Biomedical subjects

G McTavish

Publications and source records attributed to G McTavish.

7 recordsLinked to original sources

PubMed1995

Combined laparoscopy and minilaparotomy for outpatient reversal of tubal sterilization.

This retrospective study determines risks, outcomes, and cost savings in microscopic tubal sterilization reversal done by minilaparotomy. From January 1992 to December 1993, 40 women, as outpatients, had combined laparoscopy and minilaparotomy for tubal anastomosis. The mean operating time was 1.7 hours, mean blood loss was 20 mL, and mean recovery time was 3.2 hours. Thirty-seven patients (93%) were discharged on the same day, two stayed for 23 hours, and one patient required hospitalization for 2 nights. There were no immediate or postoperative complications. Early crude pregnancy rate was 60%, with an 8% ectopic rate. Tubal patency was confirmed in 39 (98%). The average total cost to the patient was $5,200. Microsurgical tubal anastomosis can be done safely and successfully on an outpatient basis, reducing costs and morbidity and accelerating the patient's return to activity.

Adult↗

PubMed1994

Laparoscopic Use of Argon Beam Coagulator in the Management of Endometriosis

Fifty-five patients with endometriosis in whom argon beam coagulation was used through the laparoscope for coagulation of endometrial lesions, lysis of pelvic adhesions, uterosacral nerve ablation (LUNA) and presacral neurectomy (PSN) were evaluated retrospectively. Thirty patients (54%) had pelvic pain, and 25 patients (46%) presented with pelvic pain and/or infertility. Postoperatively, 29 (72.5%) women showed improvement of pain, 6 (15%) had no change of pain, and in 5 (12.5%) the pain became worse. Seven patients were able to conceive after longstanding infertility, for an early crude pregnancy rate of 28%. Laparoscopic use of argon beam coagulator in the treatment of endometriosis for both pain management and infertility is as effective as other electrosurgical or laser techniques.

Journal Article↗

PubMed1994

Outpatient Tubal Reanastomosis Performed by Combined Laparoscopy and Minilaparotomy

From January 1992 to July 1993, 30 women underwent minilaparotomy for tubal reanastomosis in a surgery center. Laparoscopy was done and if favorable, minilaparotomy with exteriorization of the uterus and microsurgical tubal reanastomosis was performed. Cost was determined from the surgery center and surgeon's bill and compared with hospital costs of inpatient tubal reanastomosis in nearby hospitals. Mean operating time was 1.7 hours, and mean blood loss was 20 ml. Twenty-seven (90%) were discharged the same day, two (6.6%) were 23 hour stay, and one required hospitalization for two nights. There were no immediate or postoperative complications. Early crude pregnancy rate was 50% with 10% ectopic rate. Tubal patency was confirmed in 29 (96%) patients. The average total cost to the patient was $5,200.00. Tubal reanastomosis can be effectively performed as an outpatient, reducing costs, giving comparable pregnancy rates, and accelerating patient recovery.

Journal Article↗

PubMed1994

Laparoscopic Incidental Appendectomy: Prevention or Therapy?

This retrospective review describes our experience with the benefits of laparoscopic incidental appendectomy performed in association with various gynecologic procedures. Eighty-five women in the reproductive age group (25 to 48 years of age) were included in this study. Indications for laparoscopy included pelvic pain, pelvic adhesions, and possible endometriosis. There was no immediate or late procedure-related morbidity to the procedure. Visible pathology of the appendix was detected in 16.8% of patients. Of grossly normal appendices, histopathologic examination revealed pathology in 42.4% of cases. Our results suggest that because of the high incidence of pathology in this age group of women, incidental appendectomy at the time of laparoscopy may serve both as a preventive and a therapeutic measure.

Journal Article↗

PubMed1994

Laparoscopic Presacral Neurectomy Versus Neurotomy with the Argon Beam Coagulator

Presacral neurectomy is effective treatment for dysmenorrhea and midline pelvic pain. The purpose of this paper is to report the benefits of the argon beam coagulator (ABC) used laparoscopically to perform a presacral neurotomy compared with conventional techniques for presacral neurectomy. In 51 patients undergoing laparoscopic presacral neurectomy, 34 were performed using the ABC only without dissection or excision, and 17 underwent presacral neurectomy by conventional methods. Postoperative pain reduction was the same in both groups, 77% versus 73%, with average anesthesia time 64 minutes for the ABC neurotomy versus 92 minutes with conventional techniques. One major vascular complication requiring immediate laparotomy occurred in the ABC group. When properly applied laparoscopically, the ABC is an effective tool to rapidly coagulate and separate the presacral nerves with minimal smoke, excellent visualization and no retroperitoneal dissection.

Journal Article↗

PubMed1993

Laparoscopically assisted vaginal hysterectomy. The initial Nashville, Tennessee, experience.

It is now possible to begin a difficult hysterectomy via laparoscopy with or without adnexal removal and then complete the operation vaginally. We report our successful experience with laparoscopically assisted vaginal hysterectomy in 62 of 68 patients. Techniques used for hemostatic separation of the uterus and adnexal pedicles included an automatic laparoscopic stapling device (49 cases), bipolar coagulation with sharp transection (11) and combined techniques (2). Minor complications occurred in four patients. Six patients had their operations converted from laparoscopy to laparotomy because of significant adhesions (three), large fibroids (two) and poor access due to obesity (one). The use of a stapling device required less anesthesia time (1 hour, 57 minutes, vs. 3 hours, 43 minutes), a smaller blood loss (145 vs. 247 mL) and shorter hospital stays (2.53 vs. 2.75 days) than did laparoscopic bipolar coagulation. However, the average hospital costs were greater for disposable automatic stapling devices and trocars when compared to bipolar coagulation techniques ($9,310 vs. $6,227). Postoperative patient satisfaction with the operation was high (98%), with a high rate of symptom resolution (95%). Laparoscopically assisted vaginal hysterectomy is a safe, effective operation in selected cases and may soon become a common alternative to abdominal hysterectomy in certain cases.

Adult↗

PubMed1985

Hymenolepis microstoma: histopathological changes in mice maintained at different environmental temperatures.

Livers of uninfected mice maintained at 5 C did not differ histologically from mice kept at 21 C, but the hepatocytes of mice kept at 35 C were depleted of glycogen. Regardless of temperature, infection with a single Hymenolepis microstoma induced inflammatory changes in the livers of all mice. However, the degree of histopathology was less in mice kept at 21 C than in mice at 5 C or 35 C. Infected mice in the hot and cold environments developed necrotic lesions in their liver parenchyma. Livers of mice kept at 35 C contained many foreign body giant cells. Temperature had no histological effect on the common bile duct, but in all infected mice there was a pronounced thickening of the bile duct wall due to intensive infiltration of the submucosa with fibrous connective elements and inflammatory leucocytes.

Animals↗