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PubMed · 10674598

Endobag extractor to remove masses during laparoscopy.

O R Köchli·M P Schnegg·D J Müller·D V Surbek
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Abstract

BACKGROUND: Intra-abdominal masses are removed during laparoscopy using different types of endobags. However, in many cases the specimens are larger than the trocar or the incision in the abdomen, with a potential risk of endobag rupture. INSTRUMENT: We developed an instrument to facilitate extraction of an endobag during laparoscopy without the need for a conventional minilaparotomy. The endobag extractor has three removable diverging blades that symmetrically enlarge the operative canal in the abdominal wall if spread after sharp extension of the skin incision. The full endobag can be drawn through the canal without the risk of endobag rupture because the size of the canal can be individualized, building a funnel. EXPERIENCE: We removed various kinds of ovarian tumors, specimens from salpingo-oophorectomies, and other specimens in 22 cases. CONCLUSION: This new instrument allows easy removal of surgical specimens during laparoscopy without conventional minilaparotomy, regardless of the type of endobag used. We believe this instrument lessens the risk of endobag rupture.

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Fallopian TubesFemaleGynecologic Surgical ProceduresHumansLaparoscopyOvarian NeoplasmsOvariectomyOvaryPregnancyPregnancy, EctopicSpecimen HandlingJournal Article

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BibTeXRIS

O R Köchli, M P Schnegg, D J Müller, D V Surbek. 2000. Endobag extractor to remove masses during laparoscopy.. https://doi.org/10.1016/s0029-7844(99)00516-5

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Fallopian tube sperm perfusion: the impact of sperm count and morphology on pregnancy rates.

BACKGROUND AND OBJECTIVE: To evaluate the effect of changed criteria for sperm count and morphology when performing fallopian tube sperm perfusion (FSP) in unexplained infertility. PATIENTS AND METHODS: We report on a longitudinal study in which two periods of insemination cycles are compared. One hundred and eighty-three couples who started 361 stimulation cycles intended for FSP were included in the first period and 190 couples starting 303 cycles in the second period. The sperm requirement in the first study period was at least 7 million sperm in the prepared test sample. The FSP cycle included downregulation, controlled ovarian hyperstimulation (COH), ovulation induction and intrauterine and intrafallopian tube insemination using a sperm suspension of 3 mL volume. To avoid high-order multiple pregnancies, cycles at risk were converted to in vitro fertilization (IVF). Based on the results from the first period, sperm requirements were lowered to a sperm count of 3 million and at least 5% normal morphology according to strict criteria. RESULTS: FSP was performed in 51% and 60% of started cycles during the two periods with similar pregnancy (24% and 23%) and birth (15% and 19%) rates. Neither sperm count nor morphology above the requirements affected pregnancy rates. IVF-converted, completed cycles reached equal pregnancy (41%) and delivery (32%) rates in both periods. Multiple pregnancy rates were higher after IVF (38%) than after FSP (24%). CONCLUSION: The lowered requirements for sperm count and morphology have not impaired pregnancy results after FSP. Patients who either completed an FSP cycle or had their cycle converted to IVF were all at high risk of multiple pregnancy.

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