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Re: GYN: Laparoscopy with IUD in situ From: Garry E. Siegel, M.D. (garrys@mindspring.com) Thu Aug 28 21:24:04 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: GIN11153@aol.com: "Re: GEN: Office system for medical assistant notification" Previous message: Garry E. Siegel, M.D.: "GEN: Office system for medical assistant notification" In reply to: Marco A. Pelosi, III, MD: "Re: GYN: Laparoscopy with IUD in situ" Thanks, Marco. Garry At Thu, 28 Aug 2003, Marco A. Pelosi, III, MD wrote: > >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 > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: GIN11153@aol.com: "Re: GEN: Office system for medical assistant notification" Previous message: Garry E. Siegel, M.D.: "GEN: Office system for medical assistant notification" In reply to: Marco A. Pelosi, III, MD: "Re: GYN: Laparoscopy with IUD in situ"

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