Toward adhesion-free endoscopy?

3 03 2014

To the Editor:

Although the influence of CO2 insufflation on adhesion formation remains controversial, its non-physiological effects include tissue acidosis combined with metabolic hypoxemia and other respiratory and cardiovascular alterations. Therefore, the suggested hypothesis in a recent article by Corona et al. (1) that CO2-pneumoperitoneum should be supplemented by N2O seems to be promising. Read the rest of this entry »

Endoscopic loops for laparoscopic myomectomy

12 11 2010

To the Editor:

We have read with interest the recent paper by Zhao et al., describing laparoscopic myomectomy with vasopressin and loop ligation of the surgical base of fibroids’ pseudocapsule (1).

This combined approach was effective in reducing bleeding during myomectomy for large fibroids. A double technique was needed because the pseudo-capsule globally surrounds the fibroids with its peri-myomatous vessels. Therefore, the loop at the surgical base of the fibroid deals with the vessels there located, while those overlying the fibroid, the first ones to be incised by the surgeon, are pharmacologically ligated by the vasopressin. Unfortunately, the intramyometrial injection of vasopressin implies risks due to potential intravasation and serious complications have been reported with its use (2). Read the rest of this entry »