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Biomedical subjects

C Nezhat

Publications and source records attributed to C Nezhat.

At least 91 records · Page 5Linked to original sources
PubMed1991

Incidental appendectomy during videolaseroscopy.

One hundred incidental appendectomies were performed in patients undergoing operative laparoscopy (videolaseroscopy) for evaluating and treating various major diseases of the reproductive organs. Except for a fever resolving within 24 hours in one case and mild periumbilical ecchymosis, there were no intraoperative or postoperative complications. All patients were discharged within 24 hours of surgery. Average hospital stay was 14 hours. All cases have been followed up for a minimum of 8 months. We believe any risk associated with elective appendectomy as reported here is minimal and outweighed by the benefits of eliminating future emergency appendectomy, simplifying future differential diagnosis of pelvic pain and removing unsuspected abnormality found in the appendix.

Adolescent↗
PubMed1991

Videolaseroscopy for oophorectomy.

Laparoscopic oophorectomy was performed on 94 ovaries in 76 patients. Indications included recurrent pain associated with endometriosis and adhesions in 17 patients (18 ovaries), ovarian endometriomas in 40 patients (40 ovaries), prophylactic oophorectomy (breast cancer) in one patient (2 ovaries), removal of the ovaries at the time of laparoscopic assisted vaginal hysterectomy in 15 patients (30 ovaries), and other indications in three patients (four ovaries).

Adult↗
PubMed1991

Laparoscopic ovarian cystectomy during pregnancy.

A pregnant woman with a history of endometriosis and persistent bilateral adnexal masses underwent laparoscopic ovarian cystectomies at 16 weeks of gestation. There were no adverse sequelae, and the patient had an otherwise uneventful pregnancy and delivery. Operative laparoscopy should be considered to replace laparotomy in appropriate cases during pregnancy.

Adult↗
PubMed1991

Salpingectomy via laparoscopy: a new surgical approach.

This study presents 100 consecutive cases of total salpingectomy performed via laparoscopy for indications of ruptured or recurrent ectopic pregnancy, hydrosalpinges, torsion of the fallopian tube, hematosalpinges, or extensive adhesions. A multiple abdominal puncture approach was used, and salpingectomy was accomplished by electrosurgical coagulation and laser transection of the isthmus, mesosalpinx, and tubo-ovarian ligaments using the CO2 laser. The fallopian tubes were removed from the pelvic cavity through one of the suprapubic punctures. The mean duration of the procedure was 22 minutes, and the mean duration of hospitalization after surgery 7.4 hours. No major intraoperative or postoperative complications were encountered. Laparoscopic salpingectomy appears to be a safe and relatively simple procedure associated with the advantages of outpatient surgery.

Adult↗
PubMed1991

Laparoscopically assisted anterior rectal wall resection and reanastomosis for deeply infiltrating endometriosis.

A 28-year-old woman, presented with a history of long-standing, severe pelvic and bowel endometriosis. Pronounced cul-de-sac tenderness and nodularity were noted on pelvic examination. Videolaseroscopy was undertaken, the rectum was mobilized, and the tumor was prolapsed to the level of the anus. Anterior rectal wall resection and reanastomosis were performed; the colon was returned to the pelvis under direct visualization via laparoscope.

Adult↗
PubMed1991

Comparison of direct insertion of disposable and standard reusable laparoscopic trocars and previous pneumoperitoneum with Veress needle.

A randomized prospective study was conducted to evaluate the ease of use and safety of direct insertion of laparoscopic trocars. Comparison of previous pneumoperitoneum by Veress needle insertion with direct insertion of the reusable conventional laparoscopic trocar and direct insertion of the disposable shielded trocar revealed minor complication rates of 22, 6 and 0%, respectively. No major complications occurred in this series of 200 patients.

Female↗
PubMed1991

Surgery for endometriosis.

Advanced operative laparoscopy in general, and videolaseroscopy using CO2 laser via operative channel of the laparoscope and video, specifically, has revolutionized the management of endometriosis. Adhesion formation is reduced and subsequent fertility rates exceed those obtained with laparotomy. The most complicated cases of endometriosis, including involvement of the rectovaginal septum, gastrointestine, and urinary tract, can now be treated endoscopically by an experienced operative laparoscopist.

Abdominal Neoplasms↗
PubMed1990

Fimbrioscopy and salpingoscopy in patients with minimal to moderate pelvic endometriosis.

Fimbrioscopy and salpingoscopy were performed with a rigid salpingoscope during operative laparoscopy in 100 patients with minimal to moderate endometriosis and in 20 normal controls. Five women with endometriosis had perifimbrial adhesions, compared with none of the controls. No subject in either group had adhesion formation of the endosalpinx. These observations indicate that there is no association between endometriosis and intratubal disease.

Endometriosis↗
PubMed1989

Videolaseroscopy for the treatment of endometriosis associated with infertility.

Recent advances in laparoscopic surgery have enabled the gynecologic surgeon to treat an increased number of diseases of the reproductive organs by using the laser through the laparoscope. This article reviews the results of 243 patients with infertility associated with endometriosis ranging in severity from mild to extensive who were treated by the same surgeon using CO2 laser laparoscopically with videocamera augmentation and control. Of the 243 infertility patients, 168 (69.1%) achieved pregnancy. The pregnancy rates were 71.8% in 39 patients with stage I disease, 69.8% in 86 patients with stage II disease, 67.2% of 67 patients with stage III disease, and 68.6% in 51 patients with stage IV disease. The life table and two-parameter exponential model were used to calculate monthly fecundity, "cure," and "probability of pregnancy" rates. The results indicate that videolaseroscopic treatment of endometriosis associated with infertility, in surgically experienced hands, is at least as efficacious as other forms of therapy for mild and moderate cases of disease, but appears to be more successful than laparotomy for the more severe and extensive stages of disease.

Adult↗
PubMed1989

Safe laser endoscopic excision or vaporization of peritoneal endometriosis.

In using laser laparoscopy for the treatment of endometriosis, protecting patients from inadvertent injury to pelvic structures adjacent to diseased tissue has been a major concern. In many cases, because of this risk, surgeons have stopped short of effecting thorough treatment of endometrial implants on the bowel, bladder, ureters, or great vessels. In a large series of patients, we have used hydrodissection successfully with few complications. We believe that the technique of hydrodissection is a safe and efficient method, permitting more thorough treatment of endometriosis that otherwise might be deemed untreatable by laser laparoscopy.

Abdominal Injuries↗
PubMed1989

Laparoscopic removal of dermoid cysts.

Nine reproductive-age women underwent removal of unilateral or bilateral dermoid cysts via laparoscopy. Over a follow-up period of 12-42 months, there were no immediate or long-term complications. Four patients have had repeat laparoscopy for evaluation of possible pelvic adhesion formation; one had mild periovarian adhesions and the pelvis appeared normal in the other three.

Adult↗
PubMed1989

Endoscopic infertility surgery.

Since the introduction of endoscopy by Jacobaeus in 1910, there has been a dramatic change in the pattern of and approach to the diagnosis and treatment of various diseases of the female reproductive organs. The advances in techniques of operative endoscopy, in high technology and in instrumentation (such as endoscopes, video cameras and videomonitors) have made it possible to perform laparoscopically many of the infertility-related procedures previously requiring laparotomy. The advantages of such surgery are the rapid recovery time, decreased time lost from work, smaller scars, reduced cost, avoidance of risks and complications of laparotomy, and, perhaps, better results.

Adnexal Diseases↗
PubMed1987

Smoke from laser surgery: is there a health hazard?

The composition of plume produced during carbon dioxide laser endoscopic treatment for endometriosis was examined to determine whether it represented a hazard to the surgical staff. A total of 32 plume samples were collected from 17 women undergoing laser laparoscopic treatment for endometriosis and/or adhesions. The smoke was found to consist of particles having a median aerodynamic diameter of 0.31 micron with a range of 0.10-0.80 micron. The size range has two consequences: 1) using a human red blood cell as a model for all cells, it can be stated with greater than 99.9999% certainty that no cell-size particles, including cancer cells, are present in the plume; 2) particles in this size range are too small to be effectively filtered by currently available surgical masks.

Adult↗
PubMed1987

Videolaseroscopy and laser laparoscopy in gynaecology.

Laser laparoscopy has greatly expanded the potential applications of laparoscopy in gynaecology. Videolaseroscopy is a new refinement in the technique, which we believe is beneficial, not only to the patient, but also to the treating physician and the operating room staff. The clinical results of the beneficial application of this technique in the treatment of endometriosis and other diseases of the reproductive organs will be presented.

Endometriosis↗
PubMed1987

Surgical treatment of endometriosis via laser laparoscopy and videolaseroscopy.

The CO2 laser has been used laparoscopically for the removal of endometriotic implants, drainage of endometriomas, and lysis of adnexal adhesions in 102 patients. These patients were followed for a period ranging from 12 to 18 months, during which there were 62 pregnancies including 9 spontaneous abortions and 1 elective termination of a pregnancy. The rates of conception after surgery were as follows: 75% for patients with mild endometriosis (stage I/American Fertility Society), 62% for patients with moderate endometriosis (stage II/AFS), 42.1% for patients with severe endometriosis (stage III/ASF) and 50% for patients with extensive endometriosis (stage IV/AFS). Standard treatment of infertility associated with endometriosis includes both medical (danazol, oral contraceptives, progestins) and surgical (laparotomy, laparoscopy), or combined approaches. This study reports on the CO2 laser used laparoscopically in the treatment of endometriosis associated with infertility. Of 102 patients presenting with infertility attributed to endometriosis, 60.7% conceived within 24 months following laser laparoscopy. In this patient group, no immediate or subsequent laparotomy was required prior to achieving conception, nor was hormonal therapy enacted during the postsurgical study period.

Adult↗
PubMed1986

Surgical treatment of endometriosis via laser laparoscopy.

The carbon dioxide laser has been used laparoscopically for the removal of endometriotic implants, excision of endometrioma capsules, and lysis of adnexal adhesions in 102 patients. These patients were followed for a period ranging from 12 to 18 months, during which time there were 62 pregnancies, including 9 spontaneous abortions and 1 elective termination. The rates of conception after surgery were as follows: 75% for patients with mild endometriosis, 62% for patients with moderate endometriosis, 42.1% for patients with severe endometriosis, and 50% for patients with extensive endometriosis. Of 102 patients presenting with infertility attributed to endometriosis, 60.7% conceived within 24 months after laser laparoscopy. In this patient group, no immediate or subsequent laparotomy was required before conception was achieved, nor was hormonal therapy enacted during the study period after surgery.

Adult↗