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Re: LSH was UAE Option From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com) Fri Aug 27 09:40:59 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Barborza@aol.com: "Re: OB-GYN-L digest 3318" Previous message: Richard Chudacoff, MD: "Re: UAE Option" In reply to: RModugno@aol.com: "Re: LSH was UAE Option" Next in thread: Larry Glazerman: "Re: LSH was UAE Option" Reply: Larry Glazerman: "Re: LSH was UAE Option" It should not take much longer than an LAVH, prior to going below. Therefore an hour to 90 minutes, max. Morcellation only takes 5 minutes and then your done. The benefit is no rounding the next day, no staple removal and no six week post op exam 1. I use the harmonic scalpel 2. Usually just cauterize and place Surgicel 3. Bipolar cautery-Kleppinger -- Richard Chudacoff, MD -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of RModugno@aol.com Sent: Friday, August 27, 2004 7:53 AM To: Multiple recipients of list OB-GYN-L Subject: Re: LSH was UAE Option In a message dated 8/26/2004 6:38:44 PM Eastern Daylight Time, ENDODOK@aol.com writes: >I inform the patient of all options  including "doing nothing". When I >compare a  "one hour-home the same day-  treat other associated conditions (endo?)- >resume 95-99% ALL ACTIVITIES,  including sex, in 5-7 days, LSH" to UAE ( cost, >pain, continuation of periods)  the vast majority of patients choose LSH. I >had to deal with 2 post-embolization  syndrome patients ( pain, chills fever >etc) and have so informed the  interventional radiologists that they MUST  deal >with these  problems, not the primary gynecologist. >    Kaiser in Santa Monica recently compared costs of  LSH vs TAH. >LSH=$5000. TAH= $9000. LSH the hysterectomy procedure of choice in Kaiser   >San Diego >hospitals. No way can UAE compete cost wise. >    The MRI -controlled focused ultrasound  ("ExAblate"?) procedure developed >in Israel reportedly destroys fibroids without  pain, or surgical >intervention. The company has applied for FDA approval here in  USA. This might put gyn >surgeons out of business. > >J.Glenn Bradley MD > Interesting post Glenn.I assume, however that most general gynecologists cannot complete a LSH in one hour. I also assume that many general gynecologists could do a TAH or TVH within an hour or thereabouts. The reimbursement rate in Georgia for hysterectomies of all types ( excluding radicals), is about 850 to 950 dollars. Soooo... it may be cost effective for the physician to do the procedure they are most adept at, in the shortest time, rather than a "foreveroscopy". At our institution we have to present proof of a training session in the use of the power morcellator - as you know these injuries never occur with TAH or TVH. Some technical questions: 1)What do you use to amputate the uterus in LSH? 2)Do you suture the cervical stump? 3) How do you secure the uterine artery pedicles? Robert Modugno MD MBA FACOG Marietta, GA http://www.novaobgyn.yourmd.com Next message: Barborza@aol.com: "Re: OB-GYN-L digest 3318" Previous message: Richard Chudacoff, MD: "Re: UAE Option" In reply to: RModugno@aol.com: "Re: LSH was UAE Option" Next in thread: Larry Glazerman: "Re: LSH was UAE Option" Reply: Larry Glazerman: "Re: LSH was UAE Option"

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