May 17th 2024
A recent study suggests that higher CASP8 expression in embryos is associated with successful implantation outcomes in women of advanced maternal age, as presented at ACOG 2024.
23rd Annual International Congress on the Future of Breast Cancer® East
July 19-20, 2024
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15th Annual International Symposium on Ovarian Cancer and Other Gynecologic Malignancies™
May 11, 2024
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Community Practice Connections™: 14th Annual International Symposium on Ovarian Cancer and Other Gynecologic Malignancies
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4th Annual International Congress on the Future of Women’s Health™
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Patient, Provider, and Caregiver Connection™: Exploring Unmet Needs In Postpartum Depression – Making the Case for Early Detection and Novel Treatments
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Identifying Health Care Inequities in Screening, Diagnosis, and Trial Access for Breast Cancer Care: Taking Action With Evidence-Based Solutions
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Diagnosing Uterine and Tubal Pathology in Infertility: Which Method is Best?
June 30th 2011The diagnosis of uterine and/or tubal pathology as causes of female infertility represents a fundamental step in the evaluation of the infertile couple. Apart from the invasive diagnostic procedures, several others diagnostic techniques useful to the clinical evaluation of the uterine cavity and tubal anatomy are: transvaginal sonography (TVS), hysterosalpingography (HSG), hysteroscopy and hydrosonography (HDS) and laparoscopy.
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When Is Infertility Surgery Indicated?
June 30th 2011The role of reproductive surgery has been questioned in the current environment of improving techniques and success rates with in vitro fertilization (IVF). Another emerging obstacle is the declining number of these types of surgeries being performed in response to the increasing numbers of patients opting for IVF.
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The Use Of Microendoscopy For Diagnostic And Therapeutic Office Laparoscopy Under Local Anesthesia
June 30th 2011Since the first laparoscopy was performed in humans by Jacobaeus in 1910, great strides have been made by surgeons in utilizing this valuable tool.1 Unfortunately, the expense of performing even diagnostic laparoscopy has become prohibitive. With the high cost of medical care, measures must be taken to decrease this monumental problem. For years, laparoscopy has been performed under local anesthesia with minimal reported complications.
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Prevention and Management of Laparoendoscopic Surgical Complications Laparoscopic Myomectomy
June 30th 2011Uterine myomas are the most common tumors of the female genital tract. = Hysterectomy has been a very common therapy in patients who have completed reproduction. In fact, uterine myomas = account for 20% of the 650,000 hysterectomies performed annually in the United States. Interest in uterine = preservation and organ preserving surgery through techniques of minimally invasive surgery has increased since the first = reports of laparoscopic myomectomy in 1980.
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Prevention and Management of Laparoendoscopic Surgical Complications
June 30th 2011Laparoscopic urinary bladder surgery primarily involves retropubic bladder neck suspension procedures. Because variations of the laparoscopic Burch procedure (Tanagho, Hodgkinson) are most frequently performed, this chapter will focus on the complications of the laparoscopic Burch procedure - avoidance, recognition, and treatment.
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Endometrial Ablation and Hysteroscopic Surgery
June 30th 2011Over the past decade, a technique has been developed that can reduce or stop your periods without a hysterectomy. This surgery can be done in women who have flooding either with or without fibroid tumors. Dr. Dott was one of the surgeons who introduced this minimally invasive procedure in Atlanta. He has performed this procedure many times and is certified by the Accreditation Council for Gynecological Endoscopy in Advanced Hysteroscopic Surgery. He has taught this procedure in training institutions both in the United States and Russia.
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The First World Congress On: Controversies in Obstetrics, Gynecology & Infertility
June 30th 2011Laparoscopic hysterectomy was first described in 1989 (Reich) and rapidly thereafter in 1991 laparoscopic pelvic lymphadenectomy was also described (Querleu). During the 1990s the role of pelvic and latterly para aortic lymphadenectomy has been extended and is now an integral part of best practice Gynaecological Oncology Departments.
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The Association Between Infertility and Endometriosis and the Treatment
June 30th 2011Endometriosis is a gynecological disease affecting women in their reproductive years. The reported incidence of endometriosis among infertile women is 20-50%, and 39-59% among those with pelvic pain. This is in contrast to 15-18% incidental findings of endometriosis among women undergoing tubal sterilization. The question of whether endometriosis causes infertility has been a subject of debate for many years. In this review, the association between infertility and endometriosis and the treatment are discussed.
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Transvaginal Hydro Laparoscopy: Preliminary Assessment of Cost-Effectiveness
June 30th 2011Transvaginal hydro laparoscopy (THL) is a new approach to pelvic anatomic evaluation in the infertile woman. In this procedure a dilating trocar is inserted through the osterior vaginal wall for endoscopic pelvic examination. Normal saline is used to float the bowel out of the pelvis so that one can evaluate the distal Fallopian tubes, ovarian surfaces, pelvic sidewalls, and the cul-de-sac. The THL procedure makes in-office pelvic endoscopy, hysteroscopy, and dye hydrotubation a reality.
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Hysteroscopic Fluid Management
June 30th 2011Hysteroscopy performed with liquid media at a sufficient pressure, usually between 70 mm and 90 mm Hg of true intrauterine pressure, will bring about satisfactory uterine distention, but not necessarily adequate visualization. Depending on the amount of intraoperative bleeding, an adequate flow rate of the media with separate channels of entry and egress is necessary to have a clear operative field.
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The first use of hysteroscopy as a diagnostic tool occurred in 1869 by Pantaleoni who used a tube with an external light source to detect “vegetations in the uterine cavity.”[1] Since that time, improvements in optics, light sources and video cameras have made office hysteroscopy an invaluable tool in the diagnosis of abnormal uterine bleeding. Additionally, the office hysteroscope has the potential for use in treatment of certain disorders of the uterine cavity.
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The Use of VaperTrode® Vaporization Electrode in Operative Hysteroscopy
June 30th 2011For the gynecologist, the introduction of the resectoscope revolutionized the management of submucous myomata that cause uncontrollable uterine bleeding, infertility and pregnancy wastage, and the con-servative control of persistent and excessive uterine bleeding unrelated to uterine filling defects.
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Laparoscopic Excision of Deep Fibrotic Endometriosis of the Cul-de-sac and Rectum
June 29th 2011Diagnosis and treatment of endometriosis is the most frequent reason for gynecologic operative laparoscopy in the United States (Peterson et al,1990). Therefore, the laparoscopist must be thoroughly familiar with the current standards of diagnosis and management of this complex disease.
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Laparoscopic rectosigmoid resection in case of deep endometriosis
June 29th 2011Introduction: Intestinal endometriosis is a disabling disease present in 6% to 30% of deep endometriosis cases. It can be the cause of abdominal bloating, constipation, intestinal cramping and painful bowel movements, defecation pain and intestinal stenosis up to intestinal occlusion. Colorectal endometriosis requires surgical treatment that can be performed by abdominal route or by laparoscopy. The present study describes the total laparoscopic rectosigmoid resection in case of deep endometriosis with bowel involvement.
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Laparoscopic Radical Hysterectomy and Bilateral Pelvic Lymphadenectomy using the Harmonic Scalpel
June 29th 2011The patient was a 30 year old female patient, para 0, who was diagnosed to have a cervical adenocarcinoma on a screening PAP smear. A subsequent endocervical curettage revealed a moderately differentiated adenocarcinoma with focal invasion. She underwent a cone biopsy and a repeated endocervical curettage which revealed an adenocarcinoma in situ with two foci of microinvasion consisting with a Stage IA2 lesion.
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Laser Surgery for Endometriosis
June 28th 2011To interpret the literature describing the results of surgery for endometriosis, a clear understanding of the evolution and limitations of the various techniques is necessary. Up to the end of the 1970’s, minimal and mild endometriosis was destroyed endoscopically by heat application (endothermia) and by unipolar or bipolar coagulation. Treatment of more severe endometriotic disease was mostly radical by hysterectomy, often leaving some rectovaginal endometriosis which has not been fully recognised before 1989.
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Laser surgery for endometriosis : deep endometriosis
June 28th 2011Endometriosis can infiltrate the surrounding tissues resulting in an important sclerotic, and inflammatory reaction which can translate clinically in nodularity, bowel stenosis and ureteral obstruction. The most severe forms such as rectovaginal endometriosis and endometriosis invading the rectum or the sigmoid have been known since the beginning of this century. These conditions, however, are relatively rare with an estimated prevalence of less than 1%.
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Laparoscopy, looking inside the abdomen through a tube placed through a small incision, is a procedure commonly used by gynecologists to diagnose and treat a number of medical conditions. Since the early 1900's when rudimentary laparoscopes were used to visualize, but not treat, abdominal diseases, advancements in this technique have led to the ability to perform complex surgical procedures through a few small incisions, rather than the larger incisions used in the past.
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Most patients with endometriosis do not have intestinal (GI) involvement. Among the difficult cases of endometriosis I see from around the world, only 27% have GI involvement. Since over 1900 patients with endometriosis have undergone surgery at St. Charles, that means I’ve operated on over 500 patients with GI involvement. The symptoms of GI involvement depend on the severity and location of the disease. The severity of disease depends on the depth of invasion into the bowel wall.
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Diagnostic Laparoscopy in Gynaecological Problems: A Retrospective Study
June 28th 2011Objective: To study the findings obtained by diagnostic laparoscopy in gynaecological problems in order to re-assess the role of laparoscopy in the diagnosis of gynaecological problems during the study period.
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Tubal Ectopic Pregnancy: Laparoscopy vs. Laparotomy
June 28th 2011Objectives: To compare the efficiency of laparoscopic treatment versus conventional abdominal surgery in the treatment of ectopic pregnancy (EP) and to review the clinical presentation, evaluate methods of diagnosis, and identifying the risk factors.
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Extraperitoneal Laparoscopic Aortic Lynphadenectomy in Gynecological Cancer
June 28th 2011A preliminary examination under anaesthesia should be performed, the results of pre-operative investigations should be checked to confirm the indications and limitations of the proposed procedure. The retroperitoneal lomboaortic lymphadenectomy achieved via a left internal iliac approach (Dargent et al, 2ooo). The left side is chosen for this approach because most of the lymphnodes are found in the left paraortic region (Michel et al,1998) and because it is also possible to dissect on the right side via this approach (Dargent et al, 2000).If the preoperative work-up reveals right side adenopathy, a similar approach on the right is entirely possible.
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FERTILOSCOPY in the MANAGEMENT OF FEMALE INFERTILITY
June 28th 2011Following the first studies carried on by S. Gordts, the technique of Fertiloscopy has been developed, starting in 1997, by A.Watrelot at the "Centre Lyonnais de recherche et d'étude de la stérilité (CRES®)". Fertiloscopy is a new minimally invasive methods for the exploration of the posterior cul-de-sac which allows a complete work out of the mechanical factors of female infertility.
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Office Hysteroscopy in Diagnosis of Uterine Fibroids
June 27th 2011In order to evaluate uterine fibroids, we need to know what is on the inside of the uterus. Many times ultrasound (or saline enhanced ultrasound) or MRI will provide the information we need. Many women are subjected to endometrial biopsy which is good to rule out cancer, but useless in diagnosing submucous fibroids and polyps. Fortunately it is easy to look directly into the uterus using a thin telescope called a hysteroscope.
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Ob/Gyns and Reproductive Endocrinologists: Silent Partners in Fertility Treatment
June 26th 2011As doctors, we often consult closely with colleagues regarding treatment and diagnosis. However, for a reproductive endocrinologist like myself, sometimes the most important colleague is one who does not have an office down the hall. Ob/gyns are likely the first specialists to field patient questions about fertility, and patients rely on ob/gyns to alert them when they need to see a fertility specialist.
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