Laparoscope: From 2 Different Sources
An instrument consisting, essentially, of a rigid or ?exible cylinder, an eyepiece and a light source, which is inserted through a small incision into the abdominal cavity (which has already been distended with carbon dioxode gas). The laparoscope allows the contents of the abdominal cavity to be examined without performing a LAPAROTOMY. Some operations may be performed using the laparoscope to guide the manipulation of instruments inserted through another small incision – for example, STERILISATION; CHOLECYSTECTOMY. (See also ENDOSCOPE; MINIMALLY INVASIVE SURGERY (MIS).)
(peritoneoscope) n. a surgical instrument (a type of *endoscope) comprising an illuminated viewing tube generally connected to a camera, with the image viewed on a video screen. It is inserted through the abdominal wall to enable the surgeon to view the abdominal organs (see laparoscopy). It can be used as a means to allow surgical procedures to be carried out with special instruments, through several small skin incisions. See also minimally invasive surgery.
Examination of the interior of the abdomen using a laparoscope, which is a type of endoscope. Laparoscopy is widely used in gynaecology. Surgical procedures such as appendicectomy and cholecystectomy are now often performed laparoscopically (see minimally invasive surgery).... laparoscopy
(Further information about the subject and the terms used can be found at http:// www.hfea.gov.uk/glossary)
This technique is used when normal methods of attempted CONCEPTION or ARTIFICIAL INSEMINATION with healthy SEMEN have failed. In the UK, assisted-conception procedures are governed by the Human Fertilisation & Embryology Act 1990, which set up the Human Fertilisation & Embryology Authority (HFEA).
Human Fertilisation & Embryology Act 1990 UK legislation was prompted by the report on in vitro fertilisation produced by a government-appointed committee chaired by Baroness Warnock. This followed the birth, in 1978, of the ?rst ‘test-tube’ baby.
This Act allows regulation monitoring of all treatment centres to ensure that they carry out treatment and research responsibly. It covers any fertilisation that uses donated eggs or sperm (called gametes) – for example, donor insemination or embryos (see EMBRYO) grown outside the human body (known as licensed treatment). The Act also covers research on human embryos with especial emphasis on foolproof labelling and immaculate data collection.
Human Fertilisation & EmbryologyAuthority (HFEA) Set up by the UK government following the Warnock report, the Authority’s 221 members inspect and license centres carrying out fertilisation treatments using donated eggs and sperm. It publishes a code of practice advising centres on how to conduct their activities and maintains a register of information on donors, patients and all treatments. It also reviews routinely progress and research in fertility treatment and the attempted development of human CLONING. Cloning to produce viable embryos (reproductive cloning) is forbidden, but limited licensing of the technique is allowed in specialist centres to enable them to produce cells for medical treatment (therapeutic cloning).
In vitro fertilisation (IVF) In this technique, the female partner receives drugs to enhance OVULATION. Just before the eggs are released from the ovary (see OVARIES), several ripe eggs are collected under ULTRASOUND guidance or through a LAPAROSCOPE. The eggs are incubated with the prepared sperm. About 40 hours later, once the eggs are fertilised, two eggs (three in special circumstances) are transferred into the mother’s UTERUS via the cervix (neck of the womb). Pregnancy should then proceed normally. About one in ?ve IVF pregnancies results in the birth of a child. The success rate is lower in women over 40.
Indications In women with severely damaged FALLOPIAN TUBES, IVF o?ers the only chance of pregnancy. The method is also used in couples with unexplained infertility or with male-factor infertility (where sperms are abnormal or their count low). Women who have had an early or surgically induced MENOPAUSE can become pregnant using donor eggs. A quarter of these pregnancies are multiple – that is, produce twins or more. Twins and triplets are more likely to be premature. The main danger of ovarian stimulation for IVF is hyperstimulation which can cause ovarian cysts. (See OVARIES, DISEASES OF.)... assisted conception
Surgical repair of a HERNIA. This may be done as an open operation or as MINIMALLY INVASIVE SURGERY (MIS) using a LAPAROSCOPE.... herniorraphy
Fertilisation of the egg (ovum) outside the body. The fertilised ovum is then incubated until the blastocyst stage develops, when it is implanted into the UTERUS. The procedure was developed in Britain and the ?rst successful in vitro baby, a girl, was born in 1978. IVF is used when a woman has blocked FALLOPIAN TUBES or when the sperm and ovum are unable to fuse in the reproductive tract. Hormone treatment results in the potential mother’s producing several mature ova, some of which are removed from the ovary using a LAPAROSCOPE and fertilised with her partner’s semen. (See ASSISTED CONCEPTION.)... in vitro fertilisation (ivf)
n. a surgical procedure for treating stress incontinence in women in which the upper part of the vaginal wall is fixed to the anterior abdominal wall by unabsorbable suture material. It may be performed through an abdominal incision (Burch colposuspension) or using a laparoscope (laparoscopic colposuspension). These techniques have now been largely replaced by other less invasive sling procedures, such as *tension-free vaginal tape.... colposuspension
The protrusion of an organ, or part of an organ, through the wall of the cavity that normally contains it. The most common types of hernia involve the organs of the abdomen which can herniate externally through the abdominal wall, or internally usually through a defect in the diaphragm. External hernias appear as a swelling, covered with skin, which bulges out on coughing or straining but which can normally be made to disappear with gentle pressure.
Types Inguinal hernia appears in the groin; less common is femoral hernia, which appears just below the groin. Incisional hernia may occur through a defect in any abdominal surgical scar, a paraumbilical hernia arising just to the side of the umbilicus and an epigastric hernia in the mid line above the umbilicus. In children, herniation may occur through the umbilicus itself, which is a natural weak spot. The commonest internal hernia is a hiatus hernia, when part of the stomach slips upwards into the chest through the DIAPHRAGM (see diagram).
Site of inguinal hernia (shaded).
Causes Hernias may be due to a defect present at birth (congenital), or may develop later in life (acquired). Acquired hernias arise due to the development of a defect or injury of the abdominal wall or due to increased pressure within the abdominal cavity, which forces the organ through a potential weakness. Such causes include chronic coughing or excessive straining due to constipation.
Complications Small hernias may cause no problems at all. However, some may be large and cumbersome, or may give rise to a dragging sensation or even pain.
Although most reduce spontaneously under the effects of gravity or gentle pressure, any organs that may have been displaced inside some hernias may become stuck, when they are said to be irreducible. If the contents become so trapped that their blood supply is cut o?, then strangulation occurs. This is a surgical emergency because the strangulated organs will soon die or rupture. When strangulation – usually of a loop of intestine – does occur, the hernia becomes irreducible, red, and very painful. If the hernia contains bowel, then the bowel may also become obstructed.
Treatment Conservative treatment with a compression belt, or truss, is now used only for those un?t for surgery or while awaiting surgery. Surgical repair can be at an open operation or by laparoscope, and consists of returning the herniated organs to their proper place and then repairing the defect through which the hernia occurred. This may be done safely under local or general anaesthetic, often as a day-case procedure, and most operative repairs result in a permanent cure.... hernia
a technique used in laparoscopic surgery in which the skin, muscle, fascia, and peritoneum are incised under direct vision to allow the insertion of a blunt *trocar, through which the laparoscope is introduced. [H. M. Hasson (21st century), US gynaecologist]... hasson technique
n. surgical repair of a hernia. It can be performed through a *laparoscope. See also hernioplasty; herniotomy.... herniorrhaphy
n. see laparoscope.... peritoneoscope
n. the presence of fragments of endometrial tissue at sites in the pelvis outside the uterus or, rarely, throughout the body (e.g. in the lung, rectum, or umbilicus). It is thought to be caused by retrograde *menstruation. When the tissue has infiltrated the wall of the uterus (myometrium) the condition is known as adenomyosis. Symptoms vary, but typically include pelvic pain, severe *dysmenorrhoea, *dyspareunia, infertility, and a pelvic mass (or any combination of these). Medical treatment is aimed at suppressing ovulation using *gonadorelin analogues, combined oral contraceptives, or the intrauterine system (see IUS). High-dose progestogens suppress *gonadotrophins (FSH and LH), shrink implanted endometrial tissue, and reduce retrograde menstruation. They have a similar efficacy to other medical treatments, are cheaper, and have fewer side-effects than gonadorelin analogues. Surgical treatment may also be necessary, usually by laser or ablative therapy via the laparoscope. More radical surgical treatment in the form of a total hysterectomy and bilateral salpingo-oophorectomy is sometimes required.... endometriosis
(IVF) fertilization of an ovum outside the body, the resultant *zygote being incubated to the *blastocyst stage and then implanted in the uterus. The technique, pioneered in Britain, resulted in 1978 in the birth of the first test-tube baby. IVF may be undertaken when a woman has blocked Fallopian tubes, unexplained infertility, endometriosis, or ovulation disorders; it is also carried out for purposes of surrogacy and egg donation. The mother-to-be is given hormone therapy causing a number of ova to mature at the same time (see superovulation). Several of them are then removed from the ovary through a laparoscope. The ova are mixed with spermatozoa and incubated in a culture medium until the blastocyst is formed. The blastocyst is then implanted in the mother’s uterus and the pregnancy proceeds normally. IVF is regulated by the *Human Fertilisation and Embryology Act 1990 via the Human Fertilisation and Embryology Authority.... in vitro fertilization
(minimal-access surgery) surgical intervention involving the least possible physical trauma to the patient, particularly surgery performed using an operating laparoscope or other endoscope (see laparoscopy) passed through tiny incisions; it is known popularly as keyhole surgery. Several types of abdominal surgery, including gall bladder removal (see cholecystectomy) and extracorporeal shock-wave *lithotripsy for stones in the urinary or bile drainage system, are commonly performed in this way. Such methods are usually more comfortable and allow the patient to resume normal activity much sooner than would be possible after more conventional procedures. See also interventional radiology.... minimally invasive surgery
n. 1. a surgical operation or any other process that induces *sterility in men or women. In women, hysterectomy and bilateral oophorectomy (surgical removal of both ovaries) are 100% effective and permanent. Alternatively, the Fallopian tubes may be removed (see salpingectomy) or divided and/or ligated. These operations can be performed through the abdomen or the vagina. The modern technique (tubal occlusion) is to occlude (close) permanently the inner (lower) half of the Fallopian tube through a *laparoscope. The occluding device is usually a clip (the Hulka-Clemens or Filshie clips) or a small plastic ring (Falope ring); *diathermy coagulation carries greater dangers (e.g. bowel burns) and is now little used. A more recent method is the use of a rapid-setting plastic introduced into the tubes through a hysteroscope (see hysteroscopy). Men are usually sterilized by *vasectomy. See also castration. 2. the process by which all types of microorganisms (including spores) are destroyed. This is achieved by the use of heat, radiation, chemicals, or filtration. See also autoclave.... sterilization
Health Encyclopedia