Re: Gyrus/Ligasure
From: Bernard Cristalli (bcrist@club-internet.fr)
Wed Dec 31 03:48:41 2008
Is it sensible to perform a 2 hours procedure vaginally when can do it
more safely and in a shorter time abdominally?
The longer the procedure, the heavier the bleeding, the riskier the
procedure and the more likely the complications.
And 97% of my hysterectomies are vaginal (a bit less in cancer cases).
This intervention has to be easy or not to be.
B
Dr Eberhard W Lisse a écrit :
> Agreed, neither me or you have any evidence to support your
> statements :-)-O
>
> el
>
> On 30 Dec 2008, at 17:38 , Bernard Cristalli wrote:
>
>> What are your evidences?
>> :-)=0
>>
>> Dr Eberhard W Lisse a écrit :
>>> Bernard,
>>>
>>> What you are saying, is total nonsense. Never mind unencumbered
>>> by evidence.
>>>
>>> el
>>>
>>> On 30 Dec 2008, at 13:13 , R. Daniel Braun wrote:
>>>
>>>> Or perhaps change the time frames if 80% of his cases are on 20
>>>> week size or
>>>> greater uteri.
>>>>
>>>> Dan
>>>>
>>>> On Tue, Dec 30, 2008 at 3:30 AM, Bernard Cristalli
>>>> <bcrist@club-internet.fr>wrote:
>>>>
>>>>> This is quality of care (with a touch of pissing contest)
>>>>> Would you say a surgeon who performs all of his TVH in more than
>>>>> one hour
>>>>> is a professionnal?
>>>>> He's a MD, sure, but not a surgeon.
>>>>> This is a simple and "designed" procedure which has to be done in
>>>>> less than
>>>>> one hour in 95% and less than half an hour in 50% of the cases. If
>>>>> it's not
>>>>> so, the surgeon must quit or reappraise its indications.
>>>>> Bernard
>>>>>
>>>>> Andrew Folley a écrit :
>>>>>
>>>>>> Does anyone else feel that all this talk about how fast we can do a
>>>>>> surgery is totally unprofessional and inappropriate? agf
>>>>>>
>>>>>> ------------------------------------------------------------------------
>>>>>>
>>>>>> ------------------------------------------------------------------------
>>>>>> Date: Mon, 29 Dec 2008 12:03:44 -0600
>>>>>> ------------------------------------------------------------------------
>>>>>> From: rmodugno@aol.com
>>>>>> To: ob-gyn-l@mail.obgyn.net
>>>>>> Subject: Re: Gyrus/Ligasure
>>>>>>
>>>>>> -----Original Message-----
>>>>>> From: Dr Eberhard W Lisse <el@lisse.na>
>>>>>> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>
>>>>>> Sent: Mon, 29 Dec 2008 1:09 am
>>>>>> Subject: Re: Gyrus/Ligasure
>>>>>>
>>>>>> I generally ask my anesthetist to write down incision time and last
>>>>>> staple/suture in at C/S and TAH. And I agree, I often find that my
>>>>>> impression about how long it took is usually way off. 12 minutes
>>>>>> for a
>>>>>> vaginal hysterectomy, who is he kidding?
>>>>>> *****************************************************************
>>>>>> One of my first attendings in residency in South Africa was S.
>>>>>> Joel-Cohen. His book is based on the time and motion studies he
>>>>>> did on many
>>>>>> normal uteri - He took about 20 minutes per hysterectomy.
>>>>>> Is speed always the quality indicator?I'm reminded of the story
>>>>>> of the
>>>>>> young bull and the old bull standing on a hill overlooking a herd of
>>>>>> heifers. The young bull said:"Let's run down and have us a few!"
>>>>>> The old
>>>>>> bull said: " Let's walk down and do the lot!"
>>>>>> Robert Modugno MD MBA FACOG
>>>>>> Sylva, NC
>>>>>>
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>>>>>>>
>>>>>>
>>>>>
>>>>
>>>> --
>>>> R. Daniel Braun, MD FACOG(L) ABMP CMTh
>>>> Professor Emeritus
>>>> Dept. of Obstetrics and Gynecology
>>>> Indiana U. School of Medicine
>>>>
>>>> R. Daniel Braun
>>>>
>>>> "Science without Religion is LAME; Religion without Science is
>>>> BLIND"
>>>> Einstein 1941
>>>
>>> --
>>> Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar)
>>> el@lisse.NA el108-ARIN / * | Telephone: +264 81 124 6733 (cell)
>>> PO Box 8421 \ / Please send DNS/NA-NiC related e-mail
>>> Bachbrecht, Namibia ;____/ to dns-admin@na-nic.com.na
>>>
>>
>
> --
> Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar)
> el@lisse.NA el108-ARIN / * | Telephone: +264 81 124 6733 (cell)
> PO Box 8421 \ / Please send DNS/NA-NiC related e-mail
> Bachbrecht, Namibia ;____/ to dns-admin@na-nic.com.na
>
