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Biomedical subjects

D A Tsin

Publications and source records attributed to D A Tsin.

9 recordsLinked to original sources
PubMed2001

Operative culdolaparoscopy: a new approach combining operative culdoscopy and minilaparoscopy.

The tendency is to use small cannulas for operative laparoscopy; however, working with these cannulas may have technical limitations. We developed a technique for performing appendectomy combining culdoscopy and minilaparoscopy. It uses 3- or 5-mm abdominal cannulas, and the large 10- or 12-mm cannula is inserted into the posterior vaginal fornix under laparoscopic surveillance. The vaginal port is used to introduce operative instruments and extract specimens, and for vision. Culdolaparoscopy avoids additional or large abdominal ports, thus overcoming limitations of small cannulas.

Adult↗
PubMed2000

Laparoscopic myomectomy in a patient with Mayer-Rokitansky-Kuster-Hauser syndrome.

A 36-year-old woman had primary amenorrhea, pelvic pain, Mayer-Rokitansky-Kuster-Hauser syndrome, and an 8.5-cm, solid pelvic mass. The leiomyoma uteri was removed laparoscopically from the vestigial mullerian duct with secondary vaginopoiesis. The patient had a satisfactory clinical outcome. Finding of a leiomyoma in a patient with Rokitansky syndrome is rare. To our knowledge this is the first such case in which the myoma was removed by laparoscopy.

Adult↗
PubMed1999

Laparoscopic leash: a simple technique to prevent specimen loss during operative laparoscopy.

BACKGROUND: Surgical specimens can be lost in the peritoneal cavity during operative laparoscopy. Although specimens left might cause no complications, peritonitis and adhesion formation have been reported, requiring subsequent laparoscopy or laparotomy. We report a simple technique to prevent loss of surgical specimens during laparoscopy. TECHNIQUE: A suture is placed through the specimen, and the trocar sleeve is removed. Free ends of the suture are held with a clamp outside the abdomen while the port is reinserted into the abdomen. The suture is pulled to see the specimen when necessary. When morcellation is required, the leashed area of the specimen is the last to be extracted. This procedure takes less than 2 minutes. EXPERIENCE: We have used this technique for longer than 1 year for 18 myomectomies and seven bilateral salpingo-oophorectomies. No specimens were lost in the peritoneal cavity, and there were no complications related to the procedure. CONCLUSION: The laparoscopic leash is a simple and reproducible preventive technique that adds insignificant time to operations but saves much time that might be wasted localizing a misplaced specimen.

Equipment Design↗
PubMed1996

Laparoscopic techniques for extracting ovarian teratomas.

We performed two techniques for laparoscopic extraction of benign ovarian teratomas. For cysts up to 5 cm, we used the pouch technique, with partial extraction followed by enlargement of the hypogastric port. A skin incision was enlarged to allow the use of a scalpel in the pouch. This enabled us to perform several stab incisions in the cyst to spill its contents while still holding it in the pouch. This was followed by suction irrigation and forceps removal of the contents until the collapsed cyst could be removed in the pouch. For a cyst over 5 cm, we performed endoscopic aspiration irrigation with hot water inside the cyst, followed by partial extraction of the cyst; an opening was made in the exposed cyst wall and the contents extracted as described. When the cyst wall collapsed, we proceeded with the final extraction. When spillage occurred, it was managed with extensive warm lavage of the peritoneum, skimming the floating debris with suction tubing until clear, and underwater inspection and removal of teeth and other solid material. With these techniques, we experienced no complications.

Female↗
PubMed1995

Laparo-vaginal treatment of uterine procidentia.

The following is a description of a combined vaginal and laparoscopic repair of vaginal eversion with uterine prolapse (procidentia). There are few procedures that seek to correct the condition while preserving vaginal function. Among them are (1) vaginal approach for sacrospinous fixation, (2) abdominal sling procedures, and (3) abdominal and laparoscopic approaches for promontorial fixation. We are presenting a technical report of a modified sling procedure done via laparoscopy. This technique achieves the functional vaginal reconstruction and avoids the potentially dangerous bleeding associated with the sacral fixation. It has also been our experience that the sacrospinous fixation technique affords limited visual exposure, and henceforth the laparoscopic vaginal sling procedure may be a better alternative.

Female↗
PubMed1993

Laparoscopic and hysteroscopic approach for tubal anastomosis.

The laparotomy approach for microsurgical repair of tubo-tubal anastomosis is a well-established method. This article describes a novel technique of end to end tubo-tubal re-anastomosis using the minimally invasive methods of video laparoscopy, video hysteroscopy, and lasers in four women. This procedure is applicable to women of reproductive age who have previously been subjected to voluntary sterilization procedures. The long-term results of this new technique remain to be evaluated. However, the minimal surgical approach has met with early success and patient approval.

Adult↗
PubMedDate not supplied

Culdolaparoscopy: a preliminary report.

OBJECTIVE: To introduce a surgical technique that combines culdoscopy with laparoscopy and microlaparoscopy. METHODS: This was a feasibility study conducted at The Mount Sinai Hospital of Queens. The technique is used when a larger port is required during laparoscopy or microlaparoscopy procedures. The additional port is placed in the vagina and, under laparoscopic surveillance, into the posterior cul-de-sac. RESULTS: This operation has been performed successfully in 5 oophorectomies, 4 myomectomies, 3 salpingoophorectomies, and 1 salpingectomy. CONCLUSION: This technique reduces the need for abdominal ports in excess of 5 mm. These ports can have a visual or operative function depending on the nature or stage of the procedure. The vaginal port can serve a visual function similar to that of culdoscopy or may be used for the introduction of operative instruments and the extraction of specimens. A principal benefit of using the larger vaginal port is derived from the capability of assisting laparoscopy and allowing the surgeon to use fewer and smaller abdominal trocars.

Combined Modality Therapy↗