Apparently conflicting results have been reported regarding the incidence, and even the existence... more Apparently conflicting results have been reported regarding the incidence, and even the existence, of endometriosis in visually normal peritoneum. The present study was undertaken in view of the fact that the presence and incidence of nonvisualized deep and/or microscopic endometriosis may be of importance in patient management. One patient in this study demonstrated a 1-mm lesion of endometriosis beneath visually normal peritoneum. Two additional patients had cellular surface zones of possible endometrial stroma without a contiguous epithelial component. The results support the existence of unrecognized subperitoneal and microscopic surface endometriosis.
Operative Laparoscopy (Minimally Invasive Surgery): State of the Art
Journal of Gynecologic Surgery, 1992
In any body cavity, endoscopic surgery is possible and usually preferable. Advantages include bet... more In any body cavity, endoscopic surgery is possible and usually preferable. Advantages include better exposure, magnification, and operating very close to the affected tissue. We demonstrate some of the past, present, and future of laparoscopy.
With the advent of minimally invasive laparoscopic techniques, most gynecologic procedures for be... more With the advent of minimally invasive laparoscopic techniques, most gynecologic procedures for benign conditions can be performed in an outpatient setting. However, the role of such techniques in gynecologic oncology is not well defined. By reviewing the literature and presenting some new data, we attempt to elucidate the applications of operative videolaparoscopy in gynecologic oncology. Advanced laparoscopic techniques are utilized for the management of cervical cancer as well as the staging and treatment of endometrial and ovarian cancers. Such techniques are used in performing radical hysterectomy for early stage cervical cancer, pelvic and paraaortic lymphadenectomy, and second look laparoscopy following chemotherapy for ovarian cancer. Even though preliminary data are encouraging, large prospective controlled studies with long-term follow-up are necessary to better define the role and limitations of laparoscopy in the treatment of gynecologic malignancies.
Of these 456 subjects, 17% were younger than 20 years of age, 65% were between 21 and 45 years, a... more Of these 456 subjects, 17% were younger than 20 years of age, 65% were between 21 and 45 years, and 18% were over 45 years. In all age groups, the majority of patients (54%) showed spontaneous regression. The progression rate was significantly higher in younger patients (Ͻ20 years) than in older patients (P Ͻ 0.025).
Advances in operative laparoscopic techniques have made possible the extension of this technology... more Advances in operative laparoscopic techniques have made possible the extension of this technology to the treatment of women with ovarian cancer. We present a detailed case series of eight patients with ovarian cancer who underwent a total of 11 operative laparoscopies for treatment of ovarian cancer ranging in stage from IA to IIIC. Three patients underwent initial laparoscopic staging and therapeutic debulking procedures. In three other cases that were incompletely staged via laparotomy, laparoscopy was used to complete the staging. Interval laparoscopic tumor debulking combined with second-look laparoscopy was performed in four cases. We describe our experience with these new applications of evolving techniques with particular regard to potential advantages, disadvantages, and complications. This detailed preliminary case series suggests the need for prospective clinical studies to establish the safety and efficacy of the approach.
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Papers by F. Nezhat