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Re: Laparoscopic chicken From: Richard Chudacoff (rchudacoff@mylinuxisp.com) Wed Jan 30 13:21:17 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Meenan, Anna: "Re: Gyn: You can't please all of the people all of the time--long" Previous message: art fougner, md: "Re: Laparoscopic chicken" In reply to: rmodugno@aol.com: "Laparoscopic chicken" Next in thread: Richard Chudacoff: "Re: Laparoscopic chicken" Absolutely. The reason is that I can see so much better with the laparoscopic. Put a veres and then a 5 mm scope in the left upper quadrant, mid clavicular line, about 4-5 cm below the costal margin. From there you can see where to put all your other ports and start lysing adhesions. Use the Ace harmonic scalpel in max mode and keep it moving with tension, to decrease lateral thermal spread. It is better to leave peritoneum on the bowel than bowel on the peritoneum. While you might spend an extra 30-60 minutes doing the case, you save that time in rounding and post-op visits. My theory is I'd rather be in the OR than rounding. -- Richard Chudacoff, MD, FACOG Las Vegas International Center for Advanced Gynecologic Care (Specializing in minimally and non-invasive surgery) 2481 Professional Court Las Vegas, NV 89128 TEL: 702-485-8893 FAX: 702-974-0945 www.lasvegasgyncenter.com <http://www.lasvegasgyncenter.com/> The information in this e-mail may be confidential and/or privileged. If you are not the intended recipient or an authorized representative of the intended recipient, you are hereby notified that any review, dissemination or copying of this e-mail and its attachments, if any, or the information contained herein is prohibited. If you have received the e-mail in error, please immediately notify the sender by return e-mail or phone and delete this e-mail. Thank you. _____ From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of rmodugno@aol.com Sent: Wednesday, January 30, 2008 11:00 AM To: Multiple recipients of list OB-GYN-L Subject: Laparoscopic chicken 39 year old with 5 previous c/s. Had a bladder entry with repair during one of them. One year ago had laparoscopic right oophorectomy and adhesiolysis. Op report - "extensive adhesions" Complains of menemetrorhagia, deep dyspareunia and worsening dysmenorrhea. Pelvic exam: normal size mobile anteverted uterus - tender.Reproduces pain with coitus. Ultrasound: normal uterus and 2cm simple left ovarian cyst. Patient considering hysterectomy. (See subject line above). I would do a scalpel-guided total abdominal hysterectomy with left salpingo-oophorectomy. Would any of the brave ( Glazerman? Chudacoff?) consider a laparoscopic approach. Any thoughts? Robert Modugno MD MBA FACOG Sylva, NC _____ More new features than ever. Check out the new AOL Mail <http://o.aolcdn.com/cdn.webmail.aol.com/mailtour/aol/en-us/text.htm?ncid=ao lcmp00050000000003> ! Next message: Meenan, Anna: "Re: Gyn: You can't please all of the people all of the time--long" Previous message: art fougner, md: "Re: Laparoscopic chicken" In reply to: rmodugno@aol.com: "Laparoscopic chicken" Next in thread: Richard Chudacoff: "Re: Laparoscopic chicken"

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