R Kung | PubMed Health

PubMed1996

Laparoscopic Two-Team Sling for Stress Urinary Incontinence

The two-team sling procedure is recommended for women with recurrent stress urinary incontinence (SUI), particularly those with low urethral pressures. These procedures have been performed for 20 years using a combined abdominovaginal approach and Marlex mesh. From July 1993 to February 1996, 100 cases of laparoscopic two-team procedures were performed using both extraperitoneal and intraperitoneal approaches. An overall success rate of 95% was achieved with a mean follow-up of 1.5 years (range 6 mo-3 yrs). Complications were small bowel perforation (1%) from the umbilical cannula requiring laparotomy and small bowel resection, inadvertent cystotomy (3%), voiding dysfunction (3%), and mesh erosion (3%). The mean operating time was 70 minutes and average length of hospital stay was 1.5 days. The laparascopic two-team sling is a suitable surgical alternative for women with recurrent SUI.

Journal Article↗

PubMed1995

Menses cup evaluation study.

OBJECTIVE: To determine whether the menses cup is well tolerated by menstruating women. DESIGN: Prospective descriptive clinical study. SETTING: Normal human volunteers in an academic research environment. PARTICIPANTS: Fifty-one menstruating women recruited between June to December 1991. INTERVENTIONS: Each participant was provided with two menses cups and an instruction sheet. Baseline information, including age, occupation, martial status, parity, description of menstrual flow, and current method used to cope with menstrual flow was collected. Subjects were asked to describe their experience with the cup at 1-, 2-, 6-, and 12-month intervals. MAIN OUTCOME MEASURE: The proportion of women who found the cup acceptable. RESULTS: The cup was used by 51 subjects for a total of 159 cycles. Overall, 23 women (45%) found the cup an acceptable method for coping with menses. Among 29 (57%) women who used the cup for two or more cycles, 62% found it acceptable. CONCLUSION: The menses cup may be an acceptable method for some women for coping with menstrual flow.

Equipment and Supplies↗

PubMed1990

A new 1.9-mu wavelength laser for neurosurgery.

The 1.9-mu wavelength component of a 1.9/1.06-mu two-wavelength laser with near-continuous wave properties was tested for its potential use in neurosurgery. The 1.9-mu wavelength has tissue-ablative capabilities, while the 1.06-mu wavelength (Nd:YAG) is suitable for achieving hemostasis. The advantages of the 1.9-mu wavelength over the CO2 laser include its ability to transmit through silica fiberoptic delivery systems and its deeper penetration in water (approximately 100 mu, a depth 10 times greater than for the CO2 laser), which is compatible with irrigation during ablation. To test the effectiveness of the laser, bilateral craniotomies were performed in anesthetized rats immobilized in a stereotactic frame. Under an operating microscope, lesions were made on the cortex by delivering the 1.9-mu laser beam through a 400-mu fiber at an average power of 1 W over a range of fluences. Subjective intraoperative observations were notable for minimal bleeding, absence of charring when the tissue was irrigated with a thin stream of saline, and uniform lesion formation. For comparison, lesions were generated with a commercially available continuous-wave CO2 laser at equivalent power and fluences. Histological specimens were divided into three groups based on the study after laser application: acute (30 minutes), subacute (48 hours), and chronic (14 days). The extent of thermal injury for the 1.9-mu laser in the acute lesions was quantitatively and histologically similar to that generated by the CO2 laser. Regions of injury extended approximately from the apex of the lesion, and crater depths generated by both lasers were similar (250 to 750 mu) in the range of fluences investigated (1.25 to 10 kJ/sq cm). Subacute and chronic histological specimens demonstrated inflammatory and repair responses that correlated with the acute injury regions in both the 1.9-mu and CO2 laser-treated specimens. This study demonstrates a neurosurgical potential for a new two-wavelength laser that ablates tissue effectively with limited thermal injury. The 1.9-mu laser is comparable to the widely used CO2 laser but offers several unique advantages, including the ability for delivery through a fiberoptic system and to irrigate tissue during use.

Animals↗