Ever wonder about investing in 3D technology, the best candidates for LESS, and the utility of dual-function instruments? Here's one OB/GYN's opinion.
Complex GYN surgeries require a competency level that traditional training often can't provide. Here, the latest trends in surgical training are discussed.
Adhesions occur after almost every abdominal surgery and are the leading cause of intestinal obstruction. Here, tips for adhesion prevention and how to correct them when they do occur are provided.
Recently a letter was sent to the Women's Health Forum by a patient who had undergone numerous surgeries in an effort to alleviate her pain due to surgical adhesions. Additionally, I recently had a patient whose case demonstrates a rather typical story for post-surgical adhesions, and her management. These two patient cases I hope you will find informative and "food for thought".
Neutrophils infiltrate the endometrium pre-menstrually and after long-term progestin only-contraceptive (LTPOC) treatment. Trafficking of neutrophils involves endothelial cell-expressed intercellular adhesion molecule (ICAM-1).
Chronic pelvic pain and/or associated intestinal disturbance are a major cause of misery for thousands of patients. Often in constant pain, the patient experiences loneliness, hopelessness, frustration and desperation with thoughts of suicide. Family and work relationships are strained to the limit. Although ADHESIONS are often (but not always) the cause of this pain, treatment for adhesions is not performed either because the surgeon does not believe that adhesions can cause the problem, or because lysis of adhesions is considered too difficult or futile.
Pelvic adhesions cause many problems for millions of women. From obstructed tubes associated with infertility, to pelvic tenderness, and painful intercourse, to chronic pelvic pain. Curiously, adhesions can be very extensive, yet relatively silent. They may remain silent indefinitely, or long after the causative event, become symptomatic. The causes of adhesions are multiple but basically the tissue irritation that produces the adhesive process arises from an inflammatory event, or from trauma (i.e. post surgical).
I have a case that I've known for some time. She is a case of diagnosed endometriosis. I did her adhesiolisis in 1993 and then she got pregnant, then she had a big endometriotic cyst and I removed it and then she got pregnant again. In the last six years, she got 2 endometriotic cysts that were very big and causing agonizing pains and had to be surgically removed in 2 occasions. Last year she got pregnant spontaneously but missed abortion at 14 weeks and had to evacuate by extramniotic PG.