Re: LSH was UAE Option
From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Sat Aug 28 08:21:04 2004
Thanks Robert and Larry.
Garry
At Sat, 28 Aug 2004, Larry Glazerman wrote:
>
>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
>
--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA
