Biomedical subjects

JF Daniell

Publications and source records attributed to JF Daniell.

4 recordsLinked to original sources

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↗