Comparison of laparoscopy-assisted vaginal hysterectomy as endoscopic single-station surgery and conventional laparoscopic hysterectomy —surgical effects on safety and quality of life
ConclusionLESS hysterectomy is a reliable and safe option in gynecologic surgery. Compared to conventional laparoscopic hysterectomy, LESS surgery demonstrated comparable surgical properties in regard to blood loss, duration of surgery, and intra-/postoperative complications. Notably, patients undergoing LESS hysterectomy experienced some less pain postoperatively. (Source: Gynecological Surgery)
Source: Gynecological Surgery - August 16, 2019 Category: OBGYN Source Type: research

Correction to: Comparing self-assessment of laparoscopic technical skills with expert opinion for gynecological surgeons in an operative setting
In the publication of this article [1], the contributing author Wesam Aleyadeh was missing. This has now been updated in this correction. (Source: Gynecological Surgery)
Source: Gynecological Surgery - May 27, 2019 Category: OBGYN Source Type: research

Prediction of unsuccessful endometrial ablation: a retrospective study
ConclusionWe propose two multivariate models to predict the chance of failure and surgical re-intervention within 2  years after EA. Due to the permanent character of EA, the increasing number of post-operative failure and re-interventions, these prediction models could be useful for both the doctor and patient and may contribute to the shared decision-making. (Source: Gynecological Surgery)
Source: Gynecological Surgery - May 1, 2019 Category: OBGYN Source Type: research

Implementing robotic assisted myomectomy in surgical practice – a retrospective cohort study
AbstractBackgroundTo 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 of the primary fibroid, type, and location), operating time, blood loss, hospitalization length, complications during and after surgery, and complications during posttreatment pregnancies. Comparisons were based on chi-...
Source: Gynecological Surgery - April 1, 2019 Category: OBGYN Source Type: research

A value-based evaluation of minimally invasive hysterectomy approaches
AbstractBackgroundWith 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 direct hospital costs.MethodsSequential mixed methods; retrospective chart review of all women (N = 2689) ≥ 18 years old who underwent hysterectomy for benign conditions from 2011 through 20...
Source: Gynecological Surgery - March 18, 2019 Category: OBGYN Source Type: research

Gasless laparoendoscopic single-site surgery with intraoperative autologous blood transfusion for management of ectopic pregnancy with significant hemoperitoneum: a retrospective observational study
ConclusionGasless LESS surgery with intraoperative autologous blood transfusion is a feasible minimally invasive surgical option with avoidance to use homologous blood for management of selected cases of ectopic pregnancy even with significant hemoperitoneum. (Source: Gynecological Surgery)
Source: Gynecological Surgery - March 5, 2019 Category: OBGYN Source Type: research

Symptomatic endometriosis developing several years after menopause in the absence of increased circulating estrogen concentrations: a systematic review and seven case reports
ConclusionsSymptomatic and clinically progressive endometriosis after menopause in the absence of increased systemic estrogen concentrations or exogenous estrogen intake starts more than 10  years after menopause in the majority of women. This observation suggests that a genetic and/or epigenetic incident caused estrogen-independent progression, increased sensitivity to estrogens or increased local production of estrogens. This observation is important for understanding the pathophys iology of endometriosis, for the management of postmenopausal endometriosis, and for individualization of medical therapy of endometri...
Source: Gynecological Surgery - February 15, 2019 Category: OBGYN Source Type: research

The diagnosis and management of interstitial ectopic pregnancies: a review
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 data, we set out to determine what the b est evidence-based practice for the management of interstitial ectopic pregnancies is, what protocols can be used and whether this improves post-operative outcomes and ...
Source: Gynecological Surgery - February 4, 2019 Category: OBGYN Source Type: research

Pelvic exenteration in gynecologic cancer: complications and oncological outcome
ConclusionsPE provides about a 40% 4-year survival chance in a selected group of patients. The early-complications rate and 30-day mortality were acceptable. Nevertheless, the medium-late complication grades II –V were 65, 48, 18 and 9%, respectively. We must focus on identifying those patients who could potentially benefit most from PE. (Source: Gynecological Surgery)
Source: Gynecological Surgery - January 28, 2019 Category: OBGYN Source Type: research

Didactic lectures versus simulation training: a randomised pilot evaluation of its impact on surgical skill
ConclusionsThis study clearly demonstrates that exposure to simulation training is superior compared to didactic lecture-based teaching for the acquisition of surgical skills. (Source: Gynecological Surgery)
Source: Gynecological Surgery - December 18, 2018 Category: OBGYN Source Type: research

Safety and efficacy of non-absorbable mesh in contemporary gynaecological surgery
AbstractMesh-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 with mesh-specific complications, underlining the need for shared decision-making between physicians and patients prior to mesh surgery.Transvaginal non-absorbable mesh implants for pelvic organ prolapse are associated wi...
Source: Gynecological Surgery - November 23, 2018 Category: OBGYN Source Type: research

Elective uterine artery embolization prior to laparoscopic resection of interstitial pregnancy: two cases and literature review
ConclusionWe report on the use of elective UAE prior to laparoscopic resection of IP, because of signs of strong vascularization on ultrasound. This strategy coincided with a nearly bloodless operation. Literature review suggests that this is one of the effective methods to reduce blood loss intra-operatively. (Source: Gynecological Surgery)
Source: Gynecological Surgery - November 14, 2018 Category: OBGYN Source Type: research

Total laparoscopic hysterectomy for benign disease: outcomes and literature analysis
ConclusionsTotal laparoscopic hysterectomy is a procedure with a low incidence of complications. Our data compare favorably with the data of the other listed studies. (Source: Gynecological Surgery)
Source: Gynecological Surgery - November 14, 2018 Category: OBGYN Source Type: research

A PET-positive rapidly growing mass of the abdominal wall after cesarean section with an unexpected diagnosis  of vernix caseosa granuloma: a case report
ConclusionsThe present case provides information on an abdominal wall  foreign body granuloma arisen from meconium and vernix caseosa after cesarean section, which presented an atypical clinical picture, mimicking a desmoid, thus requiring a careful diagnostic and treatment approach. (Source: Gynecological Surgery)
Source: Gynecological Surgery - October 10, 2018 Category: OBGYN Source Type: research

Comparing self-assessment of laparoscopic technical skills with expert opinion for gynecological surgeons in an operative setting
ConclusionSelf-assessment of surgical laparoscopic skills is higher than expert evaluation of these technical skills. Quality assurance measures need to be revisited and restructured through more frequent assessments using peer and expert assessment alongside self-assessment. Gynecologists also need to undergo proper assessment prior to starting independently performing procedures that require new skills. (Source: Gynecological Surgery)
Source: Gynecological Surgery - September 26, 2018 Category: OBGYN Source Type: research

Laparoscopic-guided transversus abdominis plane block versus trocar site local anesthetic infiltration in gynecologic laparoscopy
ConclusionLaparoscopic-guided transversus abdominis plane block is more effective in reduction of both pain scores in the early postoperative period and the cumulative narcotics consumption than trocar site local anesthetic infiltration in gynecologic laparoscopy.Trial registrationClinical Trials.govNCT02973451 (Source: Gynecological Surgery)
Source: Gynecological Surgery - September 17, 2018 Category: OBGYN Source Type: research

Feasibility of sentinel lymph node fluorescence detection during robotic laparoendoscopic single-site surgery in early endometrial cancer: a prospective case series
ConclusionsThe present study demonstrates the feasibility and applicability of robotic single-site approach with SLN fluorescence detection for the staging of low-risk endometrial cancer. (Source: Gynecological Surgery)
Source: Gynecological Surgery - August 22, 2018 Category: OBGYN Source Type: research

Chronic pelvic pain and the role of exploratory laparoscopy as diagnostic and therapeutic tool: a retrospective observational study
AbstractBackgroundForty 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 study was designed in a tertiary referral center for endometriosis. Forty-eight patients complaining of CPP and scheduled for exploratory laparoscopy were included. Pelvic pain intensity was assessed using the visua...
Source: Gynecological Surgery - July 20, 2018 Category: OBGYN Source Type: research

Fertility outcome after treatment of retained products of conception: a systematic review
ConclusionThere is insufficient evidence on how different treatment options for RPOC affect future reproductive outcomes. Results from ongoing RCTs are needed to guide clinicians towards choosing the best treatment. (Source: Gynecological Surgery)
Source: Gynecological Surgery - July 16, 2018 Category: OBGYN Source Type: research

Laparoscopic sacrocolpopexy is as safe in septuagenarians or elder as in younger women
AbstractBackgroundData 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 an 18-year period. Data included were patient demographics, operative variables, intra-operative, and early ( ≤ 3 months) postoperative complications. Complications were graded according to the Clavi...
Source: Gynecological Surgery - June 5, 2018 Category: OBGYN Source Type: research

Correction to: Prevalence and predictors of burnout among obstetrics and gynecology residents in Canada
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. (Source: Gynecological Surgery)
Source: Gynecological Surgery - May 22, 2018 Category: OBGYN Source Type: research

Fetoscopic endoluminal tracheal occlusion and reestablishment of fetal airways for congenital diaphragmatic hernia
ConclusionFor left-sided severe and moderate CDH, the procedure is considered investigational and is currently being evaluated in a global randomized clinical trial (https://www.totaltrial.eu/). The procedure can be clinically offered to fetuses with severe right-sided CDH. (Source: Gynecological Surgery)
Source: Gynecological Surgery - May 8, 2018 Category: OBGYN Source Type: research

Surgical outcomes of laparoscopic hysterectomy with concomitant endometriosis without bowel or bladder dissection: a cohort analysis to define a case-mix variable
AbstractBackgroundPelvic 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 of 2655 LH ’s were analyzed, of which 397 (15.0%) with concomitant endometriosis. For blood loss and operative time, no measurable association was found for stages I (n = 106) and II (n =&thin...
Source: Gynecological Surgery - March 16, 2018 Category: OBGYN Source Type: research

Implementation of laparoscopic hysterectomy for endometrial cancer over the past decade
ConclusionsImplementation of laparoscopic hysterectomy for early-stage EC increased from 11 to 85% in 10  years. Implementation of TLH was often preceded by LAVH and was faster in teaching hospitals. (Source: Gynecological Surgery)
Source: Gynecological Surgery - February 27, 2018 Category: OBGYN Source Type: research

Feasibility and safety of total laparoscopic hysterectomy for huge uteri without the use of uterine manipulator: description of emblematic cases
ConclusionsAlthough we believe in the great usefulness of the uterine manipulator in performing TLH for huge uteri, in the present paper, we demonstrate the feasibility and safety of such complex surgery also when the use of this tool is not possible due to unfavorable anatomical condition. (Source: Gynecological Surgery)
Source: Gynecological Surgery - February 26, 2018 Category: OBGYN Source Type: research

Correction to: Cadaveric surgery in core gynaecology training: a feasibility study
CorrectionAfter publication of the original article [1] it was brought to our attention that author Laura Delgaty was incorrectly included as Laura Delegate. The correct spelling of the author ’s name is included in the author list of this correction and updated in the original article. (Source: Gynecological Surgery)
Source: Gynecological Surgery - February 19, 2018 Category: OBGYN Source Type: research

Cadaveric surgery in core gynaecology training: a feasibility study
ConclusionsIt is pragmatically feasible to provide procedure-specific cadaveric surgical training alongside supervised clinical training. This small, non-generalisable study suggests that cadaveric training may contribute to an increase in surgical self-confidence and efficacy. This will form the basis of a larger study and needs to be explored in more depth with a larger population. (Source: Gynecological Surgery)
Source: Gynecological Surgery - January 16, 2018 Category: OBGYN Source Type: research

Clinical characteristic and intraoperative findings of uterine perforation patients in using of intrauterine devices (IUDs)
ConclusionsUnique clinical characteristics of IUD migration were identified in patients with uterine perforation. Hysteroscopy and/or laparoscopy were the effective approaches to remove the migrated IUDs. Improving operating skills is required at the lower level of health care system. (Source: Gynecological Surgery)
Source: Gynecological Surgery - January 16, 2018 Category: OBGYN Source Type: research

Cadaveric surgery in core gynaecology training: a feasibility study
ConclusionsIt is pragmatically feasible to provide procedure-specific cadaveric surgical training alongside supervised clinical training. This small, non-generalisable study suggests that cadaveric training may contribute to an increase in surgical self-confidence and efficacy. This will form the basis of a larger study and needs to be explored in more depth with a larger population. (Source: Gynecological Surgery)
Source: Gynecological Surgery - January 16, 2018 Category: OBGYN Source Type: research

Clinical characteristic and intraoperative findings of uterine perforation patients in using of intrauterine devices (IUDs)
ConclusionsUnique clinical characteristics of IUD migration were identified in patients with uterine perforation. Hysteroscopy and/or laparoscopy were the effective approaches to remove the migrated IUDs. Improving operating skills is required at the lower level of health care system. (Source: Gynecological Surgery)
Source: Gynecological Surgery - January 16, 2018 Category: OBGYN Source Type: research

Safety aspects of hysteroscopy, specifically in relation to entry and specimen retrieval: a UK survey of practice
ConclusionThis study highlights varied practice across the UK regarding safety aspects of hysteroscopy, in relation to entry and specimen retrieval. There is a need for increased awareness of the risks of hysteroscopy and paramount precautions that should be performed routinely as part of their practice. Standardised guidelines may be a beneficial tool to help bring about this change in practice, leading to a reduction in uterine perforation rates. (Source: Gynecological Surgery)
Source: Gynecological Surgery - January 15, 2018 Category: OBGYN Source Type: research

A long-term cohort study of surgery for recurrent prolapse comparing mesh augmented anterior repairs to anterior colporrhaphy
ConclusionsA vaginal mesh repair using a non-absorbable trans-obturator mesh has improved satisfaction compared to an anterior colporrhaphy. (Source: Gynecological Surgery)
Source: Gynecological Surgery - January 10, 2018 Category: OBGYN Source Type: research

A randomized control trial to evaluate the importance of pre-training basic laparoscopic psychomotor skills upon the learning curve of laparoscopic intra-corporeal knot tying
AbstractBackgroundTraining of basic laparoscopic psychomotor skills improves the acquisition of more advanced laparoscopic tasks, such as laparoscopic intra-corporeal knot tying (LICK). This randomized controlled trial was designed to evaluate whether pre-training of basic skills, as laparoscopic camera navigation (LCN), hand-eye coordination (HEC), and bimanual coordination (BMC), and the combination of the three of them, has any beneficial effect upon the learning curve of LICK. The study was carried out in a private center in Asunci ón, Paraguay, by 80 medical students without any experience in surgery. Four lapa...
Source: Gynecological Surgery - December 20, 2017 Category: OBGYN Source Type: research

Recommendations for the surgical treatment of endometriosis —part 1: ovarian endometrioma
AbstractStudy questionWhat does this document on the surgical treatment of endometriosis jointly prepared by the European Society for Gynaecological Endoscopy (ESGE), ESHRE, and the World Endometriosis Society (WES) provide?Summary answerThis document provides recommendations covering technical aspects of different methods of surgery for endometriomas in women of reproductive age.What is already knownEndometriomas (ovarian endometriotic cysts) are a commonly diagnosed form of endometriosis, owing to the relative ease and accuracy of ultrasound diagnosis. They frequently present a clinical dilemma as to whether and how to t...
Source: Gynecological Surgery - December 19, 2017 Category: OBGYN Source Type: research

Treating symptomatic uterine fibroids with myomectomy: current practice and views of UK consultants
(Source: Gynecological Surgery)
Source: Gynecological Surgery - December 19, 2017 Category: OBGYN Source Type: research