Atlas of Laparoscopy and Hysteroscopy Techniques, Third by Togas Tulandi

By Togas Tulandi

This superbly illustrated e-book presents a realistic step by step consultant to the entire laparoscopic and hysteroscopic tactics played by means of gynecologists. every one method is defined intimately and completely illustrated with colour images. the capability problems are defined, and the situations within which a process is contraindicated are tested. The 3rd variation of the "Manual of Laparoscopic and Hysteroscopic ideas" has been multiplied and broadly up-to-date with new chapters together with: transvaginal hydrolaparoscopy, laparoscopy radical trachelectomy, laparoscopic stomach cerclage, and hysteroscopy sterilization.
"Manual of Laparoscopic and Hysteroscopic innovations" is a useful source for busy practising gynecologists who are looking to research step by step options of a surgery.

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Cochrane Database Syst Rev 2005;(3):CD004992. qxp 9/14/2007 10:24 AM Page 39 7 Laparoscopic treatment of ovarian remnant Camran Nezhat, Ceana Nezhat, and Farr Nezhat Ovarian remnants occur when ovarian tissue is inadvertently left in the pelvic cavity after oophorectomy. The remaining functional ovarian tissue can respond to hormonal stimulation with growth, cystic degeneration, or hemorrhage, and produces pain. Predisposing factors include increased vascularity causing difficult hemostasis, endometriosis, pelvic inflammatory disease, pelvic adhesions, multiple previous operations, and altered anatomy.

Some authors have reported closure of the ovary with surgical glue or sutures when the remaining ovarian flaps are unequal in size. Laser vaporization or electrocoagulation of the inner cyst wall has been shown to be effective; however, it was not possible to judge the thermal injury. Superficial destruction results in high recurrence rates, whereas deep destruction often causes bleeding. For large cyst Ͼ5 cm, the size and the thin ovarian capsule precludes excision and/or vaporization. Therefore, either an adnexectomy or a two-step surgery should be performed.

The forceps are pulled in opposite directions until the cyst wall is detached from the ovarian tissue. Hemostasis should be performed during dissection. It is more difficult to secure the bleeding at the completion of dissection, when the ovarian tissue has retracted. To avoid ovarian damage, one should follow the proper cleavage plane. This plane is reached when the outer surface of the cyst wall appears white. 9). 7 After incision of the ovary, the cleavage plane is easily identified (arrow).

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