Letters.

Rejects No-Mask Argument

Although it is certainly true that aseptic technique under the most stringent precautions leaves a lot to be desired, there is no reason for Dr. Harry Reich to disregard time-honored techniques (Editor's Note, Oct. 15, 2001, p. 6).

Likewise, there is no reason to expect laparoscopic surgery to be any less sterile than laparotomy; there are multiple variables that can explain a lower infection rate with the former. I would certainly disagree with the 0.5% infection rate mentioned by Dr. Reich. Local infection alone far exceeds this.

His argument is the same one that we hear all the time from our colleagues that a vaginal delivery is not a sterile procedure.

Dr. Reich seemed to conclude that conversion to the video camera without eye contact achieves an added dimension to sterility. Actually, with careful handing of the scope, asepsis could be achieved prior to the video camera.

Also, there is no reason why a uterine manipulator or an occasional rectal probe cannot be utilized without transgressing asepsis.

I am familiar with Dr. Reich's technique of leaving 1,000-2,000 cc of Ringer's lactate in the peritoneal cavity I do not know to what extent this has been adopted, nor can I accept that a salt solution is bacteriostatic or bacteriocidal.