the laparoscopic management of ectopic pregnancy

... Background In the treatment of tubal ectopic pregnancy (EP), laparoscopic surgery remains the cornerstone of treatment [1] In the absence of randomised data, the question as to whether surgical ... assess the status of the contra lateral tube during the procedure If, according to the surgeon, the condition of the contra lateral tube renders future pregnancy unlikely in case the patient will ... after the operation of the index tubal EP, the patients are contacted by means of a questionnaire, every six months for a period of 36 months The questionnaire focuses on the presence of a desire...

Ngày tải lên: 13/02/2014, 06:20

... placement of the first trocar at the lower border of the umbilicus Insufflation CO2 pressure was maintained constant at 604 15 mmHg At the end of the procedure, after ensuring hemostasis, the gas ... in the early stage of the operation due to increasing of intraperitoneal pressure from CO2 insufflation The effect of intraperitoneal pressure increment and reversed Trendelenberg position of the ... after evacuation of the carbon dioxide A p-value of less than 0.05 was accepted for statistically significant Results The age of the patients was 24 to 76 years (mean = 37 years) The body mass index...

Ngày tải lên: 05/03/2014, 15:20

... Mỗi néphrone có nhiệm vụ lọc, tái hấp thu tiết nước tiểu vào bể thận Từ bể thận nước tiểu chảy theo niệu quản xuống bàng quang Nếu đơn vị thận bị viêm, bị sỏi, bị xơ làm bít lại nước tiểu bị...

Ngày tải lên: 28/07/2014, 21:21

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Ngày tải lên: 07/08/2014, 23:22

... nodes The small nodule was diagnosed as a solitary metastasis of the cecal cancer at the previous port site (Figure 2) The nodule was resected in February 2009 The tumor was located in the abdominal ... this case The operating record indicated that a wound drape had been used to prevent the implantation of tumor cells during surgery; clinico-pathologically, the depth of invasion of the primary ... slightly exposed to the abdominal cavity There was no gross evidence of metastasis in the abdominal cavity and cytological examination identified no tumor cells in the ascitic fluid The tumor was identified...

Ngày tải lên: 09/08/2014, 01:24

... resistance, the throat cavity was widened during transit through the larynx, and the cuffs were deflated When the tube was pulled further, the anvil was led from the open end of the esophagus into the ... into the right abdomen, and after grasping the esophagus with the forceps, tightened the Surgitie™, Figure A small hole was created at the tip of the open end of the esophagus obliquely cut off ... from the open end of the lifted jejunum to let a trocar pass through Then, the main unit of the automated stapler and the lifted jejunum were fastened with silk thread to prevent dropout of the...

Ngày tải lên: 09/08/2014, 01:24

... 145 mm) and that of distal margin was 50 mm (35 to 120 mm) Postoperatively, the patients had a median pain score of 2(out of 10) on the day of the operation, and a score of on the 1st postoperative ... evaluate the latest refinement, which is the SSL access system There are several advantages using the new SSL access system The low profile seal cap enables us to use a wide range of instruments The ... adenocarcinoma in of the specimens and was that of tubular adenoma with low grade dysplasia The median number of lymph nodes harvested was 24 (range 20 to 34 lymph nodes) The median length of proximal...

Ngày tải lên: 09/08/2014, 03:22

... technique from the early experiences in robotic surgery Disadvantages include the size of the robotic hardware in relation to patient body; the loss of haptic feedback; and the overall cost of the hardware, ... standard laparoscopic approach of hepatobiliary surgery is still limited due to the technical complexities of these procedures The rigid nature of the instruments with limited degrees of freedom, ... was started on the inferior half of the cyst Once the portal vein and hepatic arteries were separated from the cyst, the dissection was carried inferiorly toward the pancreas The cyst was eventually...

Ngày tải lên: 09/08/2014, 03:22

... through the lymphatic system However the unusual presentation of the case created uncertainty over the malignant potential of the tumour and the experienced surgeons deemed lymphadenectomy the most ... neurofibramatosis type (NF1) or in the Carney-Stratakis dyad Conclusions The significant majority of mesenchymal tumors of the stomach are believed to derive from the interstitial cells of Cajal, ... Department of Pathology, University of Athens, Medical School, Greece Department of Hepatobilary Surgery, Churchill Hospital, Oxford, UK 3First Department of Surgery, University of Athens Medical...

Ngày tải lên: 09/08/2014, 03:22

... segments, the employment of TEM reduces the probability of an anterior resection of the rectum The recent employment of TEM has reduced the need to perform an anterior resection of the rectum ... anterior resection of rectum The final histological diagnoses were low grade dysplasia adenomas of the rectum while only one of the rectal lesions was classified as a T1 cancer The right colon lesions ... checked the numbers and percentages MC drafted the article, updated the references and checked the numbers and percentages RC drafted the article, updated the references and checked the numbers...

Ngày tải lên: 09/08/2014, 03:23

... performance status was grade [6] The patient underwent a laparoscopic gastrojejunostomy for palliation of the GOO The peritoneal drainage catheter was placed during the laparoscopic procedure Figure ... disappearance of thickening of the gastric wall, the metastatic foci in the liver, omental infiltration of metastatic nodules, and enlarged lymph nodes were observed During laparoscopic inspection, there ... size of the hepatic metastases, and the tumor markers returned to normal levels After the completion of nine courses of chemotherapy, the gastric wall thickening, metastatic foci in the liver,...

Ngày tải lên: 09/08/2014, 03:23

... facilitates exposure of the lower border of the pancreas and dissection of the superior mesenteric vein (SMV) behind the pancreas Stay sutures are placed on either side of the lesion in the superior ... site after removal of central portion of the panOperative site after removal of central portion of the pancreas Figure Gross section of the tumor, diameter 2.8 cm Gross section of the tumor, diameter ... benefits of a resection of the central portion of the pancreas; a simplification of the procedure, and a literature review of the topic Materials and methods A review of patients who underwent...

Ngày tải lên: 09/08/2014, 04:21

... of the sacral promontory, and anterior and side walls of the pelvis below the level of the common iliacs, and tied snug to keep the expander in the pelvis With a Huber® needle inserted into the ... increased risk of small bowel adhesions and Page of fistula formation Therefore, there has been a trend away from the use of mesh, with fixation of the expander to the peritoneum with a suture the commonest ... gas and the fascia of both the Pfannenstiel and umbilical port closed The port of the expander was then placed in a small subcutaneous pocket and sutured to the fascia of the anterior Figure...

Ngày tải lên: 09/08/2014, 09:20

... laterally The action of the suture can be described in terms of force triangles extending laterally from the suture The width of these compression zones depends on the length of the suture bites and the ... depth The suture track will sometimes be longer than the radius of curvature of the needle, which will make the wound pout when the needle is in both sides of the wound (Fig 1.6) The length of the ... forceps on the same side of the tissue through which the needle is being driven The needle should be two thirds of the way from the point of the surgical needle and held at a 90° angle from the needle...

Ngày tải lên: 10/08/2014, 00:20

... platform proximal to the toothed ends for handling of suture There are multiple variations on the shape of the handles, length of the forceps, and configuration of the tips All small-toothed forceps ... through which the suture passes The handle or shaft (straight arrows) is the area by which the needle is held The most posterior aspect of the suture is the area of the swage Grasping the needle ... the needle close to the swage end because the suture can be inadvertently detached from the needle swage Additionally, the cross section of any needle is round in the area of the swage, and the...

Ngày tải lên: 10/08/2014, 00:20

... wound The timing of suture removal is at the discretion of the individual surgeon However, removal too early can induce the risk of wound dehiscence In the case of new inflammation of the surrounding ... remains on the same side of the wound when both the first and the second throw are secured The slipknot is now created (Fig 3.14) The suture is tightened by traction on the opposite ends of the suture ... using the friction of the suture to hold the suture in place With constant tension at the appropriate amount to hold the wound edges in position, the free end of the suture is pulled lightly to the...

Ngày tải lên: 10/08/2014, 00:20

... passed through the ciliary sulcus on the opposite side, also with the ab externo technique The tip of the 10-0 needle is then “docked” inside the tip of the hollow needle, and then the hollow needle ... placement of the sutures at and o’clock is not advised because of the danger of suturing through the long ciliary arteries and nerves found in these locations The aim of transscleral fixation of the ... Lens Fig 5.4 The Cincinnati modification of the Siepser slipknot method a The needle is passed through the stab incision, and then through the two edges of the iris leaflet then exiting the distal...

Ngày tải lên: 10/08/2014, 00:20

... Correct closure of perpendicular incision The distance from the point of entry of the suture to the wound (A) is equal to the distance from the wound to the point of exit (B), and the sutures are ... technique, the distance from the point of entry of the suture to the point of exit through the wound (C) should be measured from the posterior aspect of the cornea, and should be equal to the distance ... bites must be of equal tissue depth Also, the bites on either side of the perpendicular laceration must be of equal depth from the anterior perspective, and the passage of the suture of equal lengths...

Ngày tải lên: 10/08/2014, 00:20

... incision, catching the edge of the incision as one enters the eye The iris edge is then caught with the point of the suture, and the needle is then passed out of the eye through the cornea or a ... cheese-wiring of the suture and the production of a secondary iris defect A circumferential incision at the root of the iris, to either side of the coloboma, will help to mobilize the iris (Fig 8.5b) The ... tip of the hyaluronic acid cannula (Fig 8.6b) The tip of the needle may be lodged in the open bore of the cannula— using it as a guide to both penetrate the iris and remove the needle via the...

Ngày tải lên: 10/08/2014, 00:20