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P Trompeo

Publications and source records attributed to P Trompeo.

At least 19 recordsLinked to original sources

The new techniques of gynaecologic laparoscopy. Gasless, open Hasson, optic trocar.

BACKGROUND: New techniques of laparoscopy: gasless, open Hasson, optic trocars allow to avoid the risks of vessel and bowel injuries. The objective of this study was to evaluate the capability of a retractor system as an alternative to conventional technique without pneumoperitoneum and to assess if the system facilitates the use of conventional surgical instruments during gynaecological surgery. METHODS DESIGN: Prospective evaluation. SETTING: University-affiliated county hospital. PATIENTS: Gasless laparoscopy surgery was performed on 49 patients between December 1995 and July 1996 with a retractor system without pneumoperitoneum consisting of an intrabdominal retractor using conventional surgical and laparoscopic instruments and to enable a simultaneous vaginal approach. RESULTS: Gasless laparoscopy was successful in 44 (90%) of cases. A simultaneous vaginal approach was used in one third of indications including vaginal myomectomy and laparoscopic assisted hysterectomy. Conversion to laparotomy was required in 5% of cases. Mean procedure duration was 90 minutes and mean hospitalisation time was 5.7 days. CONCLUSIONS: The introduction of new techniques of laparoscopy: gasless, open Hasson, optic trocars has broadened the application of operative laparoscopy. Gasless technique in lieu of conventional laparoscopy can be performed reliably and safely for most gynaecological indications. The most outstanding benefit of this method is that it can be combined with a vaginal approach which is not possible using a pneumoperitoneum due to gas leakage. The place of gasless laparoscopy will depend on continuing development by instrument manufacturers, in order to achieve an instrument providing vision as good as that seen with the pneumoperitoneum.

Female↗

[Celio-assisted vaginal surgery].

BACKGROUND: Remarkable progress has been made in laparoscopic surgery over the past few years. The evolution of laparoscopic techniques has enabled surgeons to undertake celio-assisted vaginal operations. In particular, the possibility of using mechanical retractors to lift the abdominal wall as an alternative to pneumoperitoneum now enables surgeons to operate simultaneously using a transvaginal and laparoscopic approach. Gas-free laparoscopy has introduced a new and very interesting concept of laparovaginal surgery. The uterus is in fact both an abdominal and pelvic organ and can therefore be reached more easily and with greater safety using a combined vaginal and laparoscopic technique. METHODS: A group of 17 patients underwent celio-assisted vaginal surgery. A prospective study was performed in patients with indications for vaginal operations who had given their informed consent to the use of this new surgical technique. Their mean age was 49.4 years. Mean parity was 1. RESULTS: Vaginal myomectomy was performed in 58.8% of cases, whereas 41.2% underwent vaginal hysterectomy. Laparoconversion was necessary in 17.6% of cases. Postoperative complications were rare (11.7%). The mean duration of surgery was 122.7 minutes. Mean hospital stay was 3.7 days. CONCLUSIONS: The considerable advantages of celio-assisted vaginal surgery using gas-free laparoscopy may be summed up as reduced operating time and reduced intra-abdominal pressure which significantly diminish the risk of thromboembolism. The disadvantages that were noted compared to pneumoperitoneum include: diminished lateral exposure of the abdominal cavity and paracholic grooves, reduced lifting of the rib margin and a greater presence of the intestinal ansae in the laparoscopic visual field in obese patients.

Abdomen↗

[Transvaginal echographic evaluation of myometrial invasion in patients with endometrial cancer].

Twenty-one patients with endometrial cancer who underwent laparotomy, were pre-operatively examined by transvaginal sonography. A deep myometrial invasion (> 50%) was noted sonographically in 9 patients (42.3%), with a superficial invasion (< 50%) in 12 (57.2%). A deep invasion was histologically seen in 10 patients (47.6%), with a superficial invasion in 11 (52.4%). In myometrial deep invasion evaluation, transvaginal sonography showed a 90% sensibility, a 73% specificity, a 75% positive predictive value and a 93% negative predictive value. In 3 cases (14.3%) the invasion depth was sonographically overestimated and in 1 case (4.8%) underestimated. These results make possible an important role of transvaginal sonography in staging endometrial cancer, to select patients needing for pelvic and lomboaortic lymphadenectomy over total abdominal hysterectomy with vaginal collar.

Aged↗

[Management of delivery in podalic birth: cesarean section or vaginal delivery?].

Three hundred and thirty-six births with podalic presentation (3.15% of total deliveries) took place during the period 1978-89 in the Department of Obstetrics and Gynecology of Pinerolo Hospital. The nature of the delivery, the age of pregnant women, together with the length of pregnancy, the number of previous children, the number of days spent in hospital, complications, birth weight, and Apgar scores 1 and 5 minutes after birth were recorded. The most striking result is the increase in the number of caesarean section.

Cesarean Section↗

[Ovarian dysgerminoma. Report of a case with successive pregnancies].

The case of a young woman is described who gave birth to two children following the removal of an ovarian dysgerminoma and currently enjoys good health eight years after the operation. The tumour was a pure dysgerminoma, with a diameter of 12 cm, which affected the left ovary. Surgical treatment alone was used.

Adult↗