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Prediction of unsuccessful endometrial ablation: random forest vs logistic regression Gynecol. Surg. Pub Date : 2021-06-29 Kelly Yvonne Roger Stevens, Liesbet Lagaert, Tom Bakkes, Malou Evi Gelderblom, Saskia Houterman, Tanja Gijsen, Benedictus C. Schoot
Five percent of pre-menopausal women experience abnormal uterine bleeding. Endometrial ablation (EA) is one of the treatment options for this common problem. However, this technique shows a decrease in patient satisfaction and treatment efficacy on the long term. To develop a prediction model to predict surgical re-intervention (for example re-ablation or hysterectomy) within 2 years after endometrial
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Defining the limits of caesarean scar niche repair: new anatomical landmarks Gynecol. Surg. Pub Date : 2021-06-22 Tanushree Rao, Neera Lambert, Bhaswati Ghosh, Timothy Chang
Caesarean scar niche is increasingly being seen due to the rise in the number of caesarean sections worldwide. Indications and the ideal route for niche repair are still being researched. If the residual myometrium is less than 3 mm thick and potential fertility is needed, laparoscopy is the ideal surgical method for caesarean scar niche repair. The aim of this video presentation is to demonstrate
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A novel approach to minimally invasive hysterectomy without the use of a uterine manipulator: Kamran’s TLH Gynecol. Surg. Pub Date : 2021-06-21 Ahmed M. Gendia, Noel E. Donlon, Waseem M. Kamran
Hysterectomy remains one of the most common major gynaecological procedures, with total laparoscopic hysterectomy (TLH) now established as the technique of choice over conventional open approaches. This approach depends on the use of a uterine manipulator to facilitate uterine retraction and colpotomy. This study describes a novel approach in performing total laparoscopic hysterectomy without the use
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Laparoscopic uterosacral ligament suspension versus sacrospinous ligament fixation for apical prolapse: perioperative outcomes Gynecol. Surg. Pub Date : 2021-06-14 Martina G. Gabra, Veronica Winget, Mohammad T. Torabi, Ilana Addis, Kenneth Hatch, John Heusinkveld
Pelvic organ prolapse can be repaired vaginally or laparoscopically. Studies comparing vaginal repair with sacrospinous ligament fixation (SSLF) or uterosacral ligament suspension (V-USLS) have found no difference in functional or adverse outcomes. Laparoscopic USLS (L-USLS) is becoming a popular treatment for pelvic organ prolapse because it has a low rate of ureteral compromise. To date, no studies
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Is it possible to estimate the need for surgical management in patients with a tubo-ovarian abscess at admission? A retrospective long-term analysis Gynecol. Surg. Pub Date : 2021-06-07 Murat Gözüküçük, Esra Gülen Yıldız
This study aimed to determine the possible prognostic factors correlated with the treatment modalities of tubo-ovarian abscesses (TOAs) and thus to assess whether the need for surgery was predictable at the time of initial admission. Between January 2012 and December 2019, patients who were hospitalized with a TOA in our clinic were retrospectively recruited. The age of the patients, clinical and sonographic
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Medical and surgical interventions to improve the quality of life for endometriosis patients: a systematic review Gynecol. Surg. Pub Date : 2021-06-03 Maurizio Nicola D’Alterio, Stefania Saponara, Mirian Agus, Antonio Simone Laganà, Marco Noventa, Emanuela Stochino Loi, Anis Feki, Stefano Angioni
Endometriosis impairs the quality of life (QoL) of many women, including their social relationships, daily activity, productivity at work, and family planning. The aim of this review was to determine the instruments used to examine QoL in previous clinical studies of endometriosis and to evaluate the effect of medical and surgical interventions for endometriosis on QoL. We conducted a systematic search
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Does hysteroscopy in women with persistent gestational trophoblastic disease reduce the need for chemotherapy? A prospective, single-arm, clinical trial pilot study Gynecol. Surg. Pub Date : 2021-06-03 Fatemeh Davari Tanha, Saghar Samimi Sede, Fariba Yarandi, Elham Shirali, Maliheh Fakehi, Zeinab Shaker, Mahsa Ghajarzadeh, Marjan Ghaemi
This study aimed to describe the efficacy of hysteroscopy in the management of women with the persistent gestational trophoblastic disease (PGTD)/GTN to reduce the need for chemotherapy. This prospective, single-arm, clinical trial study was recruited in an educational referral hospital between September 2018 and September 2019. Totally, 30 participants with a history of hydatidiform mole that was
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The use of hysteroscopic metroplasty with diode laser to increase endometrial volume in women with septate uterus: preliminary results Gynecol. Surg. Pub Date : 2021-06-01 Luigi Nappi, Maddalena Falagario, Stefano Angioni, Vincenzo De Feo, Michele Bollino, Felice Sorrentino
Septate uterus is a common Mullerian ducts anomaly. The aim of our pilot study was the evaluation of diode laser hysteroscopic metroplasty efficacy to increase endometrial volume in women with septate uterus. We prospectively enrolled 10 consecutive patients with septate uterus undergoing office hysteroscopic metroplasty with diode laser between February and November 2019. Endometrial volume was evaluated
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Applied anatomy knowledge in gynaecology and obstetrics: the trainees’ perception Gynecol. Surg. Pub Date : 2021-05-18 Fida Asali, Ismaiel Abu Mahfouz, Heba Abu Saleem, Salem Abu Mahfouz, Maha T. Mohammad, Oqba Al-Kuran
Medical education has recognised the importance of anatomy teaching. Limitations in applied anatomy knowledge exist among obstetrics and gynaecology (O&G) trainees. This study aims to evaluate the knowledge of O&G trainees in applied anatomy and study-associated factors. The questionnaire-based study involved O&G trainees between 1/8/2019 and 1/12/2019. Data collected included age, gender, evaluation
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Laparoscopy approach to sigmoid colon perforation secondary to intrauterine device migration Gynecol. Surg. Pub Date : 2021-05-12 Henry Robayo-Amortegui, Marcela Rincon-Vanegas, Adolfredo Ballestas-Blanquicet, Jair Ruiz-Fonseca
Currently, the intrauterine device (IUD) is one of the most used contraceptive methods worldwide, since it has shown to be effective and reversible. One of its complications is the migration of the device, which can affect close organs by perforating them. We present the case of a patient who presented a colouterine fistula secondary to an IUD migration.
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Effects of delayed suprapubic port removal on post-laparoscopic shoulder pain: a randomized controlled trial Gynecol. Surg. Pub Date : 2021-05-11 Amphan Chalermchockcharoenkit, Pattaya Hengrasmee, Paiboon Sophontanarak, Korakot Sirimai, Pavit Sutchritpongsa, Pisutt Srichaikul
One of the major drawbacks of gynecologic laparoscopy is post-laparoscopic shoulder pain (PLSP) that is believed to result from intra-abdominal CO2 retention leading to peritoneal and diaphragmatic stretching and causing referred pain in C4 dermatome. Several interventions have been applied to prevent and reduce its incidence and severity, with contradictory results. Only pulmonary recruitment maneuver
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The development and psychometric validation of a low-cost anthropomorphic 3D-printout simulator for training basic skills applicable to office-based hysteroscopy Gynecol. Surg. Pub Date : 2021-05-03 Ana Rita Peixoto Panazzolo, Leisa Beatriz Grando, Lia Karina Volpato, Getúlio R. de Oliveira Filho
Hysteroscopy training requires the development of specific psychomotor skills. Few validated low-cost models exist in hysteroscopy. The main objective of this study is to determine face, content, and construct validity of a simulator designed for training basic hysteroscopy skills applied to office-based hysteroscopy. Twenty-five hysteroscopy experts and 30 gynecology residents participated in this
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Femoral nerve injury in gynecologic surgery: medico-legal issues for best surgical practices Gynecol. Surg. Pub Date : 2021-04-30 Piergiorgio Fedeli, Maurizio Guida, Pasquale Giugliano, Laura Letizia Mazzarelli, Annalisa D’Apuzzo, Roberto Scendoni, Giuseppe Vacchiano
Femoral nerve injury following gynecologic surgery may be a postoperative complication, leading to medical malpractice claims and litigation. A retrospective analysis was performed on data collected from 973 medico-legal reports of suspected malpractice in gynecologic surgery, filed with the Italian Court between 2000 and 2010. Twelve cases were selected for proven negligence, after a blinded investigation
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The impact of previous cesarean section on the outcome of patients with non-adherent placenta previa Gynecol. Surg. Pub Date : 2021-04-29 Amer Sindiani, Nail Obeidat, Omar Abu-Azzam, Heba Hijazi
To evaluate the impact of previous lower segment cesarean section on maternal and fetal outcomes of patients with non-adherent placenta previa This is a retrospective study of all patients who delivered at a tertiary referral university hospital by lower uterine cesarean section with non-adherent placenta previa, over a 10-year period. Data were obtained through hospital registry and medical records
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Indocyanine green fluorescence imaging, sentinel lymph node mapping in patients with vulvar cancer: peritumoral injection dosage and waiting times in our experience Gynecol. Surg. Pub Date : 2021-04-05 P. Scollo, M. Ferrara, B. Pecorino, A. B. Di Stefano, G. Scibilia
Vulvar cancer is a rare gynecological malignancy that primarily affects women of postmenopausal age. Treatment is mainly surgical, particularly for vulvar squamous cell carcinoma, the most prevalent histotype. In patients with unifocal tumors with a maximum diameter of <4 cm, in the absence of suspected inguinal lymph nodes, sentinel lymph node (SLN) biopsy is recommended. The use of a radioactive
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Adnexal masses during pregnancy: management for a better approach Gynecol. Surg. Pub Date : 2021-03-12 Simona Martone, Libera Troìa, Stefano Luisi
The incidence of adnexal masses, due to large use of ultrasound during pregnancy, has considerably increased during last years. Large percentage of ovarian masses found during pregnancy consists in simple cysts and they tend to disappear spontaneously during pregnancy. There are still a percentage of masses that persist in second and third trimester that need to be monitored and, sometimes, surgically
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Dissection of the uterine wall in a scarred uterus: a case report Gynecol. Surg. Pub Date : 2021-03-02 Sanne J. M. Zilver, Wouter Wegdam, Angelo B. Hooker
Uterine rupture is a potentially fatal complication during pregnancy, delivery, or postpartum. Women attempting a trial of labor after a cesarean section have an increased risk of a subsequent rupture. We report a case of a 24-year-old woman, gravida 2 para 1 with a previous cesarean section who underwent a trial of labor. During labor she complained of pain while labor progressed rapidly. Because
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Emergency peripartum hysterectomy in a tertiary teaching hospital in Northern Jordan: a 15-year review Gynecol. Surg. Pub Date : 2021-02-18 Hasan Rawashdeh, Rawan Obeidat, Lubna Masaadeh
Emergency peripartum hysterectomy is a major operation performed when conservative measures fail to stop life-threatening postpartum hemorrhage. It is associated with a high rate of maternal morbidity among survivors. This work aims to evaluate the incidence, indication, and complications of peripartum hysterectomy at King Abdulla University Hospital over 15 years. A retrospective cohort study of emergency
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A novel approach to minimally invasive hysterectomy without the use of a uterine manipulator: Kamran’s TLH technique Gynecol. Surg. Pub Date : 2020-09-25 Ahmed M. Gendia, Noel E. Donlon, Waseem M. Kamran
Background There are a number of techniques documented in the literature to perform laparoscopic hysterectomy, and here, we propose a safe and novel technique that obviates the need for a pelvic assistant, removes the need for a uterine manipulator and can potentially reduce operative duration. Results Total laparoscopic hysterectomy can be approached without the use of uterine manipulator or vaginal
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A retrospective study of a novel non-umbilical laparoscopic entry port in thin patients—Jain point Gynecol. Surg. Pub Date : 2020-08-31 Nutan Jain, Shalini Singh, Kiran Kumari Mandal, Apoorva Walia, Vandana Jain, Richa Kalia
Background To bring forth a novel non-umbilical entry port in case of thin patient. Methods This is a retrospective study carried out at Vardhman Trauma and Laparoscopy Centre on thin patients from 2011 to 2019. Out of 7324 patients operated between 1 January 2011 and 31 December 2019 at this hospital, 398 met the criteria for thin patients (BMI < 18.5 kg/m 2 ). Results A total of 398 patients who
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Histological findings of patients with adnexal torsion who underwent surgical treatment: short reminder Gynecol. Surg. Pub Date : 2020-08-26 Ritva Nissi, Markku Santala, Anne Talvensaari-Mattila
Background Ovarian torsion is a rare emergency condition in women. Early diagnosis is necessary to preserve fertility. Case Our study evaluated 40 patients, who underwent laparoscopic surgery. The aims of this retrospective study were to emphasize the importance of early diagnosis in ovarian torsion, evaluate the process of patient treatment, and investigate the number of patients treated by minimally
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Sigmoid vaginoplasty in Mayer-Rokitansky-Kuster-Hauser syndrome Gynecol. Surg. Pub Date : 2020-08-18 Ibrahim Amadou Magagi, Harissou Adamou, Souleymane Oumarou Garba, Maazou Halidou, Ousseini Adakal, Oumarou Habou, Maman Bachir Abdoulaye, Madi Nayama, Rachid Sani
Introduction Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH) is characterized by congenital aplasia of the uterus and upper 2/3 of the vagina, with normal female secondary sexual characteristics and a normal karyotype (46, XX). The frequency is 1/4500–5000 female births. The aim of this study was to report the management of MRKH syndrome with sigmoid vaginoplasty. Patients and method This study included
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Hysteroscopic view with targeted biopsy in the assessment of endometrial carcinoma. What is the rate of underestimatated diagnosis? The results of a multicenter Italian trial Gynecol. Surg. Pub Date : 2020-07-19 Giancarlo Garuti, Stefano Angioni, Liliana Mereu, Stefano Calzolari, Luca Mannini, Federica Scrimin, Paolo Casadio, Davide De Alberti, Luigi Nappi, Enrico Busato, Francesco P. G. Leone, Gaetano Perrini, Vito Cela, Massimo Luerti
Objective In the last two decades, many reports demonstrated the unreliability of endometrial biopsy pathology showing an AH (atypical hyperplasia) to exclude a synchronous EEC (endometrioid endometrial carcinoma), with an underestimation of EEC in up to 50% of women. Hysteroscopy is now considered the standard diagnostic tool for endometrial pathology. However, a recent meta-analysis showed that hysteroscopically
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An evaluation of a Myomscore in the preoperative assessment of uterus myomatosus: a new diagnostic standard? The experience at the Mathilden Hospital in Herford, Germany Gynecol. Surg. Pub Date : 2020-07-06 R. Wojdat, E. Malanowska
Introduction Preoperative diagnosis of unsuspected malignant mesenchymal tumors is often challenging [1]. They can occasionally be confused with benign fibroids, which are the most common tumors in women of reproductive age [2, 3]. A wide variety of technologies and tools are involved in the diagnostic of uterine fibroids [4, 5]. However, we often choose expensive MRI, which cannot reliably distinguish
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Extending cervicoplastic surgery: an alternative technique to overcome the limitation of office hysteroscopy Gynecol. Surg. Pub Date : 2020-07-01 Stefano Calzolari, Chiara Comito, Dora Pavone, Flavia Sorbi, Eleonora Castellacci, Giovanna Giarrè, Karin Louise Andersson, Valeria Dubini, Felice Petraglia
Our objective is to show a feasible approach to the hysteroscopic procedures when the cervical canal has a diameter smaller than the lesion. Our study is designed as a case series and illustration of the surgical hysteroscopic technique. A group of patients ( n = 37) underwent office hysteroscopy in Regional Reference Center for Hysteroscopy Service at Palagi Hospital, Florence, Italy, to see and treat
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Laparoscopic-assisted myomectomy with uterine artery occlusion at a freestanding ambulatory surgery center: a case series Gynecol. Surg. Pub Date : 2020-06-16 Paul MacKoul, Natalya Danilyants, Faraj Touchan, Louise Q. van der Does, Leah R. Haworth, Nilofar Kazi
Background Non-hysteroscopic myomectomy is infrequently performed in a freestanding ambulatory setting, in part due to risks of intraoperative hemorrhage. There are also concerns about increased surgical risks for morbidly obese patients in this setting. The purpose of this study is to report the surgical outcomes of a series of laparoscopic-assisted myomectomy (LAM) cases at a freestanding ambulatory
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Endometrial stromal sarcoma presented as endometrial polyp: a rare case Gynecol. Surg. Pub Date : 2020-06-01 Daniilidis Angelos, Liberis Anastasios, Miliaras Dimosthenis, Dampali Roxani, Papanikolaou Alexis, Dinas Konstantinos
Endometrial stromal sarcomas are rare malignant mesenchymal tumors, occurring in the age group of 45–55 years. We report a case of low-grade endometrial stromal sarcoma in a 39-year-old woman, whose ultrasound examination suggested a large endometrial polyp. Polypectomy followed by laparoscopic total hysterectomy with bilateral salpingo-oophorectomy was performed. The final histological examination
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Hysteroscopic treatment of retained placental tissue: a case report Gynecol. Surg. Pub Date : 2020-06-01 Daniilidis Angelos, Liberis Anastasios, Papandreou Panagiotis, Sidiropoulos Konstantinos, Pratilas George, Dinas Konstantinos
Retained placenta tissue is a rare condition, and its diagnosis and surgical treatment are often challenging. Conventionally, the surgical management of such cases is largely performed using blind dilation and curettage. Our case demonstrates that the successful complete removal of retained placental tissues can be achieved with operative hysteroscopy with minimal use of electrosurgery in order to
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Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy? Gynecol. Surg. Pub Date : 2020-05-26 Kiper Aslan, Adnan Orhan, Engin Türkgeldi, Ebru Suer, Nergis Duzok, Kemal Özerkan, Barış Ata, Gürkan Uncu
Objective To determine whether hemorrhage and complication rates vary according to the location of the dominant fibroid following laparoscopic myomectomy. Background Laparoscopic myomectomy is associated with less postoperative pain, analgesic requirement, shorter hospitalization period, and less febrile complications when compared to conventional laparotomy. Despite the advantages, complications like
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Laparoscopy in the coronavirus disease 2019 (COVID-19) era Gynecol. Surg. Pub Date : 2020-05-14 Stefano Angioni
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged in China at the end of 2019 has become a pandemic infection that has now involved 200 countries with 465,915 confirmed cases and 21,031 confirmed deaths. Unfortunately, many data have shown that the high number of undocumented infections could have a major role in the rapid diffusion of the disease. In most of the nations
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Preclinical evaluation of a new robot-assisted surgical system for use in gynecology minimal access surgery Gynecol. Surg. Pub Date : 2020-04-14 Marcus Carey, Anish Bali, Ivilina Pandeva, Ashish Pradhan, Mark Slack
Robot-assisted laparoscopy has been developed to overcome some of the important limitations of conventional laparoscopy. In particular, the provision of stable magnified three-dimensional vision, tremor filtering, motion scaling, and articulated instruments with robot-assisted surgery has the potential to enable more surgeons to perform more complex surgery compared with conventional laparoscopy. The
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Laparoscopic hysterectomy versus total abdominal hysterectomy: a retrospective study at a tertiary hospital Gynecol. Surg. Pub Date : 2020-04-10 Mahmoud Elmorsi Aboulfotouh, Fouad Chaalan, Abdelbaset Fakhry Mohammed
Objective To compare laparoscopic hysterectomy (LH) with total abdominal hysterectomy (TAH) regarding different outcome measures at our tertiary hospital. Study design This retrospective comparative cross-sectional study was conducted at the Department of Obstetrics and Gynecology Department, Women’s Hospital, Hamad Medical Corporation, Doha, Qatar. It included 44 patients who had LH (group 1) and
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Medical management of deeply infiltrating endometriosis - 7 year experience in a tertiary endometriosis centre in London Gynecol. Surg. Pub Date : 2019-12-01 Marianne Wild, Tariq Miskry, Asmaa Al-Kufaishi, Gillian Rose, Mary Crofton
BackgroundDeeply infiltrating endometriosis has an estimated prevalence of 1% in women of reproductive age. Ninety percent have rectovaginal lesions but disease may also include the bowel, bladder and ureters. Current practice often favours minimally invasive surgical excision; however, there is increasing evidence that medical management can be as effective as long as obstructive uropathy and bowel
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Laparoscopic lateral suspension: a single-site and single-surgeon experience Gynecol. Surg. Pub Date : 2019-12-01 Claudia Mang, Hansjörg Huemer, Ariane Birkenmaier, Jörg Humburg
BackgroundIn the reconstructive surgery for pelvic organ prolapse (POP), different newer mesh fixation techniques as an alternative to sacrocolpopexy has been developed. In order to gain more data about the different techniques, it is important to analyze success and recurrence rates of surgical procedures.MethodsCollection and analysis of data from patients treated with laparoscopic lateral suspension
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The role of diagnostic hysteroscopy in diagnosis of incomplete uterine septum in patients with recurrent pregnancy loss in the era of transvaginal 3D ultrasound scan Gynecol. Surg. Pub Date : 2019-12-01 O. Abuzeid, J. LaChance, J. Hebert, M. I. Abuzeid, R. Welch
PurposeTo determine the accuracy of transvaginal 3D ultrasound scan (TV 3D US) in detecting partial septate uterus (PSU) in patients with recurrent pregnancy loss (RPL).MethodsThis retrospective study included 113 patients with an initial diagnosis of unexplained RPL, who were subsequently found to have PSU on diagnostic hysteroscopy and who had TV 3D US prior to surgery. The diagnosis of PSU was made
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The utility of fibrinogen level as a predictor of complications after laparoscopic gynecologic surgery: a prospective observational study Gynecol. Surg. Pub Date : 2019-11-01 Antonio Macciò, Giacomo Chiappe, Paraskevas Kotsonis, Fabrizio Lavra, Romualdo Nieddu, Paolo Onnis, Elisabetta Sanna, Valerio Mais, Clelia Madeddu
BackgroundComplications after laparoscopic gynecological surgery may increase patients’ morbidity and mortality; therefore, their timely diagnosis and early treatment would help clinicians to avoid life-threatening situations. We aimed to evaluate the predictive role of fibrinogen for diagnosing complications after laparoscopic gynecologic surgery for benign and malignant conditions.Patients and methodsAll
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Effectiveness of ovarian suspension in preventing postoperative ovarian adhesions in patients with severe pelvic endometriosis—a case-control study Gynecol. Surg. Pub Date : 2019-10-29 Zahra Dehbashi, Shaheen Khazali, Fateme Davari Tanha, Farnaz Mottahedian, Mahsa Ghajarzadeh, Saghar Samimi Sadeh, Koorosh Kamali
BackgroundEndometriosis can exert obvious negative effects on women’s quality of life.Excisional surgery is among the most effective treatments for severe pelvic endometriosis. The prevalence of severe pelvic adhesions following a laparoscopic examination of severe endometriosis varies between 50 and 100%. Temporary intraoperative ovarian suspension is a method for the reduction of adhesions is in
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Comparison of laparoscopy-assisted vaginal hysterectomy as endoscopic single-station surgery and conventional laparoscopic hysterectomy—surgical effects on safety and quality of life Gynecol. Surg. Pub Date : 2019-08-16 Alexander Mustea, Bernd Holthaus, Haytham Elmeligy, Stefanie Krüger-Rehberg, Dominika Trojnarska, Zaher Alwafai, Juliane Sternberg, Matthias B. Stope, Thomas Kohlmann, Ivo Meinhold-Heerlein, Dominique Koensgen
BackgroundTo extend the benefits of minimally invasive surgery, an increasing enthusiasm has emerged for the laparo-endoscopic single-site surgery (LESS). The idea of LESS is to allow inserting multiple laparoscopic instruments through only one umbilical incision instead of multiple abdominal incisions.MethodsSixty patients from three different centers in Germany were randomized (1:1) to conventional
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Correction to: Comparing self-assessment of laparoscopic technical skills with expert opinion for gynecological surgeons in an operative setting Gynecol. Surg. Pub Date : 2019-05-27 Rami Kilani, Wesam Aleyadeh
In the publication of this article [1], the contributing author Wesam Aleyadeh was missing. This has now been updated in this correction.
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Prediction of unsuccessful endometrial ablation: a retrospective study Gynecol. Surg. Pub Date : 2019-05-01 K. Y. R. Stevens, D. Meulenbroeks, S. Houterman, T. Gijsen, S. Weyers, B. C. Schoot
BackgroundEndometrial ablation (EA) is a frequently used treatment for abnormal uterine bleeding, mainly due to the low risks, low costs and short recovery time associated with the procedure. On the short term, it seems successful, long-term follow-up however, shows decreasing patient satisfaction as well as treament efficacy. There even is a post-ablation hysterectomy rate up to 21%. Multiple factors
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Implementing robotic assisted myomectomy in surgical practice – a retrospective cohort study Gynecol. Surg. Pub Date : 2019-04-01 Silvie Aendekerk, Jasper Verguts, Susanne Housmans, Dirk Timmerman
BackgroundTo compare surgical outcomes of patients with leiomyomas after robotic-assisted laparoscopic myomectomy (RALM), laparoscopic myomectomy (LsM), or laparotomic myomectomy (LtM) and to construct a useful algorithm for the best modus operandi for uterine leiomyomas.MethodsDesign: A retrospective chart review. Data included patient (age and BMI) and fibroid characteristics (number, measurements
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A value-based evaluation of minimally invasive hysterectomy approaches Gynecol. Surg. Pub Date : 2019-03-18 Natalya Danilyants, Paul MacKoul, Louise van der Does, Leah Haworth, Rupen Baxi
BackgroundWith surgical care contributing to the rising healthcare costs around the globe, quantifying the value of surgical modalities is critical to pushing healthcare systems in the direction of greater sustainability. The purpose of this study was to assess and compare the value of minimally invasive hysterectomy approaches, as defined by operative outcomes and patient satisfaction relative to
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Gasless laparoendoscopic single-site surgery with intraoperative autologous blood transfusion for management of ectopic pregnancy with significant hemoperitoneum: a retrospective observational study Gynecol. Surg. Pub Date : 2019-03-05 Akihiro Takeda, Shiori Tsuge, Mayu Shibata, Sanae Shinone, Hiromi Nakamura
BackgroundWith advances in diagnostic and therapeutic modalities, earlier detection of ectopic pregnancy with minimal symptoms makes laparoscopic management more common. However, if diagnostic delay occurs, significant hemoperitoneum associated with ectopic pregnancy is still a potentially life-threatening condition, which presents a therapeutic challenge especially when minimally invasive surgical
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Symptomatic endometriosis developing several years after menopause in the absence of increased circulating estrogen concentrations: a systematic review and seven case reports Gynecol. Surg. Pub Date : 2019-02-15 Fernanda de Almeida Asencio, Helizabet Abdalla Ribeiro, Paulo Ayrosa Ribeiro, Mario Malzoni, Leila Adamyan, Anastasia Ussia, Victor Gomel, Dan C. Martin, Philippe R. Koninckx
BackgroundTo review women with symptomatic and clinically progressive endometriosis after menopause in the absence of estrogen intake or excessive systemic endogenous production.DesignSeven case reports and a systematic review of the literature from 1995 till February 2018.ResultsOnly 7 case reports from the authors and 29 cases from the literature described women with either cystic ovarian or deep
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The diagnosis and management of interstitial ectopic pregnancies: a review Gynecol. Surg. Pub Date : 2019-02-04 Maximilian Brincat, Alison Bryant-Smith, T. K. Holland
The objective of this article is to review the published literature on the diagnosis and management of interstitial pregnancies (IPs). IPs account for 2–6% of all ectopic pregnancies and have the potential to cause life-threatening haemorrhage resulting in a 2–5% mortality rate. There is little consensus on the best practice for diagnosing and managing interstitial pregnancies. By reviewing the published
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Pelvic exenteration in gynecologic cancer: complications and oncological outcome Gynecol. Surg. Pub Date : 2019-01-28 Víctor Lago, Ines Poveda, Pablo Padilla-Iserte, Eduardo Simón-Sanz, Álvaro García-Granero, Jose Luis Pontones, Luis Matute, Santiago Domingo
IntroductionPelvic exenteration (PE) is indicated in cases of unresponsive, recurrent pelvic cancer or for palliative intent. Despite the fact that the surgery is associated with a high rate of morbidity, it is currently the only real option that can effect a cure.Material and methodsPatients who underwent PE between January 2011 and July 2017 in our centre were retrospectively reviewed. Data related
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Didactic lectures versus simulation training: a randomised pilot evaluation of its impact on surgical skill Gynecol. Surg. Pub Date : 2018-12-01 Prasanna Raj Supramaniam, Monica Mittal, Rebecca Davies, Lee Nai Lim, Kirana Arambage
BackgroundThe Bristol enquiry and national surveys have highlighted medicolegal concerns, reduction in training time available for trainees and the change from trainees performing procedures for the first time on patients. The Royal Colleges have taken an active role in advocating the use of simulation training prior to doctors undertaking operative procedures in real time. This study compares didactic
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Safety and efficacy of non-absorbable mesh in contemporary gynaecological surgery Gynecol. Surg. Pub Date : 2018-11-23 Matthew Izett, Anthony Kupelian, Arvind Vashisht
Mesh-augmented pelvic floor surgery evolved to address the limitations of native tissue repair in reconstructive surgery. The development of the synthetic mid-urethral tape signalled a revolution in the treatment of stress urinary incontinence, whilst the use of mesh in abdominal apical prolapse repair may confer benefits over native tissue alternatives. However, these procedures can be associated
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Elective uterine artery embolization prior to laparoscopic resection of interstitial pregnancy: two cases and literature review Gynecol. Surg. Pub Date : 2018-11-14 Iris Verbeeck, Francesca Donders, Pieter-Jan Buyck, Dirk Timmerman, Andries Van Holsbeeck, Sandra A Cornelissen, Anne-Sophie Van Rompuy, Lien Van den Haute, Sylvie Gordts, Carla Tomassetti, Jan Deprest
BackgroundInterstitial pregnancies (IP) can be treated medically or surgically. The most common complication remains hemorrhage. The risk of that may be reduced by elective uterine artery embolization (UAE) prior to surgery, which we applied in two consecutive cases with high vascularization on ultrasound. We also reviewed larger series (n ≥ 10) on medical as well as surgical management of IP on success
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Total laparoscopic hysterectomy for benign disease: outcomes and literature analysis Gynecol. Surg. Pub Date : 2018-11-14 Liliana Mereu, Roberta Carlin, Alice Pellegrini, Francesca Guasina, Valeria Berlanda, Saverio Tateo
ObjectiveTo analyze surgical outcomes of total laparoscopic hysterectomy (TLH) for benign disease.MethodsRetrospective analysis of 361 consecutive cases, prospectively collected from January 2012 to June 2016, of women who underwent TLH in St. Chiara Hospital in Trento, Italy. Clinical, demographic, surgical, and intra and perioperative data were recorded. Complications were graded on the Clavien-Dindo
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A PET-positive rapidly growing mass of the abdominal wall after cesarean section with an unexpected diagnosis of vernix caseosa granuloma: a case report Gynecol. Surg. Pub Date : 2018-10-10 Antonio Macciò, Paraskevas Kotsonis, Fabrizio Lavra, Giacomo Chiappe, Ester Mura, Luca Melis, Clelia Madeddu
BackgroundAbdominal wall tumors are rare and include heterogeneous diseases. Among them, desmoid tumors are the most frequent and are often diagnosed in young women during or early after pregnancy; inflammatory response after trauma or microtrauma, such as after cesarean section, may favor their growth.ResultsA 37-year-old woman presented with a progressive mass in the abdominal wall after a cesarean
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Comparing self-assessment of laparoscopic technical skills with expert opinion for gynecological surgeons in an operative setting Gynecol. Surg. Pub Date : 2018-09-26 Rami Kilani
BackgroundCompetence in laparoscopic skills is important for all gynaecological surgeons. Most residency programmes teach technical skills in the operating room and through lectures, where the evaluation of surgical skills is usually done through subjective evaluation. After graduating residency, most surgeons depend on themselves to decide if they are competent in performing a certain procedure. The
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Laparoscopic-guided transversus abdominis plane block versus trocar site local anesthetic infiltration in gynecologic laparoscopy Gynecol. Surg. Pub Date : 2018-09-17 Ibrahim A. El sharkwy, Elsayed H. Noureldin, Ekramy A. Mohamed, Ali A. Mohamed
BackgroundRelieving postoperative pain and prompt resumption of physical activity are of the utmost importance for the patients and surgeons. Infiltration of local anesthetic is frequently used methods of pain control postoperatively. Laparoscopically delivered transversus abdominis plane block is a new modification of ultrasound-guided transversus abdominis plane block.This study was conducted to
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Feasibility of sentinel lymph node fluorescence detection during robotic laparoendoscopic single-site surgery in early endometrial cancer: a prospective case series Gynecol. Surg. Pub Date : 2018-08-22 Liliana Mereu, Alice Pellegrini, Roberta Carlin, Erica Terreno, Claudia Prasciolu, Saverio Tateo
BackgroundIn the last few decades, the introduction of technologies such as single-site surgery, robotics, and sentinel lymph node detection has reduced invasiveness in the treatment and staging of endometrial cancer patients. The goal of the present prospective cohort study is to evaluate the feasibility of lymph node fluorescence detection with robotic single-site approach in low-risk endometrial
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Chronic pelvic pain and the role of exploratory laparoscopy as diagnostic and therapeutic tool: a retrospective observational study Gynecol. Surg. Pub Date : 2018-07-20 Géraldine Brichant, Marie Denef, Linda Tebache, Gaëlle Poismans, Serena Pinzauti, Valérie Dechenne, Michelle Nisolle
BackgroundForty percent of exploratory laparoscopies are performed for chronic pelvic pain (CPP). However, a final diagnosis is still unreported in 35% of the patients. We decided to evaluate the identification of pathological lesions and the improvement of painful symptoms in patients with CPP and normal physical examination and imaging and who are scheduled for exploratory laparoscopy. The prospective
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Fertility outcome after treatment of retained products of conception: a systematic review Gynecol. Surg. Pub Date : 2018-07-16 Tjalina W. O. Hamerlynck, Dora Meyers, Hannelore Van der Veken, Jan Bosteels, Steven Weyers
BackgroundTreatment of retained products of conception (RPOC) can be expectant, medical or operative. Surgical removal of RPOC may lead to intrauterine adhesions (IUA) and Asherman’s syndrome.ObjectiveTo evaluate how treatment options for RPOC affect future fertility by means of a systematic review.Search strategyMEDLINE, EMBASE, The Cochrane Library, and clinical trial registers were searched, and
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Laparoscopic sacrocolpopexy is as safe in septuagenarians or elder as in younger women Gynecol. Surg. Pub Date : 2018-06-05 Karlien Vossaert, Susanne Housmans, Stefaan Pacquée, Geertje Callewaert, Laura Cattani, Frank Van der Aa, Albert Wolthuis, André D’hoore, Philip Roelandt, Jan Deprest
BackgroundData concerning laparoscopic sacrocolpopexy (LSCP) in elder women are scarce. We compared intra-operative and early-postoperative complications associated with laparoscopic colpo-, cervico-, or hysteropexy in women under and above 70 years.MethodsRetrospective assessment by an independent investigator of a prospective cohort of 571 consecutive women undergoing LSCP in a tertiary unit over
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Correction to: Prevalence and predictors of burnout among obstetrics and gynecology residents in Canada Gynecol. Surg. Pub Date : 2018-05-22 Na’ama O. Al-Ma’mari, Ashley I. Naimi, Togas Tulandi
Following the publication of this article [1], the authors have removed the “Maslach Burnout Inventory, Forms: General Survey, Human Services Survey & Educators Survey” from the supplementary materials of the article [1] due to copyright restrictions.
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Fetoscopic endoluminal tracheal occlusion and reestablishment of fetal airways for congenital diaphragmatic hernia Gynecol. Surg. Pub Date : 2018-05-08 Lennart Van der Veeken, Francesca Maria Russo, Luc De Catte, Eduard Gratacos, Alexandra Benachi, Yves Ville, Kypros Nicolaides, Christoph Berg, Glenn Gardener, Nicola Persico, Pietro Bagolan, Greg Ryan, Michael A. Belfort, Jan Deprest
BackgroundCongenital diaphragmatic hernia (CDH) is a congenital anomaly with high mortality and morbidity mainly due to pulmonary hypoplasia and hypertension. Temporary fetal tracheal occlusion to promote prenatal lung growth may improve survival. Entrapment of lung fluid stretches the airways, leading to lung growth.MethodsFetal endoluminal tracheal occlusion (FETO) is performed by percutaneous sono-endoscopic
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Surgical outcomes of laparoscopic hysterectomy with concomitant endometriosis without bowel or bladder dissection: a cohort analysis to define a case-mix variable Gynecol. Surg. Pub Date : 2018-03-16 Evelien M. Sandberg, Sara R. C. Driessen, Evelien A. T. Bak, Nan van Geloven, Judith P. Berger, Mathilde J. G. H. Smeets, Johann P. T. Rhemrev, Frank Willem Jansen
BackgroundPelvic endometriosis is often mentioned as one of the variables influencing surgical outcomes of laparoscopic hysterectomy (LH). However, its additional surgical risks have not been well established. The aim of this study was to analyze to what extent concomitant endometriosis influences surgical outcomes of LH and to determine if it should be considered as case-mix variable.ResultsA total