Laparoscopic treatment of polycystic ovaries with insulated needle cautery: a reappraisal

Felemban, Afaf; Tan, Seang Lin; Tulandi, Togas

doi:10.1016/s0015-0282(99)00534-8

Cited by 134 publications

(94 citation statements)

References 22 publications

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“…The laparoscopic approach to PCOS has been described extensively [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Local anesthesia has been used for many gynecologic procedures and has been reported to reduce the postoperative pain after day-surgery diagnostic laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…Local anesthesia has been used for many gynecologic procedures and has been reported to reduce the postoperative pain after day-surgery diagnostic laparoscopy. Previous studies documented the implementation of microlaparoscopy without general anesthesia in terms of both diagnostic efficacy [6] and pain control during and after the procedure [10,[15][16][17]. The recent development of small-diameter fiber optic microlaparoscopy allows an optical resolution comparable to that obtained with traditional 10-mm laparoscopes [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…FAI was calculated using the formula: testosterone 100/sex hormone-binding globulin. (2) Evidence of un-or hypo-ovulation or (3) ultrasonographic evidence of PCO: ovarian stromal hypertrophy and multiple small (6-8 mm) follicles arranged in the periphery [9][10][11].…”

Section: Pcos Diagnosismentioning

confidence: 99%

“…With the development of new, smalldiameter laparoscopes that provide an optical view comparable to conventional instruments, microlaparoscopy can now be used routinely for diagnostic laparoscopy [9,10]. In association with pre-and postoperative local anesthesia [9][10][11][12] and new protocols for conscious sedation [4], this new approach can be used for outpatient operative microlaparoscopy without general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

“…A newer highly advanced microendscope, using the new fiber optic technology, has solved this great problem, offering a laparoscopic view nearly similar to the traditional 10-mm telescope. This new updated 2-mm telescope has been recently applied for many gynecologic procedures, which were previously performed using the older traditional telescope [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Office microlaparoscopic ovarian drilling versus conventional laparoscopic ovarian drilling for women with polycystic ovary syndrome

Salah

2012

Gynecol Surg

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It is a prospective controlled study to compare the beneficial effects of office microlaparoscopic ovarian drilling (OMLOD) under augmented local anesthesia, as a new modality treatment option, compared to those following ovarian drilling with the conventional traditional 10-mm laparoscope under general anesthesia. The study included 60 anovulatory women with polycystic ovary syndrome (PCOS) who underwent OMLOD (study group) and 60 anovulatory PCOS women, where the conventional laparoscopic ovarian drilling (LOD), using 10-mm laparoscope under general anesthesia, was performed (comparison group). Transvaginal ultrasound scan and blood sampling to measure the serum concentrations of LH, FSH, testosterone, and androstenedione had been performed before and after the procedure. Intra-and postoperative pain score in candidate women had been evaluated during the office microlaparoscopic procedure, in addition to the number of candidates who needed extra analgesia. The women undergoing OMLOD showed a good intra-and postoperative perception pain score. The number of those patients discharged within the first 2 h after office procedure was significantly higher, without the need for postoperative analgesia with most patients. The LH/FSH ratio and mean serum concentrations of LH, testosterone, and free androgen index have decreased significantly after both OMLOD and LOD within a postoperative year follow-up. The mean ovarian volume decreased significantly (P<0.05) within the year after both OMLOD and LOD. There were no significant differences in those results after both procedures. Intra-and postoperative augmented local anesthesia allows outpatient bilateral ovarian drilling by microlaparoscopy without general anesthesia. The relatively high pregnancy rate, the simplicity of the method, and the faster discharge time after the operation offer a new modality option for patients with PCOS, who are resistant to clomiphene citrate ovarian induction. Moreover, ovarian drilling could be performed simultaneously during the routine diagnostic microlaparoscopy and integrated in the fertility work-up investigations for those patients.

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