Practical Manual of Operative Laparoscopy and Hysteroscopy

Transcription

1 Practical Manual of Operative Laparoscopy and Hysteroscopy

2 Ricardo Azziz Ana Alvarez Murphy Editors Practical Manual of Operative Laparoscopy and Hysteroscopy Illustrated by Rod W. Powers With 110 figures in 121 parts Springer-Verlag New York Berlin Heidelberg London Paris Tokyo Hong Kong Barcelona Budapest

3 Ricardo Azziz Department of Obstetrics and Gynecology The University of Alabama Birmingham, AL USA Ana Alvarez Murphy Department of Reproductive Medicine University of California San Diego School of Medicine La Jolla, CA USA Library of Congress Cataloging-in-Publication Data Practical manual of operative laparoscopy and hysteroscopy / Ricardo Azziz, Ana Alvarez Murphy, (eds.). P. cm. Includes bibliographical references and index. ISBN-l3: e-isbn-13: DOl: / Generative organs, Female-Endoscopic surgery. I. Azziz, Ricardo. II. Murphy, Ana Alvarez. [DNLM: 1. Endoscopy-methods. 2. Genital Diseases, Femalediagnosis. 3. Genital Diseases, Female-surgery. WP 660 P895] RGlO4.7.P '059-dc20 DNLMlDLC for Library of Congress Printed on acid-free paper Springer-Verlag New York, Inc. Softcover reprint of the hardcover 1st edition 1992 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer-Verlag New York, Inc., 175 Fifth Avenue, New York, NY loolo, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or disimilar methodology now known or hereafter developed is forbidden. The use of general descriptive names, trade names, trademarks, etc., in this publication, even if the former are not especially identified, is not to be taken as a sign that such names, as understood by the Trade Marks and Merchandise Marks Act, may accordingly be used freely by anyone. While the advice and information in this book is believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Production managed by Karen Phillips; manufacturing supervised by Jacqui Ashri. Typeset by Asco Trade Typesetting Ltd., Hong Kong

4 Foreword In the past decade, the future of gynecologic endoscopic surgery has been largely unpredictable. Now it is obvious that time has changed gynecology in such a way to make many of the procedures that were commonly done obsolete. At no other time in the history of gynecologic surgery has such an explosion occurred thus changing the face ofthis specialty to such a great degree. But in addition to solving many problems, the past decade has left us with many new and novel dilemmas. One of the ways in which our field has tremendously evolved is not only have some procedures become obsolete, but to some degree gynecologic surgeons have themselves become obsolete. I write this because those not trained in the new techniques have had to go back and learn these surgical procedures in an unconventional way. This "unconventional way" is attending courses, and being supervised and preceptored by members of one's own hospital staff, then finally transmitted into granting of privileges. It is the young who are the leaders and, paradoxically, bringing experience to the field. In many instances, I have seen the resident who is a better endoscopic surgeon than the Senior Attending. Not only have new techniques and operations been introduced, such as the use of the resectoscope and electrocautery to remove intrauterine myomas, but a new technology has also arisen. Mastery is imperative. One can not master these techniques by mimicking what other surgeons do, but must understand the principles of the technological advances. Laser physics and properties must be understood and, in addition, optics and television technology are critical to performing excellent endoscopic surgery. Old timers are playing catch-up ball, but it is the young that are the leaders and pioneers in our field. It is for this reason that this text represents all that is important in endoscopic surgery. It not only is a comprehensive and encyclopedic dissertation on the subject, but it is written by the young leaders in the field. This is a textbook that will go through many editions, passed on from generation to generation of endoscopic surgeons. Not only are the important subjects tackled (i.e. techniques) but also the important principles are covered: adhesion prevention, laser surgery, hemostasis and instrumentation. Such difficult topics as cost effectiveness, risk-benefit ratio and need for randomized clinical studies are attacked with fervor to evaluate results properly. This is an important text and destined to become a classic. It is comprehensive, principle oriented, and serves a real and tangible need. I write this foreword with pride as an elder in the field. Alan H. Decherney, M.D.

5 Contents Foreword... Contributors... v IX 1 Advantages and Disadvantages of Operative Endoscopy RICARDO AZZIZ 2 History of the Development of Gynecologic Endoscopic Surgery... 7 MARIAN D. DAMEWOOD 3 Principles of Endoscopic Optics and Lighting RICHARD P. BUYALOS 4 Establishing Hemostasis at Laparoscopy ANA ALVAREZ MURPHY, V. GABRIEL GARZO, and RICARDO AZZIZ 5 Principles of Endoscopic Laser Surgery RICHARD P. BUYALOS 6 Photo and Video Documentation in Endoscopic Surgery RICARDO AZZIZ 7 Principles of Laparoscopic Microsurgery and Adhesion Prevention JACQUELINE N. GUTMANN and MICHAEL P. DIAMOND 8 Technique and Instrumentation in Operative Laparoscopy ANA ALVAREZ MURPHY 9 Laparoscopic Treatment of Ectopic Pregnancies ANA ALVAREZ MURPHY, ARLENE MORALES, and CHARLES W. NAGER 10 Laparoscopic Tubal Surgery and Adhesiolysis JOHN S. HESLA and JOHN A. ROCK 11 Laparoscopic Treatment of Endometriosis DAN C. MARTIN 12 Laparoscopic Ovarian and Parovarian Surgery MICHAEL P. STEINKAMPF and RICARDO AZZIZ 13 Laparoscopic and Hysteroscopic Myomectomy BRADLEY S. HURST and WILLIAM D. SCHLAFF 125

6 viii Contents 14 Laparoscopic Treatment of Tubo-ovarian and Pelvic Abscess HARRY REICH 15 Laparoscopic Uterine Nerve Ablation, Presacral Neurectomy, and Appendectomy C. PAUL PERRY and RICARDO AZZIZ 16 Techniques and Instrumentation of Operative Hysteroscopy HOWARD A. ZACUR and DENISE MURRAY 17 Operative Hysteroscopic Procedures RICHARD E. BLACKWELL 18 Endometrial Ablation JAMES F. DANIELL 19 Hysteroscopic Treatment of Congenital Uterine Anomalies J. BENJAMIN YOUNGER 20 Transcervical Tubal Cannulation, Tuboplasty, and Falloposcopy EUGENE KATZ 21 Complications of Laparoscopic and Hysteroscopic Surgery SAMUEL SMITH 22 Training and Certification in Operative Endoscopy RICARDO AZZIZ Index

7 Contributors RICARDO AZZIZ, M.D., Associate Professor, Division of Reproductive Biology and Endocrinology, The University of Alabama at Birmingham School of Medicine, 619 South 20th St., OHB 549, Birmingham, AL USA. RICHARD E. BLACKWELL, M.D., Professor and Director, Division of Reproductive Biology and Professor and Director, Division of Reproductive Biology and Endocrinology, Department of Obstetrics and Gynecology, The University of Alabama at Birmingham School of Medicine, 619 South 20th St., OHB 555, Birmingham, AL USA. RICHARD P. BUYALOS, M.D., Assistant Professor, Division of Reproductive Endocrinology, UCLA School of Medicine, CHS, Le Conte Avenue, Los Angeles, CA USA. MARIAN D. DAMEWOOD, M.D., Associate Professor, Division of Reproductive Endocrinology, Department of Gynecology and Obstetrics, The Johns Hopkins School of Medicine, 600 North Wolfe St., Baltimore, MD USA. JAMES F. DANIELL, M.D., The Women's Health Group, Clinical Professor, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, 2222 State St., Nashville, TN USA. MICHAEL P. DIAMOND, M.D., Associate Professor, Division of Reproductive Medicine, Yale University School of Medicine, 339 Farnam Memorial Building, P.O. Box 3333, New Haven, CT USA. V. GABRIEL GARZO, M.D., Assistant Clinical Professor, Department of Reproductive Medicine, University of California at San Diego School of Medicine, 510 North Prospect, Suite 202, Redondo Beach, CA USA. JACQUELINE N. GUTMANN, M.D., Postdoctoral Associate, Division of Reproductive Medicine, Yale University School of Medicine, 339 Farnam Memorial Building, P.O. Box 333, New Haven, CT USA. JOHN S. HESLA, M.D., Assistant Professor, Division of Reproductive Endocrinology, Department of Gynecology and Obstetrics, The Johns Hopkins School of Medicine, 600 North Wolfe St., Houck 247, Baltimore, MD USA. BRADLEY S. HURST, M.D., Assistant Professor, Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Campus Box B-198, 4200 East Ninth Avenue, Denver, CO USA.

8 x Contributors EUGENE KATZ, M.D., Assistant Professor, Director, ART Program, Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, The University of Maryland, 405 West Redwood Street, 3rd Floor, Baltimore, MD, USA. DAN C. MARTIN, M.D., Reproductive Surgery, P.C., Clinical Associate Professor, Department of Obstetrics and Gynecology, University of Tennessee, Memphis, 901 Madison, Suite 805, Memphis, TN USA. ARLENE MORALES, M.D., Clinical Instructor, Department of Reproductive Medicine, University of California at San Diego, School of Medicine, La Jolla, CA USA. ANA ALVAREZ MURPHY, M.D., Assistant Professor, Department of Reproductive Medicine, University of California at San Diego, School of Medicine, La Jolla, CA USA. DENISE MURRAY, M.D., Instructor, Division of Reproductive Medicine, Department of Gynecology and Obstetrics, The Johns Hopkins School of Medicine, 600 North Wolfe St., Houch 247, Baltimore, MD USA. CHARLES W. NAGER, M.D., Assistant Professor, Department of Reproductive Medicine, University of California at San Diego, School of Medicine, La Jolla, CA USA. C. PAUL PERRY, M.D., Assistant Clinical Professor, The University of Alabama at Birmingham School of Medicine, 1006 First Street North, Alabaster, AL USA. HARRY REICH, M.D., Wyoming Valley GYN Associates; Clinical Associate Professor, Department of Obstetrics and Gynecology, Baystate Medical Center; Western Campus: Tufts University School of Medicine, 480 Pierce St., Kingston, PA USA. JOHN A. ROCK, M.D., Professor, Department of Gynecology and Obstetrics, The Johns Hopkins School of Medicine; Chairman, Department of Obstetrics and Gynecology, Union Memorial Hospital, 4th Floor, South Building, 201 East University Parkway, Baltimore, MD USA. WILLIAM D. SCHLAFF, M.D., Associate Professor and Chief, Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Campus Box B-198, 4200 East Ninth Avenue, Denver, CO USA. SAMUEL SMITH, M.D., Assistant Clinical Professor, University of Maryland School of Medicine; Director, Division of Reproductive Endocrinology-Infertility, Sinai Hospital Baltimore, Blaustein Building-2nd Floor, Belvedere at Greenspring Avenue, Baltimore, MD USA. MICHAEL P. STEINKAMPF, M.D., Associate Professor, Division of Reproductive Biology and Endocrinology, Department of Obstetrics and Gynecology, The University of Alabama at Birmingham School of Medicine, 619 South 20th Street, OHB 343, Birmingham, AL USA. J. BENJAMIN YOUNGER, M.D., Professor and Vice-Chairman, Department of Obstetrics and Gynecology, Division of Reproductive Biology and Endocrinology, The University of Alabama at Birmingham School of Medicine, 619 South 20th Street, OHB 547, Birmingham, AL USA. HOWARD A. ZACUR, M.D., Associate Professor and Director, Department of Gynecology and Obstetrics, The Johns Hopkins School of Medicine, 600 North Wolfe St., Houck 247, Baltimore, MD USA.