Biomedical subjects

van Herendael BJ

Publications and source records attributed to van Herendael BJ.

3 recordsLinked to original sources

PubMed1994

Comparison Between Abdominal and Laparoscopic Lymphadenectomy

In cervical cancer the pathologic stage is determined for two reasons: choice of treatment (surgical-radiotherapy-medical) and prognostic evaluation. In early cervical carcinoma the evaluation of pelvic lymph nodes is important. The clinical noninvasive approach using ultrasound, CT, MRI, and lymphography is of limited use because of low accuracy. Therefore, the clinical evaluation has to be performed surgically. This is required in FIGO I and FIGO IIa carcinoma with circumference < 4 cm. If the pelvic nodes are negative a radical hysterectomy is indicated; but if the nodes are positive, this procedure could be avoided and the treatment of choice is pelvic radiotherapy. In some cases radical hysterectomy is performed when the pathology of the lymph nodes is not yet known and subsequent pelvic radiotherapy is performed when the nodes are positive. This sequence of events is a major cause of complications (fistula of the intestinal or the urinary tract, ileus and lymphocysts). Laparoscopic lymphadenectomy may be the method of choice to stage these tumors with minimal discomfort for the patients. This study demonstrates that laparoscopic lymphadenectomy is comparable to open lymphadenectomy in the clinical staging of cervical cancer.

Journal Article↗

PubMed1994

Bag Surgery as Part of a Protocol to Treat Ovarian Masses by Laparoscopy

In a protocol to treat all ovarian masses endoscopically the major objection is that there are reports that even if the preoperative examinations are favorable there is still a chance as high as 2 to 6% of encountering a malignant proliferation within the cyst, necessitating a conversion to laparotomy within the same operating session. Using the following selection criteria: Premenopausal patients less than 45 years; uni-locular cysts on ultrasound or slightly septated; size of the cyst between 4 and 10 cm; benign characteristics on ultrasound; normal biochemistry, including CA 125, ESR, liver enzymes; and cysts resistant to therapy at least for 6 weeks, we have used the bags whenever the macroscopic aspect of the cyst appeared suspicious for malignancy to the surgeon. The tumor was first fully inserted in the Endo pouch (Autosuture-US Surgical) and then transected from its pedicle. We used bipolar coagulation and scissors. The bag was then brought to the abdominal wall and a minilaparotomy of 5 cm on average was performed. The bag was brought into the opening, the sac opened with scissors, the plastic spread on the skin and only then the tumor was treated inside the bag. Using this technique we did not experience any spread in the abdomen as the laparoscope remained in place and the bag prevented the pneumoperitoneum from deflating.

Journal Article↗

PubMed1994

The Role of Hysteroscopy in Missed Abortions

Reviewing the possible causes of missed abortions, it becomes obvious that culturing the tissues is the major difficulty and often a setback for the diagnosis. The reason is the difficulty for the geneticist to obtain a representative sample of fetal tissue. In a multicenter trial in Antwerp, Belgium, we designed a technique to use a hysteroscope equipped with a throughflow system and the possibility to pass instruments through a side channel, to view the fetuses from six weeks onwards. First, the sac is opened and inspected for the presence of a yolk sac. In a second step the fetus is visualized and inspected for gross anatomic malformations. If such malformations exist, biopsies are taken to confirm the visual impressions with the genetic results to make a map to diagnose genetic malformations through direct visualization. If no gross malformations are visible, biopsies are taken at specific sites to facilitate the work in the lab. The first results, including the diagnosis of a 45 X aberration, are discussed.

Journal Article↗