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Biomedical subjects

A M Siegler

Publications and source records attributed to A M Siegler.

At least 19 recordsLinked to original sources
PubMed1979

An analysis of macrosurgical and microsurgical techniques in the management of the tuboperitoneal factor in infertility.

One hundred and sixty tubal reconstructions were analyzed according to a classification which describes the type of tubal repair and the tubal segment treated. The results in 80 women who were operated upon just prior to the application of microsurgical principles were compared with those in 80 women in whom these techniques were employed. In expressing the results, no patients were excluded for any reason. Anatomical patency was not evaluated, and functional patency was measured by conception (abortion, tubal, or term pregnancy). Of the 80 women who had tuboplasty with conventional surgery, 10 (12.5%) successfully delivered at term, but 14 (17%) had tubal gestations. Almost 28% of the women (22) had successful pregnancies after microsurgery, but in 9 (11%) extrauterine pregnancies resulted. The three women with current intrauterine pregnancies could improve the microsurgical series to 31% successful pregnancies. Our initial experience with microsurgical techniques seems to show an increased number of term pregnancies, principally in patients who have undergone anastomosis.

Adult↗
PubMed1977

Prerequisites for tuboplasty.

Techniques in measuring tubal patency and interpretation of findings can be misleading. Laparoscopic study of infertile women with suspected, diseased fallopian tubes is always prerequisite to tuboplasty. Observations must be accompanied by intrauterine injection of adequate amounts of dye and gentle tubal manipulations. Determined efforts should be made to eliminate reconstructive operations on nonsalvageable tubes because successful term pregnancies following tuboplasties are related more to the extent of tubal damage than to operative technique or postoperative management.

Contrast Media↗
PubMed1977

Hysterography and Hysteroscopy in the infertile patient.

Hysterography and hysteroscopy are diagnostic techniques currently utilized in searching for intrauterine defects that can cause infertility. The purpose of this paper is to describe the basic procedures, discuss their indications and compare results obtained in the infertile patient.

Adult↗
PubMed1977

Selection of patients for Tuboplasty.

Nonoperative techniques for measuring tubal patency and interpretation of their findings can be misleading. Laparoscopic study of infertile women who have abnormal fallopian tubes should always be a prerequisite of tuboplasty. Observations must be accompanied by intrauterine injection of adequate amounts of dye and gentle tubal manipulations. These efforts will help eliminate attempts to reconstruct nonsalvageable tubes. Successful term pregnancy following tuboplasty is related to the extent of tubal damage as well as the operative technique and postoperative management.

Fallopian Tubes↗
PubMed1976

Hysteroscopic procedures in 257 patients.

Two hundred and fifty-seven hysteroscopic examinations were performed on patients who complained primarily of infertility and abnormal uterine bleeding. Organic intrauterine lesions were identified, and correlations were made with preoperative hysterograms and the tissue obtained for pathologic evaluation. The technique proved of special value for the location and resection of intrauterine devices. Failure to observe the cavity adequately and to complete the examination occurred in 20 (8%) of the patients. The most serious complication, uterine perforation, occurred in five instances but did not require additional treatment.

Adult↗
PubMed1976

The Hysteroflator 1000S.

A new electrical apparatus for CO2 hysteroscopy is described. It adds an electric suction pump to the insufflator to fix the cervical cup securely and maintain the seal indefinitely. The apparatus was used in 257 patients without any untoward effects.

Adult↗
PubMed1975

Hysteroscopy.

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Curettage↗
PubMed1975

A comparison of gas and liquid for hysteroscopy.

Attempts to inspect the uterine cavity heretofore have been thwarted because of inability to obtain its sustained adequate expansion, concern about introducing infection into the peritoneal cavity through the tube with liquid or gaseous media and the provocation of endometrial bleeding during manipulation. Recent mechanical and optical innovations may give the gynecologist the capability of overcoming these problems. In this presentation the focus was on the comparison of gas and liquid as the distending medium for hysteroscopy.

Atmospheric Pressure↗
PubMed1975

Reconstruction of fallopian tubes in previously sterilized patients.

Restoration of tubal patency after surgical sterilization in which the luminal continutiy is interrupted requires either uterine implantation of the patent distal segment or resection and end-to-end anastomosis of patent adjacent segments. Although it is logical to assume that after most tubal ligations the intramural segment remains normal and end-to-end anastomosis is possible, both segments should be evaluated and tested prior to the plastic reconstruction. The results of 178 operations collected from the literature and the author's 23 attempts at surgical reversal of previous tubal operations for surgical sterilization were described. The over-all pregnancy rate after resection and end-to-end anastomosis was 39.0%; after uterotubal implantation, it was 19.4%. The latter procedure was performed in 60% of the patients. The small series of reports makes it difficult to evaluate conception rates or to judge the merits of specific reconstructive operative techniques.

Adolescent↗