Biomedical subjects

Adam Magos

Publications and source records attributed to Adam Magos.

26 records · Page 2Linked to original sources

PubMed2002

Culdoscopy using an optical cannula.

OBJECTIVE: To describe a technique for inserting an endoscope through the posterior vaginal fornix under direct vision using an optical cannula. DESIGN: Prospective case study. SETTING: University Department of Obstetrics & Gynecology. PATIENT(S): Patients with infertility referred for investigation in secondary care. INTERVENTION(S): Insertion of culdoscope using an optical cannula. MAIN OUTCOME MEASURE(S): Successful introduction of the culdoscope. RESULT(S): Sixteen of 20 patients had successful introduction of the optical cannula. There were no reported complications. CONCLUSION(S): Insertion of a culdoscope into the cul-de-sac can be done under visual control and this may reduce the risks of complications associated with blind insertion using a modified Veress needle.

Adult↗

PubMed2002

Hysteroscopic treatment of Asherman's syndrome.

Although Asherman's syndrome (the presence of adhesions inside the cervical canal or uterine cavity) is relatively uncommon in the general population, it can be the cause of menstrual irregularity and subfertility in high risk women. The diagnosis is usually confirmed by hysterosalpinography, and more recently by hysteroscopy. Hysteroscopy has also become accepted as the optimum route of surgery, the aims being to restore the size and shape of the uterine cavity, normal endometrial function and fertility. Treatment can range from simple cervical dilatation in the case of cervical stenosis but an intact uterine cavity, to extensive adhesiolysis of dense intrauterine adhesions using scissors or electro- or laser energy. Patients in whom the uterine fundus is completely obscured, and those with a greatly narrowed, fibrotic cavity present the greatest therapeutic challenge. Several techniques have described for these difficult cases, but outcome is far worse than in patients with mild, endometrial-type adhesions. Non-hysteroscopic techniques area also beginning to be developed, but whether they will replace the current 'gold' standard of hysteroscopy remains to be seen.

Endometrium↗

PubMed2002

Development of a novel method of female sterilization: I. The development of a novel method of hysteroscopic sterilization.

BACKGROUND AND OBJECTIVES: For more than 100 years, gynecologists have attempted to effect sterilization via a transuterine approach. Our aim was to develop a safe, simple, rapid method of sterilization that could be performed in the outpatient clinic. The authors felt that a tubal screw based on a "self-tapping" screw would be less likely to become dislodged from the uterine cornu with time because multiple backward-pointing threads prevent it from being displaced. METHODS: During the development of the technique, many changes had to be made to deliver the tubal screw effectively to the uterine cornu. These involved overcoming problems of poor cornual distension before screw application, effecting the requisite deflection toward the uterine cornu, performing the screwing action with a deflected applicator, and finally disimpacting the screw. Changes were made to the tubal screw, hysteroscope, method of uterine distension, method of deflection, screw applicator, and method of disimpaction. RESULTS AND CONCLUSIONS: The system that appears to be the most efficient consists of a 25F cystoscope with a variable bridge, a 4-mm 30-degree endoscope, and an unsealed spring applicator with bayonet mounting on the screw applied with the use of a pressure bag for uterine distension with saline solution.

Female↗

PubMed2002

Development of a novel method of female sterilization: II. Retention of tubal screws in patients undergoing simultaneous laparoscopic sterilization.

BACKGROUND AND OBJECTIVES: This study was a long-term follow-up of patients in whom hysteroscopic tubal screws had been applied at the time of laparoscopic sterilization. METHODS: Tubal screw application was performed before laparoscopic Filshie clip application. Follow-up ultrasonography was arranged 3, 6, and 9 months postoperatively to confirm retention. The tubal screws were removed hysteroscopically between 12 and 20 months after sterilization under local or light general anesthesia. RESULTS: Thirty-five women agreed to take part in the study. For the purpose of analysis, these patients were divided into an initial group (cases 1-20, group A) and a later group (cases 21-35, group B). Twenty-three patients had 41 tubal screws inserted (18 women had bilateral screw application). Twenty tubal screws were removed from 13 patients between 9 and 20 months after insertion, one screw remained in situ, and 20 screws had previously been extruded. Life table analysis plots demonstrated a marked but nonsignificant difference (P = .163) in the duration of tubal screw retention between the initial patients (group A) and the later patients (group B): 46.7% versus 76.9% at 6 months and 33% versus 61.5% at 12 months (P = .09 and P = .11, respectively). CONCLUSIONS: Our experience demonstrated improved application and retention with experience and refinement of the equipment; however, retention of the tubal screws, even in the later stages of development, was poor. A relatively noninvasive method of female sterilization remains the ideal, and further refinements are required.

Fallopian Tubes↗

PubMed2002