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Biomedical subjects

V Gomel

Publications and source records attributed to V Gomel.

At least 73 records · Page 4Linked to original sources
PubMed1981

The influence of fallopian tube ampullary length on the fertility of the rabbit.

The relationship between length of the ampullary segment of the fallopian tube and degree of fertility was investigated in 22 New Zealand White rabbits subjected to the microsurgical resection of differing lengths of ampullar with preservation of the full isthmus. The correlation was poor (r = 0.33; P = not significant); the subsequent fertility being unpredictable from a given a length of remaining ampulla. These data are in contrast with those of our previous tubal resection study, where segments of proximal oviduct were excised (1). There, a linear correlation between length of oviduct remaining distally and degree of fertility was demonstrated. Possible reasons for the unpredictability of fertility after segmental resection of ampulla are discussed. Until human data are available, such animal data suggest that the length of distal tubal remnants may predict potential fertility better than the length of proximal tubal remnants. For this reason, a sterilization procedure might best be performed on the proximal oviduct (isthmus) to allow predictability of reversal of the procedure should the occasion arise.

Animals↗
PubMed1980

Microsurgical reversal of female sterilization: a reappraisal.

The role of microsurgery in reversal of sterilization has been reassessed and 118 cases reviewed. The technical variations for tubo-tubal anastomosis necessitated by the condition of the oviducts have been outlined in detail. All 118 cases were included in the analysis without requirement for a minimal postoperative trial period. Seventy-six of these (64.4%) had achieved one or more intrauterine pregnancies. There was one ectopic gestation. Forty-seven patients, reported earlier, were resurveyed. These patients had a minimal postoperative trial period of 18 months. Thirty-eight (80.8%) had achieved one or more term pregnancies or were in the latter half of a normally progressing pregnancy. The mean time interval between the reconstructive surgery and the occurrence of pregnancy was 10.2 months. The longest time interval was 40 months. An inverse relationship was noted between the total length of the reconstructed oviducts and the occurrence of pregnancy.

Adult↗
PubMed1980

The impact of microsurgery in gynecology.

Reconstructive microsurgery has been associated with significantly improved results in infertility. These techniques have made the gynecologist much more conscious of peritoneal trauma and of postoperative adhesions. It has enabled the appreciation of normal and pathologic fine morphologic details. The assimilation of microsurgical principles into gynecology will provide its major benefit in terms of prophylaxis. A pelvic laparotomy in the female infant, adolescent, or young woman will aim at conservation and the avoidance of trauma, postoperative adhesions, and future reduction of fertility. Microsurgery enables a tubal transplantation. Although this is feasible today in a homozygous twin, the wider application of this procedure must await necessary progress in immunology. Microsurgical techniques are required for extracorporeal fertilization. In the not too distant future, microsurgery will become an integral part of fertility-promoting procedures. There will no longer be the need to qualify "microsurgery" since "fertility surgery" will simply imply "fertility microsurgery."

Endometriosis↗
PubMed1980

Pregnancy, ciliary transport, and the reversed ampullary segment of the rabbit fallopian tube.

Pregnancy following reversal of an ampullary segment in the rabbit oviduct has occurred only sporadically, and then usually after repeated mating. To explain this phenomenon it has been postulated that the direction of ciliary beat in the reversed ampullary segment must revert to the normal pro-uterine direction. To test this hypothesis a segment of the ampulla was reversed by microsurgery in 10 rabbits. These were then bred repeatedly for as long as 28 weeks. A single pregnancy, at 10 weeks, ensued. Observation of ampullary transport in vivo showed that muscular activity in the reversed ampullary segment may occasionally overcome the adverse, pro-ovarian ciliary currents that were found to persist in subsequent in vitro examinations. Scanning electron microscopy confirmed normal ciliation in the reversed segment. These observations may explain the occasional transport of an ovum across the reversed ampullary segment and an isolated pregnancy in the mated rabbit.

Animals↗
PubMed1980

Giant hydrosalpinx.

A rare case of giant hydrosalpinx is presented, together with a review of the English literature on the subject. The pathology and pathophysiology of hydrosalpinx are reviewed.

Adult↗
PubMed1979

The influence of fallopian tube length on fertility in the rabbit.

The correlation between the length of the oviduct and degree of fertility was studied in 16 New Zealand White rabbits subjected to microsurgical resection of differing lengths of fallopian tube involving the isthmus in each case. A highly significant (P less than 0.005) linear correlation was found, suggesting that more than 47% of an oviduct must remain distally before fertility can be anticipated. Absence of the isthmic segment of the fallopian tube was found to be associated with supracervical fetal implantations in the uterus. The importance of the assessment of tubal length as a prelude to reconstructive surgery, especially for reversal of sterilization, is emphasized.

Animals↗
PubMed1978

Salpingostomy by microsurgery.

Salpingostomy for hydrosalpinx was carried out using a microsurgical technique. The postoperative patency rate was over 90%. Among the 41 patients followed for more than 1 year, 29% have had one or more intrauterine pregnancies and 27% have had live births. The ectopic gestation rate was 12%. All of the tubal gestations occurred in the 1st postoperative year whereas 60% of the intrauterine pregnancies occurred after the 1st year, suggesting a degree of restoration in the mucosa and the musculature of the oviduct with the re-establishment of patency and the passage of time.

Electrosurgery↗