Biomedical subjects

C H Nezhat

Publications and source records attributed to C H Nezhat.

39 records · Page 3Linked to original sources

PubMedDate not supplied

The role of laparoscopic-assisted myomectomy (LAM).

Laparoscopic myomectomy has recently gained wide acceptance. However, this procedure remains technically highly demanding and concerns have been raised regarding the prolonged time of anesthesia, increased blood loss, and possibly a higher risk of postoperative adhesion formation. Laparoscopic-assisted myomectomy (LAM) is advocated as a technique that may lessen these concerns regarding laparoscopic myomectomy while retaining the benefits of laparoscopic surgery, namely, short hospital stay, lower costs, and rapid recovery. By decreasing the technical demands, and thereby the operative time, LAM may be more widely offered to patients. In carefully selected cases, LAM is a safe and efficient alternative to both laparoscopic myomectomy and myomectomy by laparotomy. These cases include patients with numerous large or deep intramural myomas. LAM allows easier repair of the uterus and rapid morcellation of the myomas. In women who desire a future pregnancy, LAM may be a better approach because it allows meticulous suturing of the uterine defect in layers and thereby eliminates excessive electrocoagulation.

Female↗

PubMedDate not supplied

Laparoscopically assisted myomectomy: a report of a new technique in 57 cases.

OBJECTIVE: This study was undertaken to assess the efficacy of a combined operative laparoscopy and minilaparotomy technique to remove single and multiple large leiomyomas. PROCEDURE: Laparoscopy was used to treat associated pelvic pathology, to identify the leiomyoma(s) and bring it to a minilaparotomy incision and to remove by irrigation blood clots and debris at the end of the procedure. Through this incision, the leiomyoma(s) is grasped, shelled, morcellated, and the uterine defect is repaired in layers. RESULTS: We retrospectively evaluated the records of 57 women who underwent this procedure. The uteri ranged from 8 to 26 weeks' gestational size. The weight of the leiomyomas ranged from 28 g to 998 g (mean, 247 g); operative time ranged from 40 to 285 minutes (mean 127 minutes) and blood loss from 50 mL to 1,600 mL (mean, 267 mL). All procedures were completed without full laparotomy. Complications included one case of Klebsiella pneumonia requiring several days of antibiotics, and an incisional hernia at the minilaparotomy site. Forty-one patients were discharged on or before the first postoperative day, 12 on day 2, and four after 72 hours. Most women resumed normal activity within 3 weeks. CONCLUSION: We found laparoscopically assisted myomectomy to be a safe alternative to myomectomy by laparotomy. It is technically less difficult than laparoscopic myomectomy, allows better closure of the uterine defect, and may require less time to perform.

Adult↗

PubMedDate not supplied

Laparoscopy during pregnancy: a literature review.

OBJECTIVE: To review the literature regarding the role of laparoscopy during pregnancy, particularly adnexal mass and non-obstetric surgery, incorporating the results of a series of 9 cases of laparoscopy during pregnancy at our centers. MATERIALS AND METHODS: A Medline search was performed to review the literature, and the reference lists provided by those articles were further explored for citations regarding laparoscopic adnexal surgery, appendectomy, and cholecystectomy. Our series of 9 patients consisted of pregnant patients with adnexal mass or acute abdomen who would otherwise have undergone exploratory laparotomy. Follow-up data for these 9 cases were collected by office visits, inquiry to the primary referring physicians, and telephone calls to the patient. RESULTS: The literature search yielded 42 additional cases of operative pelvic laparoscopy and 51 cases of abdominal operative laparoscopy (cholecystectomy and appendectomy). The publications, particularly regarding cholecystectomy, were supportive of the laparoscopic approach during pregnancy. All of the patients in our series had favorable outcomes. CONCLUSIONS: Advanced operative laparoscopy has been successfully performed for certain indications during pregnancy.

Adnexal Diseases↗