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At least 1,693 records · Page 94Linked to original sources
PubMed1992

The effect of bipolar electrosurgical coagulation waveform on a rat uterine model of fallopian tube sterilization.

Laparoscopic bipolar electrosurgical sterilization has been employed for nearly two decades. This bipolar procedure was intended to reduce the incidence of unintended complications, such as bowel burns. However, compared to the monopolar procedure, it produced a higher failure rate. This study examines the role of the low power-high voltage coagulation waveform on the effectiveness of electrosurgical desiccation on the rat uterine model of the fallopian tube. Desiccations were performed with both Kleppinger and Storz forceps using generator settings from 2 to 6. Desiccations performed to the visual endpoint (blanch, swell, and collapse) required from 23.8 to 30.0 joules, although procedures performed at a generator setting of 2 required long application times, an average 15.4 sec (Storz) and 28.2 (Kleppinger). All bipolar procedures led to a loss of tissue at the desiccation site at 12 weeks postsurgery. Therefore, the electrosurgical coagulation waveform proved to be effective in producing adequate in vivo tissue destruction even at very low generator settings.

Animals↗
PubMed2000

Fallopian tube disease: the cobblestone pattern as a radiographic sign.

PURPOSE: To identify radiographic signs of mucosal damage by comparing hysterosalpingography with salpingoscopy in a prospective study. MATERIALS AND METHODS: Forty-one candidates for laparoscopy underwent hysterosalpingography and peroperative salpingoscopy; at both, tubal patency was noted. Radiographic criteria for mucosal abnormality were rounded filling defects (ie, the cobblestone pattern) and the absence of longitudinal radiolucent bands in the ampullary tract. At salpingoscopy, tubal mucosa was categorized by means of inspection into five classes of fold pattern: classes I and II, normal; classes III-V, abnormal. Hysterosalpingographic and salpingoscopic results were compared by means of a two-by-two table and kappa statistics. RESULTS: Seventy-four tubes were evaluated. At hysterosalpingography, 31 tubes were distally nonpatent. Of these, 26 showed a distal obstruction at salpingoscopy. None of the patent tubes at hysterosalpingography showed obstruction at salpingoscopy. The agreement between hysterosalpingography and salpingoscopy in detecting abnormal mucosal pattern was 89.2% (kappa, 0.73; P: <.001). The cobblestone pattern always corresponded to intraluminal adhesions at salpingoscopy. The absence of radiolucent bands corresponded to abnormal mucosa at salpingoscopy in four of six cases. The cobblestone pattern was found only in hydrosalpinges and never in patent tubes. Six normal patent tubes at hysterosalpingography showed intraluminal adhesions at salpingoscopy. CONCLUSION: Results indicate that the cobblestone pattern is an effective radiographic sign of intraluminal adhesions in hydrosalpinges and suggest that intraluminal disease in patent tubes might not always be excluded on normal hysterosalpingograms.

Adult↗
PubMed1983

[Late results in fallopian tubes studies on the Bleier clip].

We report on 243 patients with sterilisation by the Bleier Clip. 234 patients were operated by coeliotomia posterior. 9 cases were sterilized in combination with Caesarean section. In 4 of 243 women we observed pregnancies during the follow-up period (failure rate = 16%). The mean time of the 4 conceptions after operation was 43 months. This result shows that the primary cause was not the operation technique but the systemic failure of the Bleier Clip. In cases with controls by hysterosalpingography all Fallopian tubes were occluded, 84% together with a sactosalpinx.

Cesarean Section↗
PubMed1981

Microsurgical reanastomosis of the fallopian tubes for reversal of sterilization.

Reversal of previous tubal ligation procedures for the restoration of fertility has become an increasingly frequent request. Microsurgical techniques are believed to offer a postoperative pregnancy rate superior to that obtained with macroscopic procedures. Of 63 women who requested reversal, microsurgical reanastomosis was performed in 40. With at least 6 months' follow-up, 22 women have become pregnant (55%), and there has been 1 ectopic pregnancy (2.5%). Comparison with previous studies using standard macroscopic techniques indicates that the use of meticulous surgical methods with precise reapproximation of the fallopian tubes results in a significant (P less than .005) improvement in pregnancy rates.

Adult↗