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Gynecological Surgery

Samuel W King, Helen Jefferis, Simon Jackson, Alexander G Marfin, Natalia Price
BACKGROUND: Uterovaginal prolapse in very elderly women is a growing problem due to increased life expectancy. Surgeons and anaesthetists may be wary of performing quality of life surgery on this higher risk group. Where surgery is undertaken, it is commonly performed vaginally; there is a perception that this is better tolerated than abdominal surgery. Little data is published about laparoscopic prolapse surgery tolerability in this population, and laparoscopic surgery is perceived within the urogynaecological community as complex and lengthy and hence inherently unsuitable for the very elderly...
2017: Gynecological Surgery
Kathy Niblock, Emily Bailie, Geoff McCracken, Keith Johnston
BACKGROUND: Studies have shown that vaginal vault prolapse can affect up to 43% of women following hysterectomy for pelvic organ prolapse. Many techniques have been described to prevent and treat vaginal vault prolapse. The primary objective of our study was to compare McCall's culdoplasty (when performed along side vaginal hysterectomy) with laparoscopic uterosacral plication (when performed along side total laparoscopic hysterectomy) for prevention of vaginal vault prolapse. Secondary outcomes included inpatient stay and perioperative complications...
2017: Gynecological Surgery
Georgina Baines, Simon R Jackson, Natalia Price
No abstract text is available yet for this article.
2017: Gynecological Surgery
Liisu Saavalainen, Oskari Heikinheimo, Aila Tiitinen, Päivi Härkki
Urinary tract endometriosis (UTE) is a rare form of deep infiltrating endometriosis. We studied the operative treatment of UTE and evaluated postoperative recurrences and fertility outcomes. This is a retrospective cohort study of 53 women who underwent operative treatment for UTE in 2004-2013 at Helsinki University Hospital, and were followed-up until the end of 2014. The data were gathered from the hospital's electronic database. The main outcome measures were complications, reoperations, postoperative pregnancies, and deliveries...
2016: Gynecological Surgery
Carlos Roger Molinas, Rudi Campo
This follow-up RCT was conducted to evaluate laparoscopic psychomotor skills retention after finishing a structured training program. In a first study, 80 gynecologists were randomly allocated to four groups to follow different training programs for hand-eye coordination (task 1) with the dominant hand (task 1-a) and the non-dominant hand (task 1-b) and laparoscopic intra-corporeal knot tying (task 2) in the Laparoscopic Skills Testing and Training (LASTT) model. First, baseline skills were tested (T1). Then, participants trained task 1 (G1: 1-a and 1-b, G2: 1-a only, G3 and G4: none) and then task 2 (all groups but G4)...
2016: Gynecological Surgery
Chantal C J Alleblas, Michel P H Vleugels, Theodoor E Nieboer
Haptic feedback is drastically reduced in laparoscopic surgery compared to open surgery. Introducing enhanced haptic feedback in laparoscopic instruments might well improve surgical safety and efficiency. In the design process of a laparoscopic grasper with enhanced haptic feedback, handle design should be addressed to strive for optimal usability and comfort. Additionally, the surgeons' perspective on the potential benefits of haptic feedback should be assessed to ascertain the clinical interest of enhanced haptic feedback...
2016: Gynecological Surgery
Natalie A M Cooper, Lee Middleton, Paul Smith, Elaine Denny, Lynda Stobert, Jane Daniels, T Justin Clark
Uterine polyps can cause abnormal bleeding in women. Conventional practise is to remove them under general anaesthesia but advances in technology have made it possible to perform polypectomy in the office setting. We conducted a patient-preference study to explore women's preferences for treatment setting and to evaluate the effectiveness and treatment experience of women undergoing uterine polypectomy. Three hundred ninety-nine women with abnormal uterine bleeding who were found to have uterine polyps at diagnostic hysteroscopy were recruited...
2016: Gynecological Surgery
Sameer Umranikar, T Justin Clark, Ertan Saridogan, Dimitrios Miligkos, Kirana Arambage, Emma Torbe, Rudi Campo, Attilio Di Spiezio Sardo, Vasilios Tanos, Grigoris Grimbizis
No abstract text is available yet for this article.
2016: Gynecological Surgery
Oybek Rustamov, Monica Krishnan, Stephen A Roberts, Cheryl T Fitzgerald
Pelvic surgery can affect ovarian reserve, but estimates of the potential effect of different surgical procedures are lacking. This study examines the markers of ovarian reserve after different procedures in order to help the provision of informed consent before surgery. Anti-Müllerian hormone (AMH), antral follicle count (AFC) and follicle-stimulating hormone (FSH) of women with a history of salpingectomy, ovarian cystectomy or unilateral salpingo-oophorectomy were compared to those without history of surgery using cross-sectional data adjusting for patient and clinical factors in multivariable regression model...
2016: Gynecological Surgery
Rudi Campo, Arnaud Wattiez, Vasilis Tanos, Attilio Di Spiezio Sardo, Grigoris Grimbizis, Diethelm Wallwiener, Sara Brucker, Marco Puga, Roger Molinas, Peter O'Donovan, Jan Deprest, Yves Van Belle, Ann Lissens, Anja Herrmann, Mahmood Tahir, Chiara Benedetto, Igno Siebert, Benoit Rabischong, Rudy Leon De Wilde
In recent years, training and education in endoscopic surgery has been critically reviewed. Clinicians, both surgeons as gynaecologist who perform endoscopic surgery without proper training of the specific psychomotor skills, are at higher risk to increased patient morbidity and mortality. Although the apprentice-tutor model has long been a successful approach for training of surgeons, recently, clinicians have recognised that endoscopic surgery requires an important training phase outside the operating theatre...
2016: Gynecological Surgery
Geertje Callewaert, Jan Bosteels, Susanne Housmans, Jasper Verguts, Ben Van Cleynenbreugel, Frank Van der Aa, Dirk De Ridder, Ignace Vergote, Jan Deprest
The use of robot-assisted surgery (RAS) has gained popularity in the field of gynaecology, including pelvic floor surgery. To assess the benefits of RAS, we conducted a systematic review of randomized controlled trials comparing laparoscopic and robotic-assisted sacrocolpopexy. The Cochrane Library (1970-January 2015), MEDLINE (1966 to January 2015), and EMBASE (1974 to January 2015) were searched, as well as and the International Clinical Trials Registry Platform. We identified two randomized trials (n = 78) comparing laparoscopic with robotic sacrocolpopexy...
2016: Gynecological Surgery
J Mairos, P Di Martino
According to World Health Organization (WHO), about 1 out of 10 hospitalized patients suffers an adverse event, in developed countries, being an adverse event an injury related to medical management, in contrast to complications of disease. These events cause both unnecessary suffering and huge cost to health systems. This issue is so important that WHO has defined it as a global health problem and in 2004 launched the World Alliance for Patient Safety, with the aim to coordinate, disseminate and accelerate improvements in Patient Safety...
2016: Gynecological Surgery
Thierry Van den Bosch
No abstract text is available yet for this article.
2016: Gynecological Surgery
L van den Haak, J P T Rhemrev, M D Blikkendaal, A C M Luteijn, J J van den Dobbelsteen, S R C Driessen, F W Jansen
New surgical techniques and technology have simplified laparoscopic hysterectomy and have enhanced the safety of this procedure. However, the surgical colpotomy step has not been addressed. This study evaluates the surgical colpotomy step in laparoscopic hysterectomy with respect to difficulty and duration. Furthermore, it proposes an alternative route that may simplify this step in laparoscopic hysterectomy. A structured interview, a prospective cohort study, and a problem analysis were performed regarding experienced difficulty and duration of surgical colpotomy in laparoscopic hysterectomy...
2016: Gynecological Surgery
Zainab Kazmi, Sujata Gupta, Michael Dobson
Hydrosalpinx is a rare cause of abdominal pain in paediatric patients, though cases are documented in the literature. Its aetiology differs considerably from traditional hydrosalpinx due to ascending sexually transmitted infection. Hydrosalpinx can resent mimicking an acute abdomen or can be asymptomatic. Management of paediatric hydrosalpinx varies but often involves surgical removal of the affected tube. A 12-year-old girl presented with left-sided acute abdominal pain setting within 24 h. Initial ultrasound scan suggested presence of hydrosalpinx...
2016: Gynecological Surgery
Nataša Kenda Šuster, Marco Gergolet
The aim of the study was to evaluate whether hysteroscopic metroplasty for septate uterus represents a risk factor of adverse outcome in pregnancy, during labor, and after delivery. This is a retrospective comparative study of obstetric complications of 99 patients who underwent hysteroscopic metroplasty in a 5-year period (study group) and 4155 women, who gave birth in the same hospital in the same period (control group). No difference in obstetric outcome (preterm labor, hemorrhage before and after delivery, mean weeks of gestation at delivery, mean birth weight, breech presentation, and cesarean section rate) between the two groups has been found...
2016: Gynecological Surgery
Hans Brölmann, Marlies Bongers, José Gerardo Garza-Leal, Janesh Gupta, Sebastiaan Veersema, Rik Quartero, David Toub
The FAST-EU Trial was designed to establish the effectiveness and confirm the safety of transcervical intrauterine sonography-guided radiofrequency ablation with the VizAblate™ System in the treatment of symptomatic uterine fibroids. This was a multicenter, prospective, single-arm trial involving academic and community hospitals in the United Kingdom, the Netherlands, and Mexico. Women with qualifying uterine fibroids and heavy menstrual bleeding underwent intrauterine sonography-guided transcervical radiofrequency ablation (RFA) with the VizAblate System; anesthesia was individualized...
2016: Gynecological Surgery
Grigoris F Grimbizis, Attilio Di Spiezio Sardo, Sotirios H Saravelos, Stephan Gordts, Caterina Exacoustos, Dominique Van Schoubroeck, Carmina Bermejo, Nazar N Amso, Geeta Nargund, Dirk Timmermann, Apostolos Athanasiadis, Sara Brucker, Carlo De Angelis, Marco Gergolet, Tin Chiu Li, Vasilios Tanos, Basil Tarlatzis, Roy Farquharson, Luca Gianaroli, Rudi Campo
What is the recommended diagnostic work-up of female genital anomalies according to the European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynaecological Endoscopy (ESGE) system? The ESHRE/ESGE consensus for the diagnosis of female genital anomalies is presented. Accurate diagnosis of congenital anomalies still remains a clinical challenge due to the drawbacks of the previous classification systems and the non-systematic use of diagnostic methods with varying accuracy, with some of them quite inaccurate...
2016: Gynecological Surgery
Pietro Gambadauro, Ramesan Navaratnarajah, Vladimir Carli
This review summarises current understanding and research on the association between anxiety and outpatient hysteroscopy. Women undergoing hysteroscopy suffer from significant levels of anxiety, with repercussions on pain perception, success rates and satisfaction. Using validated tools such as the Spielberger State-Trait Anxiety Index (STAI) or the Hospital Anxiety and Depression Scale (HADS) in the outpatient hysteroscopy setting, average state anxiety scores similar or greater than those measured before more invasive procedures under general anaesthesia have been consistently reported...
2015: Gynecological Surgery
Elizabeth A Pritts, David J Vanness, Jonathan S Berek, William Parker, Ronald Feinberg, Jacqueline Feinberg, David L Olive
There is a concern regarding the risk of occult leiomyosarcomas found at surgery for presumed benign fibroids. We sought to produce a comprehensive review of published data addressing this issue and provide high-quality prevalence estimates for clinical practice and future research. A comprehensive literature search using the PubMed/MEDLINE database and the Cochrane Library was performed. Inclusion criteria were human studies, peer-reviewed, with original data, involving cases for surgery in which fibroid-related indications were the primary reason for surgery, and histopathology was provided...
2015: Gynecological Surgery
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