The Journal of the American Association of Gynecologic Laparoscopists

Traditionally, definitive treatment for symptomatic endometriosis has been total abdominal hysterectomy with bilateral salpingo-oophorectomy. However, aggressive excision of all endometriotic implants at the time of hysterectomy with preser…

The purpose of this study is to analyze the patient selection patterns of physicians in private practice performing laparoscopically assisted vaginal hysterectomy (LAVH). Forty-nine laparoscopic hysterectomies were compared to 30 vaginal hy…

The treatment of midline dysmenorrhea and pelvic pain with laparoscopic presacral neurectomy (LPSN) has been reported previously. In this prospective study, 27 women experienced severe midline dysmenorrhea/pain, and 12 of these women also h…

A 21-year-old nulligravida underwent diagnostic hysteroscopy and laparoscopic potassium-titanyl-phosphate laser ablation of pelvic peritoneal endometriosis (revised American Fertility score of 10) for dysmenorrhea, dyspareunia, and dyschezi…

To determine the accuracy of postoperative recall of preoperative pain, this prospective, longitudinal study was conducted by a general gynecologist in private practice at a referral center. Before excision of endometriosis at laparoscopy o…

Despite widespread use of operative laparoscopy for removal of endometriomata, there are inadequate data regarding subsequent adhesion formation. We performed second look laparoscopy (SLL) within 6 months of laparoscopic endometriosis cyste…

One hundred consecutive patients, age 24-62, status post total hysterectomy with and without bilateral oophorectomy (BSO), presented with chronic pelvic pain. All underwent laparoscopy. Of those who did not have BSO, 30 had definite endomet…

During multipuncture operative laparoscopy to excise peritoneal endometriosis involving the pelvic sidewall near the origin of the uterine artery, the lower portion of the hypogastric artery was perforated. The acute hemorrhage was controll…

Medical reduction of the endometrium before hysteroscopic procedures has been demonstrated by many authors. In endometrial ablation, the GnRH agonists are useful for endometrial reduction and correction of anemia preoperatively. However, in…

Transvaginal sonography has found increasing application in evaluating patients planned for endoscopic surgery. Over a 4-year period, from 1988-1992, 376 patients underwent endoscopic evaluation for pelvic pain, pelvic masses, infertility, …

Based on the statement that immune system disorders play an important role in the pathogenesis of endometriosis, we evaluated a new method of treatment. This approach permitted subsequent administration of noretisteron acetate and myelopid …

Laparoscopic surgery as an alternative to traditional laparotomies has become an important modality in the management of gynecologic diseases; however, it is not without potential risks. Case reports describe numerous complications, includi…

After enthusiastic reports in the late 1980s, many authors are disappointed by the long term results of endometrectomy. In our first series of 75 patients, all followed for at least 60 months, we have had 71% good results, including treatme…

Ovarian remnant syndrome occurs infrequently after oophorectomy, yet when present it can contribute greatly to pelvic discomfort. The syndrome may be difficult to diagnose, identify surgically, and treat without intraoperative or postoperat…

We evaluated the efficacy of a new laparoscopic ultrasonic aspirator and applied it in gynecologic endoscopy. Two procedures were selected for preliminary evaluation of the instrument; ultrasonic aspiration for selective presacral neurectom…

Three laparoscopies were performed with treatment of cul-de-sac endometriosis near the rectum Two patients had a subsequent laparotomy for rectal perforation. The bowel damage appears to have been from a combination of failure to appreciate…

Surgical modalities such as electrosurgery and lasers have been used for many years to treat endometriosis. They are relatively unselective with wide scatter, however, leading to the potential for significant tissue damage and injury. As an…

To determine if laparoscopic excision of endometriosis by electrosurgery is more rapid than by sharp dissection, a retrospective comparative study was made of operative times for the two procedures. Median operating times for laparoscopic e…