The VS-1 "insect eye" technology is a new threedimensional (3D) imaging system used for laparoscopic surgery. It is based on a microscopic array of hundreds of thousands of lenses that form a single apparatus, providing streaming 3D imaging without the side effects of previous 3D systems. This study analyzed the VS-1 system in terms of operative results and surgeon satisfaction compared with the standard two-dimensional (2D) imaging system. Eightyeight patients undergoing laparoscopic surgery of different difficulty levels, performed by three different surgeons, graded as novice or experienced, were randomly assigned for the VS-1 3D or the standard 2D imaging systems, 44 patients in each group. Results showed that, when using the 3D VS-1 system, surgery duration was reduced for both novice and experienced surgeons. Surgeons reported having good depth perception, anatomic understanding and procedure efficiency, as well as physician confidence and efficiency during complicated maneuvers. No user side effects were reported. The VS-1 "insect eye" 3D imaging system provided improved operative results when compared with the 2D imaging system, with a decrease in surgery duration, along with good surgeon confidence and satisfaction, and without user side effects.
The objective of this study was to evaluate the accuracy of frozen sections (FS) as a method for estimation of the depth of myometrial invasion in patients with stage I endometrial carcinoma. During a 3-year period (1989-1992), 46 consecutive patients with FIGO stage I endometrial carcinoma were included in this study. The depth of myometrial invasion was estimated by FS examination performed during surgery. The final histologic findings of the surgical specimen were compared to the FS evaluation. The results of this study demonstrate that deep or superficial myometrial invasions were correctly diagnosed by FS in 42 out of 46 cases (91.3%). Three cases (6.6%) with deep myometrial invasion were falsely diagnosed as superficially invasive. One case with superficial invasion (2.1%) was falsely diagnosed as deeply invasive. In conclusion, intraoperative FS examination of depth of myometrial invasion by endometrial carcinoma is a simple and accurate method, providing a good correlation with the final histologic report of the surgical specimen.
The objective of this study was to examine the analgesic effect of intraperitoneal nebulization of ropivacaine during gynecological laparoscopic procedures for patients anesthetized with an ultrashort-acting opiate. The study was a double-blinded placebo-controlled randomized trial (Canadian Task Force classification I) and involved 40 patients (20 patients in each arm) undergoing elective gynecological same-day outpatient laparoscopic surgery including unilateral/bilateral salpingo-oophorectomy or unilateral/ bilateral ovarian cystectomy at the University Hospital Ambulatory Gynecological Endoscopic Unit. The study group received 10 ml of 1 % ropivacaine, and the control group received 10 ml of sterile water by intraperitoneal nebulization. Vital signs were recorded and summarized. Postoperatively, patients were followed up for 24 h including visual analogue scale (VAS) scores and analgesic usage. Results showed no significant differences between the two groups in terms of patient characteristics and surgical data. There were no significant differences between the groups in postoperative VAS scores at rest at the different time intervals. VAS scores during strain showed significantly decreased pain at the postoperative 2-h interval (p<0.05). Postoperative opiate and nonopiate analgesia consumption was similar for both groups. Patients in the study groups required more antiemetic agents compared to the control group patients (p<0.05). There were no reported side effects related to ropivacaine. Intraperitoneal nebulization of 100 mg of ropivacaine during gynecological laparoscopy under general anesthesia with an ultrashort-acting opiate does not reduce postoperative pain and it does not reduce postoperative opiate and nonopiate analgesia consumption.
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