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At least 19 recordsLinked to original sources

Vertical Silastic ring gastroplasty: a 6-year experience.

Vertical Silastic ring gastroplasty was carried out in 71 patients as treatment for morbid obesity. The mean excess weight loss at 6 months (59 patients) and 2 years (43 patients) was 48 per cent and 65 per cent respectively. Subsequently the weight stabilized around this level with 58 per cent of the excess weight lost at 5 years (14 patients) postgastroplasty. Five patients (7 per cent) failed to lose weight. Sixteen patients (23 per cent) required revision for technical complications but continued to lose weight or to maintain a satisfactory weight. Vertical Silastic ring gastroplasty is an effective surgical method of achieving sustained weight loss.

Adolescent

Comparison of silastic rings and electrocoagulation for laparoscopic tubal ligation under local anesthesia.

OBJECTIVE: To compare objectively the pain associated with tubal occlusion by Silastic rings versus electrocoagulation during laparoscopic tubal ligation under local anesthesia. METHODS: Consecutive patients scheduled for laparoscopic tubal ligation under local anesthesia were randomized to Silastic rings (N = 50) or electrocoagulation (N = 52) as the method of tubal occlusion. Sterilization was performed under local anesthesia in a standard fashion. Bupivacaine 0.5% was used as the local anesthetic agent. Operative pain was measured based on intraoperative anesthesia requirements and a modified McGill pain questionnaire. This questionnaire was used to assess pain at 15 minutes, 1 hour, and 24 hours postoperatively. RESULTS: Demographics were similar for the two groups. Operative time was shorter in the Silastic-ring group (16.7 versus 21.8 minutes; P = .001), and this group also required less intraoperative anesthesia (P = .004). There were no statistical differences between the groups in self-reported pain intraoperatively or postoperatively. No patient in either group required antiemetics or pain medication in the recovery room. CONCLUSION: Silastic rings appear preferable to bipolar electrocoagulation for laparoscopic tubal sterilization under local anesthesia when long-acting local agents are used for tubal anesthesia.

Adult

Pharmacokinetics and pharmacodynamic effects of vaginal oestradiol administration from silastic rings in post-menopausal women.

Silastic rings releasing approximately 200 microgram of 17beta-oestradiol per day were inserted into the vaginas of 4 post-menopausal women for one to three 21-day periods. Plasma concentrations of oestrone and oestradiol were analysed by radioimmunoassay. The effect of circulating oestrogens on FSH, LH and sex-hormone binding globulin (SHBG) levels as the well as on the endometrium was studied. During the first 24 h of treatment the plasma oestradiol levels were higher than the oestrone levels. But during the following days of the 21-day periods, the levels of the two oestrogens were almost equal, varying between about 100 and 200 pg/ml plasma, a pattern similar to that seen in fertile women. the release of oestradiol from the ring gave stable plasma oestrogen levels. The FSH and LH levels were clearly depressed while the SHBG levels did not change. Characteristics of oestrogen influence were found in endometrial biopsies. The rings were well accepted and could be inserted and removed easily by the women. Absorption of oestradiol from the vagina is good and more complete than after oral administration allowing lower doses to be used for treatment.

Estradiol

A study of menstrual patterns following laparoscopic sterilization with silastic rings.

The menstrual patterns of 281 women undergoing laparoscopic sterilization with silastic rings were studied prospectively. A significant increase in dysmenorrhea and irregular periods was seen soon after sterilization but this was transient, returning to presterilization levels by 12 months. Menorrhagia was not observed and the amount of menstrual blood loss showed a trend towards normal following sterilization. No permanent adverse effects on menstrual patterns were seen in the 1st year after sterilization. It is suggested that factors other than the sterilization procedure may be responsible for the high prevalence of menstrual dysfunction that has been reported following sterilization.

Dysmenorrhea

[Gastroplasty calibrated by a silastic ring. A new technique of vertical gastroplasty in obesity].

Among the various procedures used for surgical treatment of morbid obesity, the vertical silastic ring calibrated technique is in full development. Using a linear suture stapler with 4 rows of staples makes it possible to create a gastric partition without excision of a gastric outlet. The channel is calibrated by means of a 4.5 cm long silastic ring. In a small series of 20 cases, the loss of excess weight over one year was 47 +/- 12 percent at 6 months and 59 +/- 21 percent at 12 months without mortality or morbidity.

Gastroplasty

Erosion of Marlex band and silastic ring into the stomach after gastroplasty: endoscopic recognition and management.

We report three patients who developed erosion of a Marlex band or a silastic ring that was used to reinforce the stoma after vertical stapled gastroplasty. The patients were symptomatic and the diagnosis was made by endoscopy. After endoscopic removal of the foreign body, symptoms resolved in two patients. To our knowledge, this is the first report of successful removal, by endoscopy, of an eroding mesh or a ring.

Adult

Contraceptive vaginal ring--a rising star on the contraceptive horizon.

Two studies were carried out at AIIMS to judge efficacy, side-effects and acceptability of the contraceptive vaginal ring, a Silastic ring with an inner core containing 6.0 mg levonorgestrel mixed with Silastic and an outer core of Silastic only. It releases levonorgestrel at a constant rate of 20 micrograms/day and remains effective for 90 days. The first study of 50 women lasted for 12 months and the second study of 46 women lasted 24 months. Menstrual irregularity in 36% of women was the commonest reason for discontinuation. The majority of women experienced menorrhagia or irregular spotting per vaginum. Vaginal irritation or increased vaginal discharge was the second commonest reason for discontinuation and was noted in 23% of subjects. Repeated spontaneous expulsions accounted for discontinuation in 6% of subjects. No method-related failure was noted in the study. Follow-up study revealed users to be happier with the ring than with any other method and no spouse complained of feeling the ring during coitus. With its ease of administration, absence of gastrointestinal side-effects and a high success rate, the contraceptive vaginal ring is a promising contraceptive method for the last decade of the 20th century.

Adolescent

Complications of laparoscopic sterilization. Comparison of 2 methods.

A retrospective study of 5346 cases of laparoscopic sterilization with special reference to early and late complications was undertaken. In the 6-year period from 1972 to 1978, 846 patients were sterilized by the elasticized silicone-ring technique and 4500 patients were sterilized by the electrocautery method. The electrocautery method was complicated by electrical burns in 13 cases (0.29%); 3 of these patients required bowel resections. Mechanical complications occurred in 1.6% of the Silastic-ring cases, but none of the patients required additional surgery. The Silastic-ring patients had greater postoperative abdominal pain than the electrocautery patients, but it usually abated within 48 hours. There were 15 cases of postoperative pelvic infection in the electrocautery group, and none in the Silastic-ring group. Bleeding from the mesosalpinx occurred in both groups and occurred more often with coincident suction D&C. Technical failure to perform the sterilization procedure was principally related to previous abdominal surgery. A substantial number of patients complained of menstrual irregularity and/or dysmenorrhea following these sterilization procedures. The majority of women reported unchanged or improved sexual relations. Improvement in sexual relations was reported by significantly more patients in the Silastic-ring group than in the electrocautery group.

Burns, Electric

Vertical ring gastroplasty for morbid obesity. Five year experience with 1,463 patients.

Vertical gastroplasty is a safer and simpler operation than gastric bypass for morbid obesity, but to produce permanent long-term weight loss, a permanent support is needed for the outlet of the newly created gastric pouch in vertical gastroplasty. The most important finding in this study of 1,463 patients with vertical gastroplasties was the development of a safe and practical use of a Silastic ring to permanently support the outlet. Using an uncovered Silastic ring, erosion of the ring has not been observed and long-term weight loss of 36.7 percent of original weight or 63.4 percent of excess weight has been obtained, which is equivalent to that reported for gastric bypass or other gastric reduction procedures. In addition, lower mortality and lower morbidity rates have been achieved than those reported in studies using other gastric reduction methods. Silastic ring vertical gastroplasty with an uncovered ring is the safest and most effective of the gastric reduction procedures in our experience.

Adolescent

Luteinizing hormone-releasing hormone, ovariectomy, and silastic vaginal rings in the Rhesus monkey.

The interaction of estradiol and luteinizing hormone-releasing hormone (LRH) may be a critical physiologic mechanism regulating the occurrence of ovulation in many species. These studies were conducted to assess (1) the effects of intramuscular injections of LRH in the intact female rhesus monkey and (2) the effects of estradiol in a Silastic delivery system in ovariectomized female rhesus monkeys. No changes in blood levels of luteinizing hormone (LH) were detected in response to 200 micrograms of LRH. Ovulation did not occur 48 hours after treatment. Ovariectomy decreased estradiol, increased LH, and had no effect on prolactin concentrations in sera. Insertion of a vaginal ring containing 10% estradiol increased blood estradiol levels 100-fold. Serum prolactin levels were unaffected; however, LH concentrations were altered in a multiphasic fashion. After the ring had been in place for 15 days, vaginal blood similar to menstrual flow was observed following removal.

Animals

A technique for laparoscopic pomeroy tubal ligation with endoloop sutures.

A laparoscopic technique of Pomeroy tubal ligation using endoloop sutures was compared with the conventional technique of laparoscopic tubal ligation with Silastic rings. Fifty-three patients selected from a population undergoing tubal ligation were randomized to either the Pomeroy (N = 28) or ring (N = 25) group. Mean (+/- standard deviation) operative time for the Pomeroy group was 27.39 +/- 5.95 minutes, with a range of 18-40; for the ring group, the time was 23.11 +/- 11.53 minutes, with a range of 12-58. These times were not statistically different. Operative complication were encountered only in the ring group and included two lacerations of the mesosalpinx. There were no technical or method failures over a follow-up interval of 12-18 months. Specimens confirmed tubal histology in all cases in the Pomeroy group. Laparoscopic Pomeroy tubal ligation using endoloop sutures was easily performed, comparable to laparoscopic application of Silastic rings, and provided a surgical specimen to confirm tubal histology. This aspect may represent a medicolegal advantage of documentation not available with other laparoscopic techniques of tubal ligation.

Adult