Hatern Tintara

Cost-benefit analysis of laparoscopic adnexectomy

Objective: To determine the economic feasibility (from the patients viewpoint) of laparoscopic adnexectomy (LA) in a developing country. Method: Forty‐four LA cases of benign ovarian cysts or tubal pregnancy were compared with 44 conventional open adnexectomy (OA) cases treated during the same period and matched by diagnosis, procedure and degree of difficulty. Result: The postoperative hospital stay was 1.3 ± 0.6 days (mean ± S.D.) and 5.3 ± 1.1 days (P < 0.001) for the LA and OA groups, respectively. LA cases had a shorter recovery period (5.8 ± 2.2 days vs. 27.2 ± 6.6 days, P < 0.001), but higher hospital charges (US

Laparoscopic adnexectomy for benign tubo-ovarian disease using abdominal wall lift: a comparison to laparotomy.

463.3 ± 84.9 vs. US

Simplified abdominal wall-lifting device for gasless laparoscopy

229.8 ± 92.2, P < 0.001), caused mainly (89.2%) by disposable laparoscopic instruments. Incremental cost‐benefit analysis revealed a possible saving with LA for higher income patients (US

Gasless laparoscopic hysterectomy: A comparative study with total abdominal hysterectomy

9.2 per day). Conclusions: LA in Thailand may have economic benefit only to the higher income patients. Benefits to other patients in developing countries will depend on future cost reductions of disposable instruments and/or more effective use of reusable instruments.

Effect of thread pitch on pull-out strength of laparoscopic myoma screws.

Objectives: To evaluate the results of laparoscopic adnexectomy using an abdominal wall‐lifting device compared to laparotomy. Methods: From February 1997 to December 2001, laparoscopic adnexectomy was performed in 68 cases of benign diseases in a university hospital. Three cases (4.4%) were converted to laparotomy due to poor visualization. The control group was a similar cohort of 65 patients who underwent the same procedures using laparotomy. Results: There were 59 ovarian cysts and six tubal pregnancies in each group. Mean analgesic used, hospital stay, recovery period and blood loss were 11.5 mg, 2.0 days, 1.0 week and 49 ml, compared with 151.8 mg, 4.0 days, 3.0 weeks, and 122 ml in the laparotomy group (P<0.0005). Mean operating times and hospital charges were 81.7 min and

A Comparative Study of Outcome of Laparoscopic Salpingo‐Oophorectomy versus Open Salpingo‐Oophorectomy

293.9 (US), compared with 77.1 min (P=0.108) and

Comparison of the TINTARA uterine manipulator with the Cohen cannula in gynecologic laparoscopy.

272.7 (US) (P=0.033) in the laparotomy group. No serious complications were found in either group. Conclusions: Gasless laparoscopic adnexectomy is a safe and effective technique to provide laparoscopic benefit with minimal increase in hospital charges.

Assessment of the physical properties of laparoscopic myoma-fixation devices

Objective: To develop a simplified abdominal wall‐lifting device for gasless laparoscopy. Methods: The device is composed of an electric‐power actuator, sliding arm and abdominal wall‐retractor. All parts of the device are reusable. The device provides planar displacement of the anterior abdominal wall to enable space for laparoscopy. The valveless ports and conventional instruments, as well as laparoscopic instruments, were used without a gas leak problem. Results: After preliminary success in the laboratory testing, a petition was made to the hospitals Ethic Committee. Since then we have performed 40 gasless laparoscopic procedures including 13 salpingo‐oophorectomies, 10 diagnostic laparoscopies, five tubal ligations, five ovarian cystectomies, four salpingectomies, two removals of pelvic IUDs and one laparoscopic hysterectomy. There were no surgical complications, including no abdominal wall trauma. The operative field was almost the same as that of the pneumoperitoneum technique, with the exception of morbidly obese patients. Conclusions: This preliminary experience demonstrates the efficiency of the simplified abdominal wall‐lifting device and the potential advantages of gasless laparoscopy. Continued modifications and applications are necessary to delineate the full range of benefits of this device and technique, especially in developing countries.

Ovarian neoplasms in childhood and adolescents in Songklanagarind Hospital, February 1983-March 1989.

Aim:  To evaluate the short‐term results of gasless laparoscopic hysterectomy (GLH) compared to total abdominal hysterectomy.

Effectiveness of celecoxib for pain relief and antipyresis in second trimester medical abortions with misoprostol: a randomized controlled trial

Aim:  The purpose of this study was to evaluate the effect of thread‐pitch on pull‐out strength and bending strength of buttress‐thread screws designed for laparoscopic myoma extraction.