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Biomedical subjects

W K Winer

Publications and source records attributed to W K Winer.

At least 19 recordsLinked to original sources
PubMed2001

Appendectomy in patients undergoing laparoscopic surgery for pelvic pain.

STUDY OBJECTIVE: To evaluate pathologic findings in appendixes of women undergoing laparoscopic surgery for pelvic pain. DESIGN: Retrospective study (Canadian Task Force classification II-2). SETTING: Private practice specializing in gynecologic endoscopic surgery. PATIENTS: One hundred ninety women. INTERVENTION: Prophylactic appendectomy. MEASUREMENTS AND MAIN RESULTS: On pathologic evaluation, 154 appendixes were diagnosed as having one or more abnormal findings, such as endometriosis, carcinoid, chronic appendicitis, periappendicitis, fibrous obliteration, and lymphoid hyperplasia. CONCLUSION: Women undergoing laparoscopic surgery for pelvic pain should be counseled on the high frequency of abnormal findings in the appendix, including endometriosis. Prophylactic appendectomy appears to be a worthwhile consideration in these patients.

Adolescent↗
PubMed2000

Transvaginal hydrolaparoscopy, a new technique for pelvic assessment.

Transvaginal hydrolaparoscopy is based on classic culdoscopy. With alterations in equipment and method, the procedure holds promise for evaluation of pelvic pathology. We performed transvaginal hydrolaparoscopy in the operating room just before operative laparoscopy in 15 patients, to evaluate the feasibility of this procedure. Excellent images of the cul-de-sac, fimbriae, and caudal surface of the uterus, ovaries, and pelvic sidewall were obtained. We believe this is a practical and convenient office diagnostic procedure.

Adnexal Diseases↗
PubMed1999

Developing clinical learning sites for undergraduate nursing students.

As health care continues to evolve and take on new shapes, perioperative procedures more often are occurring in nonhospital settings and with fewer opportunities for nursing intervention. Believing that nursing education must prepare nurses at the undergraduate level to provide quality and meaningful perioperative care, nursing specialists and educators at Emory University, Atlanta, developed two new clinical learning sites that allow undergraduate nursing students to learn from preceptors in advanced perioperative roles. These learning sites encourage students to develop and use critical thinking skills that are imperative to perioperative care.

Ambulatory Surgical Procedures↗
PubMed1998

Laparoscopic removal of a bladder leiomyoma.

Bladder leiomyoma is a rare tumor that is generally removed by transabdominal, vaginal, and transurethral approaches. We successfully removed a large, transmural, extravesical bladder leiomyoma by laparoscopy.

Adult↗
PubMed1998

Laparoscopic supracervical hysterectomy with a new disposable morcellator.

Laparoscopic supracervical hysterectomy (LSH) can be performed more easily with a powered morcellator for removal of the uterus. Available laparoscopic morcellators are expensive and may be difficult to use, but a new, powered, disposable instrument was developed (Diva; FemRx, Sunnyvale, CA) to morcellate the entire uterus for easy removal through a 15-mm cannula. Twelve consecutive women for whom subtotal hysterectomy was indicated underwent LSH by standard laparoscopic protocol and were monitored postoperatively for a minimum of 1 month. In the current trend of "less is more," LSH is an emerging option for less extensive hysterectomies and can be made more cost and time effective with a single-use powered morcellator.

Adult↗
PubMed1997

Laparoscopic rectocele repair using polyglactin mesh.

We assessed the efficacy of laparoscopic treatment of rectocele defect using a polyglactin mesh graft. From May 1, 1995, through September 30, 1995, we prospectively evaluated 20 women (age 38-74 yrs) undergoing pelvic floor reconstruction for symptomatic pelvic floor prolapse, with or without hysterectomy. Morbidity of the procedure was extremely low compared with standard transvaginal and transrectal approaches. Patients were followed at 3-month intervals for 1 year. Sixteen had resolution of symptoms. Laparoscopic application of polyglactin mesh for the repair of the rectocele defect is a viable option, although long-term follow-up is necessary.

Adult↗
PubMed1995

Clinical outcomes with laparoscopic approaches and open Burch procedures for urinary stress incontinence.

Laparoscopic minimally invasive approaches to urinary stress incontinence have been described in the literature since 1989. Technical advances have improved both access to the space of Retzius and the operator's ability to accomplish retropubic colposuspension. In addition to the traditional open Burch procedures, a new laparoscopic method of colposuspension is available. In one group of women, laparoscopically guided procedures were performed in the classic fashion using only sutures. In the second laparoscopic group the suspension was performed with a combination of sutures and endoscopic staples (Nolan-Lyons modification of the Burch). The third group was analyzed retrospectively by chart review and patient interview for surgical outcome data. All groups were similar demographically. Clinical outcomes were similar in the laparoscopic groups, and surgical morbidity was significantly decreased compared with traditional open procedures. Relief of symptoms was similar in all groups at 1-year follow-up. We conclude that a laparoscopic approach to retropubic colposuspension is an effective alternative with improved clinical outcomes. Additional modifications that can improve surgeons' accessibility to these techniques are feasible, with comparable clinical outcomes.

Adult↗
PubMed1995

Suggested set-up and layout of instruments and equipment for advanced operative laparoscopy.

Crucial elements that ensure the organization and smoothness of a laparoscopic procedure are clear communication among well-trained endoscopy team members, properly maintained equipment, and a sensible layout of the instruments. The team consists of the surgeon, surgical assistant, circulator, scrub nurse, laser nurse, and anesthesiologist. To promote continuity and interaction and to ensure a systematic, pleasant pace for laparoscopic procedures, the team should establish a specific routine, as well as set-up and layout of tables, equipment, and instruments. Key ingredients for advanced operative laparoscopy to be performed with optimum efficiency and effectiveness are the best organization and placement of the equipment, instrumentation, and team in a particular setting in the operating room.

Anesthesiology↗
PubMed1990

Fimbrioscopy and salpingoscopy in patients with minimal to moderate pelvic endometriosis.

Fimbrioscopy and salpingoscopy were performed with a rigid salpingoscope during operative laparoscopy in 100 patients with minimal to moderate endometriosis and in 20 normal controls. Five women with endometriosis had perifimbrial adhesions, compared with none of the controls. No subject in either group had adhesion formation of the endosalpinx. These observations indicate that there is no association between endometriosis and intratubal disease.

Endometriosis↗
PubMed1989

Laparoscopic removal of dermoid cysts.

Nine reproductive-age women underwent removal of unilateral or bilateral dermoid cysts via laparoscopy. Over a follow-up period of 12-42 months, there were no immediate or long-term complications. Four patients have had repeat laparoscopy for evaluation of possible pelvic adhesion formation; one had mild periovarian adhesions and the pelvis appeared normal in the other three.

Adult↗
PubMed1989

Endoscopic infertility surgery.

Since the introduction of endoscopy by Jacobaeus in 1910, there has been a dramatic change in the pattern of and approach to the diagnosis and treatment of various diseases of the female reproductive organs. The advances in techniques of operative endoscopy, in high technology and in instrumentation (such as endoscopes, video cameras and videomonitors) have made it possible to perform laparoscopically many of the infertility-related procedures previously requiring laparotomy. The advantages of such surgery are the rapid recovery time, decreased time lost from work, smaller scars, reduced cost, avoidance of risks and complications of laparotomy, and, perhaps, better results.

Adnexal Diseases↗
PubMed1987

Smoke from laser surgery: is there a health hazard?

The composition of plume produced during carbon dioxide laser endoscopic treatment for endometriosis was examined to determine whether it represented a hazard to the surgical staff. A total of 32 plume samples were collected from 17 women undergoing laser laparoscopic treatment for endometriosis and/or adhesions. The smoke was found to consist of particles having a median aerodynamic diameter of 0.31 micron with a range of 0.10-0.80 micron. The size range has two consequences: 1) using a human red blood cell as a model for all cells, it can be stated with greater than 99.9999% certainty that no cell-size particles, including cancer cells, are present in the plume; 2) particles in this size range are too small to be effectively filtered by currently available surgical masks.

Adult↗
PubMedDate not supplied

Laparoscopic procedures: innovations and complications.

Over the past 10 years, general surgeons began widespread use of operative laparoscopic procedures. Keep in mind that with laparoscopy, as with all surgery, risks are involved. In general, the more advanced the procedures, the greater risk potential to the patient.

Humans↗