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Tissue has been obtained with percutaneous needle techniques, peritoneoscopy, culdoscopy, and laparoscopy, but all carry a significant risk of bowel injury secondary to a closed approach in the presence of dense adhesive disease

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However, analysis of SVNV population structure revealed that there was not significant diversity among the SVNV isolates identified from 3 states (Indiana, Delaware and Alabama) and that the virus populations are not rapidly changing