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Re: Laparoscopic chickenFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Wed Jan 30 15:20:54 2008
One should do the surgery in the manner in which one is most comfortable, and there are no absolutes. Richard may be more adept at laparoscopic stuff than me, or vice versa (doubt the vice versa). I have been very pleased with the left upper quadrant approach, and sometimes that replaces the umbilical port. My concern (in addition to those mentioned already) would be over the ability to dissect the bladder laparoscopically. A V-care manipulator or similar device might faciliate this by putting the vagina on stretch and helping the bladder fall away. Another concern would be the reason she had sections, i.e. is her pelvic structure such that you can comfortable approach the vaginal portion of the case, if you choose an LAVH as opposed to LSH or TLH? Garry As an aside, is anyone using a visual obturator/direct entry 5 mm scope?
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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