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PubMed2006

Misoprostol for cervical ripening in non-pregnant women: a randomized double-blind controlled trial of oral versus vaginal regimens.

BACKGROUND: The objective was to compare the efficacy of oral versus vaginal misoprostol for cervical ripening in non-pregnant women. METHODS: Sixty non-pregnant women scheduled for diagnostic hysteroscopy were randomized by computerized randomization schedule to 400 microg of misoprostol orally (n = 30) or 200 microg vaginally (n = 30) administered 12 h prior to surgery. The diameter of the cervical canal measured with a Hegar dilator, adverse events and any complications were recorded and compared between the two groups. RESULTS: The mean pre- and post-medication cervical canal diameter and cervical diameter difference were 2.00 +/- 1.93 versus 2.37 +/- 1.83 mm (P = 0.453), 5.10 +/- 1.75 versus 5.60 +/- 1.69 mm (P = 0.265) and 3.10 +/- 1.79 versus 3.23 +/- 1.74 mm (P = 0.771) in the oral and vaginal group, respectively. Seven patients in the oral group and one patient in the vaginal group experienced diarrhoea within 24 h of administration of the misoprostol. CONCLUSION: Oral misoprostol 400 microg had similar efficacy in cervical ripening to 200 microg of vaginal misoprostol.

Administration, Intravaginal↗

PubMed1998

Simplified abdominal wall-lifting device for gasless laparoscopy.

OBJECTIVE: To develop a simplified abdominal wall-lifting device for gasless laparoscopy. METHODS: The device is composed of an electric-power actuator, sliding arm and abdominal wall-retractor. All parts of the device are reusable. The device provides planar displacement of the anterior abdominal wall to enable space for laparoscopy. The valveless ports and conventional instruments, as well as laparoscopic instruments, were used without a gas leak problem. RESULTS: After preliminary success in the laboratory testing, a petition was made to the hospital's Ethic Committee. Since then we have performed 40 gasless laparoscopic procedures including 13 salpingo-oophorectomies, 10 diagnostic laparoscopies, five tubal ligations, five ovarian cystectomies, four salpingectomies, two removals of pelvic IUDs and one laparoscopic hysterectomy. There were no surgical complications, including no abdominal wall trauma. The operative field was almost the same as that of the pneumoperitoneum technique, with the exception of morbidly obese patients. CONCLUSIONS: This preliminary experience demonstrates the efficiency of the simplified abdominal wall-lifting device and the potential advantages of gasless laparoscopy. Continued modifications and applications are necessary to delineate the full range of benefits of this device and technique, especially in developing countries.

Abdominal Muscles↗