• Journal of Veterinary Clinics
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• v.40 no.6
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• pp.438-444
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• 2023

The aim of this study was to analyze the learning curve of a low-volume veterinary surgeon for laparoscopic salpingectomy of Asiatic black bear. A total of 66 Asiatic black bears (Ursus thibetanus) were presented for sterilization using laparoscopic salpingectomy. These 66 bears were divided into three groups of 22 bears according to the order of surgery (A, B, and C groups, 22 bears per group). One veterinarian performed laparoscopic salpingectomy. There was no significant difference in age, body weight, or crown-rump length between groups. The hazard of completion for salpingectomy by 5 minutes was higher (p < 0.0001) in B and C groups than A group, whereas the hazard was not significant different between B and C groups. The factor that affected the hazard of completing salpingectomy by 5 minutes was heart rate, not age or weight. Operation time was 12.61 ± 8.04 minutes for group A, 5.35 ± 4.38 minutes for group B, and 2.80 ± 1.16 minutes for group C. The operation time for salpingectomy shortened over time. However, significant difference in operation time was present only between groups A and C (p = 0.001). The operation time for laparoscopic salpingectomy decreased rapidly for the first 7 bears (p < 0.05). It then decreased gradually until the 66th case. Operation time of laparoscopic salpingectomy was significantly decreased and stabilized after 33 cases (p < 0.05). As a result, the number of bears required for a low-volume veterinary surgeon to be proficient in laparoscopic salpingectomy is 33 or more.

• Clinical and Experimental Reproductive Medicine
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• v.39 no.4
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• pp.182-186
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• 2012

Objective: Many studies have demonstrated that hydrosalpinx has a detrimental effect on the outcome of IVF. Treating hydrosalpinges prior to the IVF procedure in women with hydrosalpinges is thought to improve the likelihood of successful IVF outcome. Vaginal ultrasound-guided aspiration of hydrosalpinx fluid (HSF) with injection of the sclerosing agent in situ might be simpler than invasive procedures like salpingectomy. Therefore, we carried out a retrospective study on the effects of ultrasound-guided HSF aspiration and injection of the sclerosing agent of ultrasonically diagnosed hydrosalpinx on IVF outcome. Methods: In our retrospective study, 97 tubal factor infertile female patients that underwent IVF treatment between January 2005 and December 2012 at the Reproductive Medicine Center of CHA Hospital were divided into two study groups. Fifty-six patients underwent interventional ultrasound sclerotherapy (group 1), and the remaining 41 patients received laparoscopic salpingectomy (group 2) before IVF. We compared the IVF outcomes of the two groups. Results: The results showed that ultrasound-guided HSF aspiration and sclerotherapy have IVF outcomes comparable to laparoscopic salpingectomy. Conclusion: Interventional ultrasound guided sclerotherapy before IVF is an effective and less invasive prophylactic intervention alternative to salpingectomy with hydrosalpinx.

• Journal of Yeungnam Medical Science
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• v.36 no.1
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• pp.59-62
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• 2019

Isolated tubal torsion is an uncommon cause of acute abdomen in pregnancy. Tubal torsion may occur in the absence of adnexal disease. Diagnosing tubal torsion is especially difficult in pregnancy because no precise preoperative radiological and biochemical investigations have been conducted. Most patients are diagnosed during surgery. Here, I present a case of isolated tubal torsion in a pregnant woman at 35 weeks and 6 days of gestation that was managed with salpingectomy and cesarean section simultaneously.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.149-151
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• 2014

A 170 kg, 9-year-old, female Asian black bear was presented for sterilization. Physical examination revealed no evidence of any abnormal clinical sign. Laparoscopic salpingectomy was performed for sterilization. A $25^{\circ}$ laparoscope was inserted in the first port, 1-cm caudal to the umbilical scar, to view the abdominal cavity. Two more ports were made 15 cm caudo-lateral to the first port bilaterally. An atraumatic grasper and a vessel-sealing device were inserted in the bilateral ports. The vessel-sealing device was used to seal and cut the fallopian tube and mesosalpinx. There was no sign of hemorrhage on the severed ends of the fallopian tube and mesosalpinx. At 4 weeks, no physical, behavioral, or other assessable impairment was found. This is the first case report in an Asian black bear to describe laparoscopic salpingectomy for sterilization.

• Journal of Medicine and Life Science
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• v.20 no.1
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• pp.48-52
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• 2023

High-grade serous carcinoma (HGSC) is the most common type of pelvic cancer among women. Serous tubal intraepithelial carcinoma (STIC) is a precursor lesion of HGSC. Herein, we report a rare occurrence of STIC in patients undergoing surgery for benign indications without a family history of ovarian cancer. A 77-year-old woman underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for uterine prolapse. Pathological examination revealed bilateral STIC without ovarian abnormalities, and no other abnormal findings were noted. Another patient, a 49-year-old woman, underwent laparoscopic total hysterectomy and bilateral salpingectomy for uterine fibroids. STIC lesions were observed in both fallopian tubes. Subsequently, a staging was performed. No additional lesions were found, and the patient was followedup through imaging and blood tests. As reports of STIC lesions are rare, data on their clinical outcomes and management strategies are limited. In this report, we present cases of incidental STIC in benign surgery and discuss its proper interpretation and management. Through the early detection of STIC lesions, patients with risk factors can be identified in advance, which will allow prevention and early detection of ovarian cancer. Opportunistic salpingectomy was also actively discussed in this regard.

• Journal of Veterinary Clinics
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• v.36 no.6
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• pp.306-313
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• 2019

It is important to identify the most suitable anesthetic agent that has minimal side effects to be able to control and perform surgeries on bears. In this study, we examined and compared the induction and recovery times as well as the physiological changes occurring during anesthesia induced by medetomidine-zolazepam/tiletamine (MZT) and xylazine-zolazepam/tiletamine (XZT) at general anesthesia for laparoscopic salpingectomy in 326 female Asiatic black bears. The body temperature, heart rate, respiratory rate, and levels of PaO₂ and EtCO₂ were the physiological changes measured during surgical procedures in female bears after anesthesia. In addition, the levels of pO₂, pCO₂, and sO₂ were measured using a portable blood gas analyzer. To induce recovery from anesthesia, bears anesthetized with MZT were intravenously administered atipamezole and bears anesthetized with XZT were intravenously administered yohimbine. The combination MZT, at dosages of 0.019 ± 0.001 mg/kg for medetomidine and 1.4 ± 0.1 mg/kg for ZT, or the combination XZT, at dosages of 2.0 ± 0.1 mg/kg for xylazine and 3.0 ± 0.1 mg/kg for ZT, proved to be reliable and effective in anesthetizing Asiatic black bears for a 40-min handling period for routine clinical procedures. The average anesthesia induction times were 16.5 ± 0.95 min for the bears in the MZT group and 12.0 ± 0.44 min for those in the XZT group. A significant difference was noted between the two drugs (P < 0.001) in terms of the average anesthesia induction time. The anesthesia induction time was shorter for bears with lower body weights than those with higher body weights (P < 0.05). The recovery time of MZT was significantly faster than that of XZT (11.3 ± 0.45 min vs. 18.5 ± 0.83 min) (P < .001). The bears anesthetized with MZT exhibited lower cardiopulmonary suppression than those anesthetized with XZT (P < 0.05). The body temperatures and EtCO₂ of bears in the M ZT group were significantly lower than those in the XZT group as time progressed after anesthesia (P < 0.05). The average pO₂ before the bears were supplied with oxygen was 64.8 ± 3.7 mmHg, but it increased to 211.5 ± 42.5 mmHg afterwards (P < 0.001). In conclusion, our results indicate that bears anesthetized with MZT have longer anesthesia induction time, shorter recovery time, slower heart and respiratory rates, and lower body temperatures and EtCO₂ than those anesthetized with XZT. These findings suggest that XZT is preferable to MZT, warranting further research on its uses and clinical responses in bears.

• Clinical and Experimental Reproductive Medicine
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• v.12 no.1
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• pp.71-81
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• 1985

A clinical analysis has been made on 717 cases of tubal sterilization which had been performed at the Dept. of Obstet. & Gynecol., Kyung Hee University Hospital from Jan. 1, 1976 to Dec. 31, 1980. The results are as follows: 1) Prominant age group consisted of those 26-30 years old with frequency of 43.9%, the average being 30.6 years old. 2) Women having 2 living children represented 52.4% of the total and the average No. of living children was 2.5. 3) According to the sex of their children, 29.7% of all cases had one son and one daughter. 12.1% of cases had no son, while 25.7% of cases had no daughter, which showed a trend of male preference. 4) 47.7% of total cases had not experienced artificial abortion before sterilization and the mean No. of artificial abortion was 1.8. 5) With respect to interval between last delivery and tubal sterilization, 76.1% of cases was sterilized within postpartum period (including-c-section) and 12.4% of cases was sterilized within 3 years. 6) The contraceptive methods prior to sterilization were 42.8% with no method used, 17.7% by condom, 16.6% by oral pills, 14.9% by IUD method. 7) 84.5% of puerperal sterilization operation was performed within 48 hours after bearing. 8) Sterilization procedures were coincidentally performed with appendectomy (36.7%), D&E (15.8%), perineorrhaphy (5.0%), salpingectomy (1.8%), and ovarian cystectomy (1.5%). 9) General anesthesia was performed in the majority cases (88.4%). 10) Complications after the procedure were encountered in 7.8% (56 cases), but no intensive medical care was required for these complications. 11) The failure (0.3%) resulting in intrauterine pregnancies occured after the laparoscopic sterilization.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.127-134
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• 1994

The aim of this study was to identify the usefulness of pelviscopy in treatment besides its diagnostic value. The advantages of pelviscopic surgery are low cost, rapid recovery, good cosmetic effect, low incidence of complication and postoperative adhesion. So most of the pelvic exploration in gynecologic patients are replaced by the pelviscopic surgery these days. Pelviscopic surgery was performed on 136 patients at the Department of Obstetrics and Gynecology, College of Medicine, Yeungnam University from May 1991 to July 1993. The results obtained were as follows : The age distribution of the patients was from 19 to 55 with age of 31.2 years, and the mean parity was 0.96, the most common indication of pelviscopic surgery was tubal pregnancy(66.9%), the second most common indications was ovarian cyst(10.3%) and the other indications were endometriosis, corpus luteum cyst rupture, parovarian cyst, foreign body, tubal ligation, hydrosalpinx, uterine myoma and diagnostic procedure. The main types of surgery were salpingectomy in 58.8% and salpingoophorectomy in 16.3%. The mean duration of hospitalization was 2.1 days without specific complications. According to these results, it was postulated that the pelviscopic surgery was a useful operative tool in gynecologic treatment and its application could be extended to many other areas of gynecology with safety by the development of surgical techniques and instruments.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.64-76
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• 1970

This report will present a clinical and statistical analysis of 210 case of Ectopic pregnancies who were treated at the Department of Obstetrics and Gynecology at Chung Nam Medical Center from January, 1966 to March, 1970. The results obtained are as follows; 1. The total number of Ectopic pregnancies was 8.22%. 2. The occurrence of Ectopic pregnancy was high in June(13.81%), low in October(2.98%). There was a higher occurrence of Ectopic pregnancy in the summer than in the winter. 3. The average age of all patients was 33.25 years. The most frequent age for this type of pregnancy was 31-35 years (32.86%) . The youngest patient was 18 years old and the oldest was 50. 4. Multipara occurred in 82.38% of the cases; Mulipara in 17. 62% and the occurrence of primipara was especially high, 20.95%. 5. 48.09% of the women had previously experienced normal deliveries; 42.8% had received artificial abortions and 5.23% had experienced spontaneous abortions. 3.8% had a previous history of Ectopic pregnancy. It was found that the occurrence of Ectopic pregnancy was more frequent in those women who had a D & C in the Past. 6. The average length of infertility was 21.7 months. The shortest length was 60 days; longest period of infertility was 19 years. 7. The occurrence of Ectopic pregnancy is higher (29.27%) in patient who have experienced only one previous D & C. The total number of patients who received a D & C was 58.57%. 3. Ectopic symptoms appeared during the first 4.7 weeks (mean) and most frequently occurred between the 5th and 6th weeks (48.57%) of pregnancy. The Symptoms were: -99.04% complained of lower abdominal pains. -80.95% experienced abnormal uttering bleeding. -42.38% experienced bleeding before the occurrence of pain. -18.57% experienced pain before the occurrence of bleeding. -8.57% experienced both pain and bleeding. -7.62% experienced only bleeding. -22.86% experienced only pain. 9. In-77.62% of the cases the annexal mass palpated. 91.42% complained of abdominal tenderness. 42.38% complained of pain when the cervix was examined. 10. Culdocentesis was performed in 86.19% of the cases. In 92.82% of the cases the presence of an Ectopic pregnancy was accurately diagnosed 11. 71.90% of the Ectopic pregnancies occurred in the ampule portion of the ovarian tube, of the total number of gestations, 40.95% were tubal abortions and 59.05% were ruptured. The ruptured group occurred more frequently in the islamic portion and interstitial portion of the tube than the aborted group. The aborted group occurred more frequently in the fimbrial extremities of the tube. 12. The blood pressure (systolic) was noted at 119-80mmHg in 81.89% of the total cases. Hemoglobin value was noted at over 8gm/㎗ in 58.57% of the cases. The average blood transfusion was 2.3 pints. 13. In 52.86% of the Ectopic pregnancies the right side of the ovarian tube was affected. The left side of the tube was affected in 47.14% of the cases. 14. 3.33% of the patients were not given an accurate diagnosis. 15. The kinds of operation performed were as follows; Salpingectomy, 41.43%; Adnectomy, 38.57% and Adnectomy with total hysterectomy, 19.05%. 16. The patient mortality rate was significantly small; only 1 case out of 210 died. This patient most likely had a profuse hemorrhage because of a ruptured tube before her admission to the hospital. 17. The patients personal feelings and attitudes must be treated with care. Particularly patients who are concerned about vaginal bleeding or the impossibility of another pregnancy.