J F Steege1. 1. Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
Abstract
OBJECTIVE: To evaluate the safety and feasibility of repeat outpatient laparoscopy following laparoscopic lysis of extensive pelvic adhesive disease in a standard operating room setting. METHODS: In a pilot study, eight patients with chronic pelvic pain associated with severe pelvic and abdominal adhesive disease underwent standard operative laparoscopic adhesiolysis. Tenckhoff catheters were placed in the abdominal wall during the procedure to allow repeat laparoscopy in an outpatient clinic setting with a 2-mm laparoscope. Successful adhesiolysis was documented in follow-up laparoscopy with the Optical Catheter System, performed 3 months later in four patients. RESULTS: Laparoscopy via the Tenckhoff catheters was accomplished in 26 of 32 attempts (81.3%). One patient had re-forming adhesions lysed with the Optical Catheter System. Simultaneous vaginal ultrasound enhanced visualization of the cul-de-sac. CONCLUSIONS: Outpatient clinic laparoscopy with a 2-mm laparoscope may prove practical for general diagnostic purposes. If validated in controlled trials with larger populations, the procedure may be an effective treatment of pelvic adhesive disease.
OBJECTIVE: To evaluate the safety and feasibility of repeat outpatient laparoscopy following laparoscopic lysis of extensive pelvic adhesive disease in a standard operating room setting. METHODS: In a pilot study, eight patients with chronic pelvic pain associated with severe pelvic and abdominal adhesive disease underwent standard operative laparoscopic adhesiolysis. Tenckhoff catheters were placed in the abdominal wall during the procedure to allow repeat laparoscopy in an outpatient clinic setting with a 2-mm laparoscope. Successful adhesiolysis was documented in follow-up laparoscopy with the Optical Catheter System, performed 3 months later in four patients. RESULTS: Laparoscopy via the Tenckhoff catheters was accomplished in 26 of 32 attempts (81.3%). One patient had re-forming adhesions lysed with the Optical Catheter System. Simultaneous vaginal ultrasound enhanced visualization of the cul-de-sac. CONCLUSIONS:Outpatient clinic laparoscopy with a 2-mm laparoscope may prove practical for general diagnostic purposes. If validated in controlled trials with larger populations, the procedure may be an effective treatment of pelvic adhesive disease.