Vaginosonography in gynecology, early pregnancy, and gynecologic carcinoma screening.
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Biomedical subjects
Publications and source records attributed to L W Popp.
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Advocates of the so-called "free hand technique" in amniocentesis argue against permanent sonographic control as follows: "Free hand technique" is the only method enabling vertical guiding of the puncture needle between abdominal wall and amniotic cavity, and hence to cover the shortest distance with the lowest risk of traumatisation. "Free hand technique" is the only method permitting sensitive guiding of the needle in amniocentesis, since the puncturing doctor can use both hands without requiring one hand for sonographic examination. Amniocentesis under permanent sonographic control is claimed to raise serious problems in guaranteeing the necessary sterility. The authors present a modification of the puncture method with permanent sonographic control. This does away with all of the above arguments against permanent sonographic control, whereas all of its obvious advantages are retained (greater safety, less risk of injury). The method employs a fixation scaffolding and an aiming groove for routine sector scanning (Figures 1 and 2). The entire system is covered in a sterile manner by a pasted-on foil sheeting after having introduced the sonographic contact gel. The only contact medium for the skin is a disinfecting agent enabling satisfactory imaging (Figure 4). This method offers the following advantages over the methods using conventional puncture soundheads: Better possibility of disinfection. No rigid guiding of needle, and hence correction can be effected even during puncture. Adjacent levels can be observed by free displacement of scanner and needle. Modifiable puncture angle in respect of skin and uterus. The fixation scaffolding does away with the need for an assistant, and enables tremor-free fixation of the scanner during puncture.(ABSTRACT TRUNCATED AT 250 WORDS)
Basing on our research work in hysteroscopy, we used recently developed small endosonographic sounds for intrauterine and later vaginal approach, for the first time in 1981. We call this method endosonography. The equipment used so far is described, the procedure explained, and the efficacy of this new technique demonstrated via several endosonograms. The advantage to transabdominal sonography is the close contact of the ultrasound transducer with the organ to be examined. This enables the use of high frequencies with correspondingly good resolution. Finally, our own experience is discussed.
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Since 1989 we have performed 21 endoscopic hernia repairs in 19 female patients. One recurrent hernia occurred 3 months after laparoscopic preperitoneal patch repair using a single layer of resorbable mesh. Hernioscopy was developed as the transcutaneous endoscopic CO2-gas dissection and subsequent inspection of the preperitoneal hernial sac. Hernioscopic stuffing of the preperitoneal hernial sac using resorbable patch material was performed in seven direct inguinal hernias and in one femoral hernia. Postoperative pain was minimal and convalescence was short. No recurrent hernia occurred during a 1-9-month follow-up.