Preoperative Ultrasound Indications Determine Excision Technique for Bowel Surgery for Deep Infiltrating Endometriosis: A Single, High Volume Center

Publication date: Available online 31 January 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Mario Malzoni, Lucia Casarella, Marina Coppola, Francesca Falcone, Domenico Iuzzolino, Marianna Rasile, Alessandra Di GiovanniABSTRACTStudy objectiveTo identify bowel nodule features of deep infiltrating endometriosis (DIE) measured via preoperative ultrasound (US) that influence laparoscopic surgical strategy.DesignA retrospective studySettingMalzoni Clinic – Endoscopica Malzoni Department, Center for Advanced Endoscopic Gynecological Surgery, Avellino - ItalyPatientsPatients undergoing laparoscopic surgery between January 1, 2014 and December 31, 2018 for clinically suspected DIE with previous US evaluation ≤ 1 month before intervention.InterventionUse of US measurements to determine laparoscopic excision technique (segmental bowel resection, discoid resection, shaving) for DIE with bowel involvement.Measurements and main resultsOf 5051 DIE surgeries, 4983 were included; 1494 (29.9%) bowel resections (512 bowel segmental resections and 982 nodulectomies [967 shaving and 15 discoid resections]) were performed, accounting for 34.3% and 65.7% of all bowel procedures, respectively. Preoperative US findings and surgical reports were collected. Sensitivity and specificity of preoperative ultrasound evaluation for all types of DIE lesions were calculated, and US measurements of bowel nodules and different surgical techniques were compared. According to US preoperat...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research

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Publication date: Available online 29 February 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Mathew Leonardi, Mercedes Espada, Sarah Choi, Danny Chou, Tim Chang, Christopher Smith, Katrina Rowan, George Condous
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Abstract OBJECTIVE: This distorted anatomical state of pouch of Douglas (POD) obliteration can be predicted with a high degree of certainty and reproducibility using the dynamic transvaginal ultrasound (TVS) sliding sign technique. Studies on POD obliteration prediction have always focused on populations in tertiary care centers with high endometriosis prevalence. In addition to patients with symptomatic endometriosis, POD obliteration may exist in individuals with asymptomatic endometriosis or other etiologies such as pelvic inflammatory disease (PID), pelvic tuberculosis, or surgical scarring. For most abdominal...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
Authors: Dinh T, Leonardi M, Espada M, Vanza K, Condous G Abstract The gold standard for diagnosis of endometriosis remains direct visualization at laparoscopy and histological confirmation. However, ultrasound is emerging as a key modality in detecting endometriosis. This case demonstrates how ultrasound has the ability to detect lesions that may not be visible on laparoscopy. A left uterosacral ligament (LUSL) deep endometriosis (DE) nodule was detected on preoperative ultrasound. During laparoscopy, no abnormalities were visualized at that site. Given ultrasound's high specificity for DE, the LUSL was resected; ...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
Publication date: Available online 29 February 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Mathew Leonardi, Mercedes Espada, Sarah Choi, Danny Chou, Tim Chang, Christopher Smith, Katrina Rowan, George Condous
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
To evaluate the diagnostic accuracy of transvaginal ultrasound in predicting a laparoscopic, surgically assigned, revised American Society of Reproductive Medicine (ASRM) endometriosis stage.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Original Article Source Type: research
Authors: Sachedina A, Todd N Abstract Most adolescents will experience discomfort during menstruation. Due to normalization of dysmenorrhea, there is delay to diagnosis and treatment. Non-steroidal anti-inflammatories are a first line treatment. Adolescents can safely be offered menstrual suppression with combined hormonal contraception, and progestin-only options. When the above are ineffective, gonadotropin releasing hormone agonists with add back treatment can be considered. Transabdominal ultrasound is indicated when first line treatments do not improve symptoms. Endometriosis should be considered in adolescent...
Source: JCRPE Journal of Clinical Research in Pediatric Endocrinology - Category: Endocrinology Tags: J Clin Res Pediatr Endocrinol Source Type: research
We present MRI and CT case examples, together with corresponding laparoscopic and histopathology images to enhance radiologists ’ understanding of this disease.
Source: Abdominal Imaging - Category: Radiology Source Type: research
ConclusionCervicovaginal aplasia can be successfully treated by laparoscopy-assisted neocervicovaginal reconstruction as demonstrated in the video.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
ConclusionCervico-vaginal aplasia can be successfully treated by laparoscopic assisted neocervico-vaginal reconstruction as demonstrated in the video.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
A 41-year-old nulliparous woman underwent assisted reproductive technology (ART) for infertility (stimulation cycles for oocyte retrieval, and embryo transfers). After two biochemical miscarriages, ultrasound and laparoscopy were performed. She reported dysmenorrhea and left sided pelvic pain. Apart from hypothyroidism, her medical history was unremarkable: of note, there was no history of laparoscopic myomectomy. Initial laparoscopy revealed “bubbles of angry-looking tissue”: biopsy reported endometriosis; cytology on peritoneal washings was negative for malignancy.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Images in Gynecological Surgery Source Type: research
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