Re: LSH was UAE Option

From: Larry Glazerman (l.glazerman@rcn.com)
Sat Aug 28 08:00:29 2004


Tom has been one of those staunchly against this technique. Craig Sobolewski and I have discussed it with him, and I still don't agree with him. I clearly respect his opinion and expertise, but disagree on this one.

--
Larry R. Glazerman, MD
Ob-Gyn at Trexlertown, PC
610-402-0161
l.glazerman@rcn.com

> -----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 10:26 PM > To: Multiple recipients of list OB-GYN-L > Subject: Re: LSH was UAE Option > > In a message dated 8/27/2004 9:59:36 PM Eastern Daylight Time, > garrys@mindspring.com (Garry E. Siegel, M.D.) writes: > > >Larry: > > > >Agree that the morcellation takes a good while if the uterus is big. > > > >What is your sequence of events, i.e. > > > >1.  Secure the infudibulo-pelvis or utero-ovarians and rounds. > >2.  Disconnect from the fundus. > >3.  Create a bladder flap. > >4.  Secure the uterines. > >5.  Morcellate in-situ. > > > >Morcellation while attached (I've never done it) sounds like it might be > >easier, as the uterus is held still by its attachment to the cervix. > > > >On the other hand, it seems like it might bleed more, as normally I > >amputate, put the specimen aside in the abdomen, and acheive hemostasis > >on the stump and THEN morcellate. > > > >What do you do? > > > >Do others leave the uterus attached? > > > >Garry > > > >PS--agree with William that someone with good lapscope skills can do > >these with a bit of coaching.  That is how I learned, so I guess my > >comment is a bit self-serving. > > > >-- > >Garry E. Siegel, M.D. > >Private Practice > >Roswell, GA > > > > Went to a meeting at our hospital in Atlanta, where a guy from out of town showed > a video where he morcellated the uterus "in situ". > > Tom Lyons, one of the "gurus" of LSH was in the audience. He was not pleased > with this technique. He believed it was a disaster waiting to happen. > > Robert Modugno MD MBA FACOG > Marietta, GA > http://www.novaobgyn.yourmd.com





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