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Biomedical subjects

J M Val-Gallas

Publications and source records attributed to J M Val-Gallas.

5 recordsLinked to original sources

Office microlaparoscopy under local anesthesia in the diagnosis and treatment of chronic pelvic pain.

STUDY OBJECTIVE: To evaluate the safety of diagnostic and operative microlaparoscopy performed in the office under local anesthesia in the diagnosis and treatment of chronic pelvic pain. DESIGN: Prospective study (Canadian Task Force classification II-2). SETTING: Office-based, free-standing private obstetrics and gynecology practice. PATIENTS: Twenty women with chronic pelvic pain. INTERVENTION: Diagnostic and operative microlaparoscopy performed under local anesthesia with conscious sedation. MEASUREMENTS AND MAIN RESULTS: All 20 patients had diagnostic microlaparoscopy and 19 had conscious pain mapping. Nine of 14 patients with endometriosis underwent fulguration of lesions and 7 of 8 with pelvic adhesions had lysis of adhesions. Four women with uterosacral ligament involvement had laparoscopic uterosacral nerve ablation. All patients tolerated office diagnostic and operative procedures without difficulty and had no complications. CONCLUSION: In selected women, several laparoscopic procedures traditionally done in a hospital or ambulatory surgery center under general anesthesia can be performed safely in the office laparoscopy suite under local anesthesia with conscious sedation.

Adolescent↗

Appendectomy under local anaesthesia following conscious pain mapping with microlaparoscopy.

The appendix is an under-appreciated source of chronic pelvic pain. Laparoscopic evaluation of the appendix is limited without intra-operative patient feedback on the presence and absence of pain. New techniques using local anaesthesia with conscious sedation have enabled us to perform operative laparoscopic surgery while the patient is awake. We report the first two cases of microlaparoscopic appendectomies performed under local anaesthesia with conscious sedation following diagnosis obtained during conscious pain mapping.

Adolescent↗

Conscious pain mapping.

STUDY OBJECTIVE: To present the technique and usefulness of conscious pain mapping. DESIGN: Prospective, observational study (Canadian Task Force classification II-2). SETTING: Gynecology departments of a university-affiliated hospital and a private community hospital. PATIENTS: Fifty consecutive women undergoing diagnostic microlaparoscopy. INTERVENTIONS: Conscious pain mapping was performed in all 50 women. MEASUREMENTS AND MAIN RESULTS: Conscious pain mapping helped to identify foci of chronic pelvic pain. The appendix and pelvic adhesions accounted for a significant amount of pelvic pain in these women. CONCLUSIONS: Conscious pain mapping helps to uncover sites of pelvic pain that might not be identified during traditional laparoscopy under general anesthesia.

Adolescent↗

A protocol for conscious sedation in microlaparoscopy.

To establish a protocol for conscious sedation in microlaparoscopy, we conducted a prospective, observational study of 74 women undergoing the procedure under local anesthesia with conscious sedation for the evaluation and treatment of chronic pelvic pain. Our protocol for conscious sedation allowed us to perform diagnostic microlaparoscopy under local anesthesia in all 74 women and operative microlaparoscopy in 52 (70.2%). This procedure is a safe and effective alternative to general anesthesia during microlaparoscopy in selected patients.

Adolescent↗

Small trocar perforation of the small bowel: a case report.

Although laparoscopy is one of the most common surgical procedures done today, bowel perforations can and do occur during the initial insertion of the Veress needle and/or trocar. Recent advances in microlaparoscopy have reduced the morbidity of this complication when encountered. We report a case of small bowel perforation following insertion of a Veress needle with its 2 mm trocar and our minimally invasive intra-operative and postoperative management of the patient.

Adult↗