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A Langebrekke

Publications and source records attributed to A Langebrekke.

18 recordsLinked to original sources
PubMed2003

Repeat hysteroscopic surgery reduces the hysterectomy rate after endometrial and myoma resection.

STUDY OBJECTIVE: To assess the efficacy of repeat transcervical resection of the endometrium (TCRE) in patients with dysfunctional uterine bleeding and myomas in whom primary resection failed. DESIGN: Retrospective analysis (Canadian Task Force classification III). SETTING: University hospital endoscopic unit. PATIENTS: Six hundred sixty-eight women. INTERVENTION: Repeat TCRE or transcervical resection of a myoma (TCRM). MEASUREMENTS AND MAIN RESULTS: Of 668 patients, 118 (17%) required repeat resection for the following reasons: pain (52, 44%), menorrhagia (39, 31%), myomas (15, 13%), perforation at the primary TCRE (6, 5%), and large fluid deficit during the procedure (6, 5%). Of 118 women undergoing repeat TCRE or TCRM, 33 (28%) eventually required hysterectomy due to pain (17, 48%), persistent bleeding (7, 27%), pain and bleeding (3, 10%), regrowth of myomas (3, 14%), and other reasons (3, 14%). CONCLUSION: Repeat resection is an option after failed primary hysteroscopic operation and may reduce the hysterectomy rate.

Adult↗
PubMed1996

Abdominal hysterectomy should not be considered as a primary method for uterine removal. A prospective randomised study of 100 patients referred to hysterectomy.

OBJECTIVE: The present study is a prospective randomized comparison of laparoscopically assisted vaginal hysterectomy (LH) with total abdominal hysterectomy (TAH). METHODS: 100 patients referred for uterine removal were included in the study, 46 undergoing LH and 54 TAH, at two teaching hospitals in Norway. RESULTS: In the LH group, the duration of surgery was longer while duration of hospitalization and time from operation to return to normal activity were shorter as compared to the TAH group. Postoperative pain, assessed by the need for analgesics, was less in the LH group. All these differences were statistically significant. There were two ureteral lesions in the LH group, and one center withdrew early from the study for this reason. CONCLUSIONS: In expert hands, LH as a primary method for uterine removal is superior to TAH.

Female↗
PubMed1995

The laparoscopic Burch procedure. A preliminary report.

Laparoscopic retropubic colposuspension (Burch procedure) is now being performed in our department as the treatment for genuine stress urinary incontinence. This study presents the first eight cases. Our experience with the laparoscopic approach seems promising. The operative technique has been developed, and the method provides better visualization of the space of Retzius, the patients experienced minimal blood loss and a shorter hospital stay than with the laparotomy approach. Although short follow-up, all the patients except one were continent after three months. This preliminary report demonstrates that laparoscopic Burch procedure may be a valuable addition to the new procedures in 'minimal invasive surgery'.

Adult↗
PubMed1993

Evaluation of endometrial thickness measured by endovaginal ultrasound in women with postmenopausal bleeding.

Endovaginal ultrasound scanning was used preoperatively in 100 women with postmenopausal vaginal bleeding referred for dilatation and curettage. The ultrasonographic appearance of the endometrium was related to the histologic diagnosis. Endometrial malignancy was found in 15 patients, in 2/45 (4.4%) of women aged less than 60 years and in 13/55 (23.6%) of women aged 60 years or more. Out of 54 patients with an endometrial thickness of less than 5 mm as measured by ultrasound, 3 had an endometrial malignancy, and 12 of 45 with an endometrial thickness of 5 mm or more, had an endometrial malignancy. The sensitivity of ultrasound to detect malignancy was 80%, the specificity was 60%, the positive and negative predictive values were 26% and 94.4%. The sensitivity and the negative predictive value was not high enough to replace histologic examination of the endometrium.

Adult↗
PubMed1993

Fertility outcome after treatment of tubal pregnancy by laparoscopic laser surgery.

In 150 women with tubal pregnancy consecutively treated over a two year period by laparoscopic techniques, 74 were treated conservatively by linear salpingotomy with carbon dioxide laser laparoscopy and 76 cases non-conservatively through the laparoscope by salpingectomy. Between 15 and 37 months later all patients were contacted by means of questionnaires to evaluate subsequent fertility outcome. Sixty-six percent (38/58) of those women who desired pregnancy after conservative laparoscopic treatment achieved an intrauterine pregnancy. The corresponding rate for women who desired pregnancy after salpingectomy was 45% (18/40). The recurrent ectopic pregnancy rates in the two groups were 7% (4/58) and 10% (4/40), respectively. This study confirms that tubal pregnancy can be appropriately managed by laparoscopic laser surgery with the advantages of minimal invasive techniques.

Female↗
PubMed1992

[Examination and treatment of gynecological bleeding disorders].

The investigation and treatment of gynaecological dysfunctional bleeding has remained largely unchanged since the problem was dealt with in a special issue of the Journal of the Norwegian Medical Association in 1976, in spite of the advent of modalities like endometrial cytology, hysteroscopy and vaginal ultrasonography, as well as knowledge about the relative lack of efficiency of dilatation and curettage in the investigation and treatment of the condition. We describe a modern programme for investigation and treatment of gynaecological dysfunctional bleeding. The programme relies on clinical assessment combined with medical therapy, with optional use of modern investigative modalities when indicated. In a strictly controlled outpatient programme the need for dilatation and curettage can be greatly reduced without jeopardizing the safety of the patient.

Adult↗
PubMed1992

Laparoscopic hysterectomy. Initial experience.

Laparoscopic hysterectomy is now being performed in our department in cases where no malignancy is suspected. This study presents the first 10 cases. Indications for hysterectomy were myomas, meno- and metrorrhagia resistant to medical and hysteroscopic treatment, and patients with pain and suspicion of having adenomyosis. No complications have been encountered during the laparoscopic operations, but one patient had a second laparoscopy on the first postoperative day due to postoperative bleeding. Another patient had a postoperative infection leading to a compression of the ureter. This report demonstrates that laparoscopic hysterectomy is a valuable addition to the new procedures in 'minimal invasive surgery', but only after long and appropriate training.

Adult↗
PubMed1991

[Laparoscopic appendectomy].

Laparoscopic techniques have extended into the operative field of surgery. Appendectomies can be performed laparoscopically. The diagnosis of appendicitis is established and the inflamed organ removed directly. The laparoscopic technique reduces the incidence of unnecessary appendectomies and corresponding morbidity. Compared with conventional appendectomy, laparoscopy leads to less post-operative pain and inability to work. We discuss the first nine patients we treated in this way.

Adult↗
PubMed1991

[Laparoscopic cholecystectomy].

Techniques and instruments have recently been developed to perform laparoscopic cholecystectomy. Compared with conventional cholecystectomy, laparoscopic cholecystectomy results in significantly less post-operative pain and a shorter stay in hospital. We describe the procedure for laparoscopic cholecystectomy, with reference to the first patients treated in this way.

Adult↗
PubMed1991

Treatment of tubal pregnancy by laparoscopic laser surgery.

We present 150 consecutive cases of tubal pregnancy treated by laparoscopic techniques. A three-puncture technique was used. 74 cases were treated conservatively by linear salpingotomy with carbon dioxide laser laparoscopy and 76 cases were treated nonconservatively through the laparoscope by salpingectomy or tubal resection. Contra-indications to laparoscopic surgery were haemodynamically unstable patient and interstitial pregnancy. Seventy-five per cent of all tubal pregnancies were treated by laparoscopy in the period studied. No complications were encountered during the laparoscopic operations. Two patients needed a second laparoscopy, while 2 others underwent a subsequent laparotomy. This study has shown that tubal ectopic pregnancies can in most cases be effectively managed by laparoscopic techniques.

Adolescent↗
PubMed1991

Laparoscopic adnexectomy.

We are now performing laparoscopic adnexectomy in selected cases of benign pathology of the adnexa. This report is presented to show that even fairly large tumors may be removed by this technique. It involves 30 cases of tumors having a diameter more than 4 cm that were operated on over a period of 12 months. Cystectomies and cystotomies were not included in this study. Patients were excluded if there was any suspicion of malignancy. Indications for laparoscopy were functional and organic cysts, tubo-ovarian abscesses, and adnex torsions due to large hydrosalpinx. No complications have been encountered during the laparoscopic operation or during the follow-up period of 6-18 months.

Abscess↗
PubMed1990

[Laparoscopic treatment of ovarian pregnancy].

Primary ovarian gestation is a rare form of ectopic pregnancy. Ovarian pregnancy comprises less than 3% of all ectopics. We describe two cases of ovarian pregnancy treated successfully by vidoelaseroscopy.

Adult↗
PubMed1989

[Laser endoscopy in gynecology].

Today endoscopic laser is applied gastroenterology, urology and otorhinolaryngology, and the technique is being steadily developed. In the gynecological field the most commonly used technique is the CO2-laser, but the ND: YAG-laser is also being applied through the hysteroscope. At our department we have done 16 laparoscopic operations using the CO2 laser. The method is described and discussed.

Adult↗