Laparoscopic Cauterization Research Articles

Factors influencing age at natural menopause

Women who experience menopause before 45 years, have an increased risk for morbidity and mortality. We aimed to identify the factors influencing the age at natural menopause and to investigate whether tubal ligation alter age at natural menopause. This cross-sectional study was conducted on total 1660 women with natural menopause. The participants were divided into two groups as the ones having menopause before age of 45 years and after 45 years old. Positive family history, smoking and use of oral contraceptive were found to increase the risk of early menopause by 3.68, 1.34 and 1.04 times, respectively. First pregnancy at older age reduced the risk of early menopause by 0.97 and obesity reduced this risk by 0.65 (95% CI 0.47-0.90). There was no significant difference between menopausal age of patients who underwent BTL (47.46 ± 4.67 years old) and those who did not (47.68 ± 5.18 years old) (P:0.320; P > 0.05). The mean age at menopause of patients who had tubal ligation with laparoscopic cauterization and Pomeroy technique was 46.91 ± 4.07 and 47.55 ± 4.76 years old, respectively (P:0.503; P > 0.05). Besides, there was no significant difference between patients having tubal ligation at the time of cesarean section and those who did not regarding menopausal age (P:0.314; P > 0.05). We recommend identifying modifiable factors and informing women at risk of early menopause. Tubal ligation, when performed correctly, should not compromise ovarian function. If tubal ligation interferes with vascular supply to the ovaries, it may not be substantial enough to result in an earlier onset of menopause.

Viability of an inguinal testis after laparoscopic cauterization and transection of its blood supply

Laparoscopic castration of cryptorchid or hemicastrated horses is a viable surgical technique; however, transection of the spermatic chord to induce avascular necrosis of testicular tissue that is left in place can result in revascularization with subsequent production of testosterone and stallion-like behavior. Endocrine tests, such as determination of testosterone concentration and the human chorionic gonadotropin response test, can be used to identify horses that presumably have been castrated but have viable testicular tissue.

Laparoscopic cautery in the treatment of endometriosis-related infertility

Life table analysis and the two-parameter exponential method have been applied to pregnancy rates in 72 patients undergoing laparoscopic cautery exclusively. Patients with male factor infertility were excluded. Estimated cure rates for patients with stage I and II disease were 98.2% and 76.6%, respectively (not significantly different). No significant difference was seen when anovulation complicated the endometriosis (68.6%). When greater than one infertility factor was present, a significant difference was observed (50.6%). Patients with stage I disease had an average fecundity of 10.30% with decreasing values observed in stage II (7.59%), anovulation (6.67%), and more than one infertility factor (3.33%). We conclude that laparoscopic cauterization is an effective mode of therapy for the treatment of stage I and II endometriosis associated with infertility.

Microsurgical reversal of tubal sterilization.

AbstractThree hundred and sixty patients underwent a microsurgical reversal of tubal sterilization. One hundred and eighty‐eight (57.2%) of these patients had been sterilized by laparoscopic cauterization. In the majority (66.4%) the reason for requesting reversal was a loss of child. The mean interval between sterilization and reversal was 39.3 months. The postoperative tubal length was 6 cm or more in 74.2%. One hundred and fifty‐one (60.4%) of 250 patients followed up for 14 to 59 months have achieved 181 pregnancies. The postoperative tubal patency rate was 88.3%. The mean interval between the surgery and the occurrence of pregnancy was 8.9 months. The success rate was analyzed according to type of sterilization procedure, duration of sterilization, site of anastomosis and postoperative tubal length.

Laparoscopic cauterization of endometriosis for fertility: a controlled study

Ninety infertility patients with moderate endometriosis were randomized between laparoscopic electrocautery and 6 months of danazol therapy and studied for 7 months after treatment. Twenty of the 45 patients undergoing electrocautery conceived (44%) during the follow-up interval. Forty-one of the 45 patients in the danazol group completed the course of therapy, and 16 of those conceived (39%) during the same follow-up interval. There was no statistical difference between the two groups (P less than 0.53). No patients in the electrocautery group experienced complications. This demonstrates that electrocautery is safe and effective in the treatment of moderate endometriosis.

Utilization of contralateral fallopian tube segments in tubal reanastomosis

A 38-year-old patient who had had a left ovarian cystectomy, partial salpingectomy, and laparoscopic cauterization of the right fallopian tube, underwent reanastomosis to attempt pregnancy. Only 3 cm of the left isthmic tubal segment were attached to the uterus; on the right, 7 cm of the distal fallopian tube was present, with the missing segment being at the uterine cornua; endometriosis was present at the site of cauterization at the right cornual area. After excision of the endometriosis, the surgeon performed anastomosis of the left proximal fallopian tubal segment to the right distal fallopian tubal segment without homotransplantation of the adnexa. The patient conceived in the 2nd cycle after hospital discharge. This new technique of tubal reanastomosis, which utilizes the patient's remaining fallopian tube segments, may give the microsurgeon another surgical option regarding tubal reanastomosis.

UTEROTUBAL IMPLANTATION AND OBSTETRIC OUTCOME AFTER PREVIOUS STERILIZATION

The liberalization of sterilization policies has resulted in an increased number of patients requesting tubal reconstructive surgery. From 1973 through 1975, a total of 18 patients were operated upon by the authors for tubal reconstructive surgery following sterilization. These patients had had either postpartum sterilization of the Pomeroy technique or interval laparoscopic cauterization and cutting. The operative technique with an open uterine approach is described in detail. This technique warrants further evaluation, particularly following laparoscopic sterilization when end-to-end anastomosis is precluded.

Failed termination of pregnancy due to uterus bicornis unicollis with bilateral pregnancy

A case of pregnancy in each horn of a uterus with a double corpus and 1 cervix and vagina (uterus bicornis unicollis) is reported. The patient had earlier undergone a suction curettage for termination of pregnancy. Histologic evidence of retained products of conception was subsequently confirmed. Hysterosalpingography confirmed the presence of 2 independent uterine horns. The right uterine horn was entered and a suction currettage was performed. The patient requested permanent sterilization and laparoscopic cauterization of the tubes was performed. This case illustrates the importance of acquiring histologic confirmation of the complete evacuation of the products of conception.

Uterotubal implantation and obstetric outcome after previous sterilization

The liberalization of sterilization policies has resulted in an increased number of patients requesting tubal reconstructive surgery. From 1973 through 1975, a total of 18 patients were operated upon by the authors for tubal reconstructive surgery following sterilization. These patients had had either postpartum sterilization of the Pomeroy technique or interval laparoscopic cauterization and cutting. The operative technique with an open uterine approach is described in detail. This technique warrants further evaluation, particularly following laparoscopic sterilization when end-to-end anastomosis is precluded.

Retention Of Defective Verres Needle Sheath In Abdominal Cavity After Laparoscopy

A 31-year-old woman complained of backache and pain subsequent to dilation/curettage and laparoscopic cauterization of tubes. An intravenous pyelogram showed a metallic foreign body in the abdomen. At laparoscopy the needle was detected posterior to the omentum and removed. There have been no reports of similar accidents in the literature or any known to the distributor of the Verres needles in the area who have since begun manufacturing an improved design. Users should be careful to inspect the cannulas and avoid roughness in cleaning and sterilizing to avoid damage to the silver-soldering which joins the stylet to the hub.

MALE AND FEMALE STERILIZATION

This brief article discusses largely the indications and techniques of female sterilization, and mentions vasectomy, which is very seldom done in Belgium. Indications fall into 3 categories: purely medical, such as hypertensive kidney disease or uncompensated valvular cardiopathy; the medico-social, in which a group of medical and social factors, such as multiparity, poverty, and mild diabetes, taken together justify sterilization; and the purely social, in which the physician uses a medical solution for a social problem. Although vasectomy is technically easier than tubal ligation, invariably the woman is sterilized in Belgium. Techniques for female sterilization include transumbilical route postpartum, lower abdominal route (Pfannenstiel's incision), the vaginal route through the cul de sac, and laparoscopic cauterization.