|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: GYN: Laparoscopy with IUD in situFrom: Marco A. Pelosi, III, MD (marcop@agoron.com)Thu Aug 28 21:20:28 2003
At Wed, 27 Aug 2003, Garry E. Siegel, M.D. wrote: > >Any thoughts about whether to place or not place a uterine manipulator >in a patient with a Mirena, in whom I'm going to do a laparoscopy for an >ovarian cyst? > >I normally use a HUMI type, or a Pelosi, the latter only going into the >uterus around 4 cm., and held on with a tenaculum. The diameter is >around 0.4 cm. > >I also could use a shallow cannula, such as a Kahn/Cohen (not sure of >the name). > >Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > My first choice would be laparoscopy sans manipulator using very steep trendelenburg and lateral tilt to displace the bowel from the side in question. Use either shoulder or hip braces to keep the patient from sliding. This is the approach I typically use for adnexal surgery when the uterus is absent and it is quite effective. My second choice would be to remove the IUD, insert a manipulator, and replace the IUD afterward. Call your Mirena rep, they usually have access to a "courtesy" IUD for special circumstances.
-- M.A. Pelosi, III, MD
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Fri May 2 04:37:13 2008 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.