Full Description
Recent years have seen important advances in the technology and techniques available to surgeons performing gynecologic surgery as well as reconstructive of clinical pelvic procedures. These developments took place in a wide variety settings from regional teaching centers to private clinical facilities. In 1996, the leading investigators from around the world gathered to discuss the present status of pelvic surgery and adhesion prevention with a look toward the future of patient care. This volume contains the proceedings of that meeting: the Third Interna tional Congress on Pelvic Surgery and Adhesion Prevention. Each chapter in cludes the material presented at the congress as well as a timely update of the authors' latest research and clinical thinking. Presentation integrating basic and clinical science provide the basis for con sidering peritoneal repair after surgery including the interaction of growth factors and other biochemical messengers. Research has increased the understanding of mesothelial reepithelialization and has led to new surgical technologies to reduce adhesion fonnation. A state-of-the-art review of emerging surgical adjuvants for adhesion prevention is provided, including discussion of barriers, gels, and poly mers as well as "designer" drugs effective at modifying the peritoneal response to injury. Assessment of clinical outcome in a wide variety of gynecologic surgical procedures brings into focus the benefits available as a result of these new tech nologies.
Contents
I. Postsurgical Peritoneal Repair.- 1. Cellular Events in Peritoneal Repair: A Review.- 2. Biochemical Messengers in Postsurgical Repair and Adhesion Formation.- 3. Comparative Tissue Repair.- 4. Response of Fetal Tissue to Wounding.- 5. Postsurgical Intraperitoneal Tissue Repair: Implication of TGF-?.- II. Developing Technology for Adhesion Prevention.- 6. Animal Adhesion Models: Design, Variables, and Relevance.- 7. Experimental Prevention of Peritoneal Adhesions in General Surgery.- 8. Tissue Protective Solutions and Films for Adhesion Prevention.- 9. Peritoneal Fibrinolysis and Adhesion Formation.- 10. Peritoneal Conditioning: The Role of the Supply of Natural Membrane Lipids.- III. Outcome Measures.- 11. Clinical Trial Design for Evaluation of Treatments Purported to Prevent Postsurgical Adhesions.- 12. Adhesions and Infertility.- 13. Laparoscopic Ovarian Surgery and Adhesions.- 14. Infertility and Ectopic Pregnancy.- 15. Clinical Significance of Adhesions in Patients with Chronic Pelvic Pain.- 16. Bowel Obstruction Related to Prior Gynecologic Surgery.- IV. Adjuvants for Clinical Use.- 17. Prognostic Factors of Distal Tubal Occlusion.- 18. Reconstruction of the Ovary with Endometrioma: A Problem of Adhesions.- 19. Use of Adhesion Prevention Barriers in Pelvic Reconstructive and Gynecologic Surgery.- 20. Prevention of Postoperative Adhesions on the Human Oviduct and of Sactosalpinges.- 21. Laparoscopic Myomectomy, Laparoscopy-Assisted Myomectomy, and Postmyomectomy Adhesions.- 22. Adhesion Prevention: The Role of Fibrin Glue.- 23. Clinical Use of Oxidized Regenerated Cellulose for the Prevention of Adhesion Formation After Laparoscopic Myomectomy.- Advances in Gynecologic Surgery (Abstracts).- 1. Adhesion Formation and Changes in Local Fibrinolytic Activity (LFA)of the Uterine Horn Tissue (UHF) After Various Types of Operations.- 2. Gyaluronidase Electrophoresis Effect on Postoperative Adhesions Formations.- 3. Prevention of Postsurgical Adhesion Formation with Polyactive, A Degradable Barrier.- 4. An Evaluation of Operator Variability in a Rat Cecal Abrasion Model for the Formation of Abdominal Models.- 5. The Evaluation of an Injectable Bioresorbable Gel on Adhesion Reduction in Two Animal Models.- 6. Seprafilm (HAL-F) Reduces Postoperative Adhesions: Initial Results of a Multicenter Gynecologic Clinical Study.- 7. Comparative Post Operative Adhesion Formation Following Laparoscopie Cholecystectomy in the Porcine Model Using Electrosurgery, Laser, and Ultrasonically Activated Scalpel.- 8. Pelvic Inflammatory Pseudotumor with Central Infectious Abscess: A Case Report.- 9. Plasminogen-Activator Inhibitor-1 (PAI-1) Remains Elevated After Surgery and Is Not Correlated with Postoperative Adhesion Score.- 10. Mannan Activation of Peritoneal Macrophages: A Method of Identifying a Cell Population Associated with Adhesions Due to Infection.- 11. Pollutants Resulting from Intraabdominal Tissue Combustion.- 12. Tissue Combustion Smoke/Plume Absorption via the Peritoneum at Laparoscopy.- 13. Vesicovaginal Fistular Repair: A New Technique to Avoid Recurrence.- 14. Review of Randomized Studies of Pharmacologic Adjuvant Used During Infertility Surgery to Prevent Postoperative Adhesion Formation.- 15. Comments on the Third International Congress on Pelvic Surgery and Adhesion Prevention: Summary.
