4.52, 6.16). Minilaparotomy vs culdoscopy: Women undergoing culdoscopy had more major morbidity than women for whom minilaparotomy was performed (Peto OR 0.14; 95% CI 0.02, 0.98). Duration of operation was about 5 minutes shorter in women undergoing culdoscopy (WMD 4.91; 95% CI 3.82, 6.01). Laparoscopy vs culdoscopy: In the one trial comparing the two interventions there were no significant differences between the groups with regard to major morbidity. Significantly more women suffered from minor morbidities in the culdoscopy group compared to the laparoscopy group (Peto OR 0.20; 95% CI 0.05, 0.77).
REVIEWERS' CONCLUSIONS
Major morbidity seems to be a rare outcome for both, laparoscopy and minilaparotomy. The included studies had limited power to demonstrate significant differences especially for the relatively rare but potentially serious outcomes. Personal preference of the woman and/or of the surgeon can guide the choice of technique. Practical aspects (e.g. cost, maintenance, and sterilisation of the instruments) must be taken into account before implementing the more sophisticated endoscopic techniques in settings with limited resources. Culdoscopy is not recommended as it carries a higher complication rate.
Topics: Culdoscopy; Female; Humans; Laparoscopy; Laparotomy; Randomized Controlled Trials as Topic; Sterilization, Tubal
PubMed: 15266447
DOI: 10.1002/14651858.CD001328.pub2 -
Fertility and Sterility Dec 1979During the past century hysteroscopy has developed into a highly sophisticated and effective technique with increasing applicability. Hysteroscopic instruments have been... (Review)
Review
During the past century hysteroscopy has developed into a highly sophisticated and effective technique with increasing applicability. Hysteroscopic instruments have been refined with fiberoptics, allowing light to be introduced into the uterine cavity with high intensity but without danger of thermal injury. Safe methods for uterine distention provide an undistorted panoramic view of the uterine cavity. As a diagnostic technique, hysteroscopy affords accuracy in detecting intrauterine conditions which may not be revealed by traditional methods of exploration. As an operative technique, hysteroscopy increases the precision of surgery and minimizes trauma to the endometrial lining, and may, on some occasions, preclude major surgical intervention. In addition, hysterscopy is potentially useful for female sterilization and offers promise as an investigative tool for studies of the intratubal milieu.
Topics: Carbon Dioxide; Culdoscopes; Culdoscopy; Dextrans; Female; Genital Diseases, Female; Glucose; Humans; Intrauterine Device Expulsion; Neoplasm Staging; Sterilization, Tubal; Uterine Diseases; Uterine Neoplasms; Uterus
PubMed: 389675
DOI: 10.1016/s0015-0282(16)44408-0 -
ISRN Obstetrics and Gynecology 2013Minimally invasive surgery has been utilized in the field of obstetrics and gynecology as far back as the 1940s when culdoscopy was first introduced as a visualization...
Minimally invasive surgery has been utilized in the field of obstetrics and gynecology as far back as the 1940s when culdoscopy was first introduced as a visualization tool. Gynecologists then began to employ minimally invasive surgery for adhesiolysis and obtaining biopsies but then expanded its use to include procedures such as tubal sterilization (Clyman (1963), L. E. Smale and M. L. Smale (1973), Thompson and Wheeless (1971), Peterson and Behrman (1971)). With advances in instrumentation, the first laparoscopic hysterectomy was successfully performed in 1989 by Reich et al. At the same time, minimally invasive surgery in gynecologic oncology was being developed alongside its benign counterpart. In the 1975s, Rosenoff et al. reported using peritoneoscopy for pretreatment evaluation in ovarian cancer, and Spinelli et al. reported on using laparoscopy for the staging of ovarian cancer. In 1993, Nichols used operative laparoscopy to perform pelvic lymphadenectomy in cervical cancer patients. The initial goals of minimally invasive surgery, not dissimilar to those of modern medicine, were to decrease the morbidity and mortality associated with surgery and therefore improve patient outcomes and patient satisfaction. This review will summarize the history and use of minimally invasive surgery in gynecologic oncology and also highlight new minimally invasive surgical approaches currently in development.
PubMed: 23997959
DOI: 10.1155/2013/312982 -
Fertility and Sterility Apr 1970
Comparative Study
Topics: Carbon Dioxide; Culdoscopy; Endometriosis; Female; Fiber Optic Technology; Humans; Infertility, Female; Laparoscopes; Laparoscopy; Methods
PubMed: 4251559
DOI: 10.1016/s0015-0282(16)37456-8