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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
Masayuki Endo, Iva Urbankova, Jaromir Vlacil, Siddarth Sengupta, Thomas Deprest, Bernd Klosterhalfen, Andrew Feola, Jan Deprest
The properties of meshes used in reconstructive surgery affect the host response and biomechanical characteristics of the grafted tissue. Whereas durable synthetics induce a chronic inflammation, biological grafts are usually considered as more biocompatible. The location of implantation is another determinant of the host response: the vagina is a different environment with specific function and anatomy. Herein, we evaluated a cross-linked acellular collagen matrix (ACM), pretreated by the anti-calcification procedure ADAPT® in a sheep model for vaginal surgery...
2015: Gynecological Surgery
Nicole M Donnellan, Suketu Mansuria, Nancy Aguwa, Deirdre Lum, Leslie Meyn, Ted Lee
Studies have shown an increased risk of vaginal cuff dehiscence following total laparoscopic hysterectomy (TLH). Patient variables associated with dehiscence have not been well described. This study aims to identify factors associated with dehiscence following varying routes of total hysterectomy. This is a retrospective, matched, case-control study of women who underwent a total hysterectomy at a large, urban, university-based teaching hospital from January 2000 to December 2011. Women who underwent a total hysterectomy and had a dehiscence (n = 31) were matched by surgical mode to the next five total hysterectomies (n = 155)...
2015: Gynecological Surgery
Marlies Bongers, Hans Brölmann, Janesh Gupta, José Gerardo Garza-Leal, David Toub
This was a prospective, longitudinal, multicenter, single-arm controlled trial, using independent core laboratory validation of MRI results, to establish the effectiveness and confirm the safety of the VizAblate® System in the treatment of symptomatic uterine fibroids. The VizAblate System is a transcervical device that ablates fibroids with radiofrequency energy, guided by a built-in intrauterine ultrasound probe. Fifty consecutive women with symptomatic uterine fibroids received treatment with the VizAblate System...
2015: Gynecological Surgery
Philippe R Koninckx, Jasper Verguts, Roberta Corona, Leila Adamyan, Ivo Brosens
The aim of this study is to verify that 10 % of N2O in CO2 sufficiently reduces pain to permit laparoscopy under local anesthesia. In nine patients undergoing laparoscopy under local anesthesia for tubal sterilization, a mixture of 86 % of CO2, 10 % of N2O, and 4 % of oxygen (the Gas Mixture) was used for the pneumoperitoneum. For CO2, N2O, and for the Gas Mixture, the pain when blowing over the tongue tip and the pH changes of saline and Hartmann's solution were estimated. In all nine patients, discomfort was minimal and the intervention was well tolerated, similar to 100 % N2O...
2015: Gynecological Surgery
Zhang Huanxiao, Chen Shuqin, Jiang Hongye, Xie Hongzhe, Niu Gang, Xu Chengkang, Guan Xiaoming, Yao Shuzhong
To propose a novel procedure as a safe and effective treatment for cesarean scar pregnancy (CSP), a cohort study was initiated in patients diagnosed with CSP and treated with transvaginal hysterotomy from December 2009 to March 2013, either as a primary or secondary therapy. All diagnoses were confirmed by both sonography and pathology, either a gestational sac or residual tissue after termination of pregnancy or miscarriage in the cesarean section scar. Basic clinical characteristics and perioperative data were collected and analyzed...
2015: Gynecological Surgery
Stephan Gordts, Patrick Puttemans, Sylvie Gordts, Ivo Brosens
The incidence and severity of endometriosis in adolescent are comparable with the incidence in adult women. The mean delay between the onset of symptoms and the final diagnosis varies between 6.4 and 11.7 years. The longer the diagnosis is delayed, the more the endometriosis can progress to a more severe stage certainly in the group of patients with pelvic pain. The evolution of endometriosis and its progressivity are not predictable, and the severity of the disease is not directly related to the degree of pain...
2015: Gynecological Surgery
Hans Brölmann, Vasilios Tanos, Grigoris Grimbizis, Thomas Ind, Kevin Philips, Thierry van den Bosch, Samir Sawalhe, Lukas van den Haak, Frank-Willem Jansen, Johanna Pijnenborg, Florin-Andrei Taran, Sara Brucker, Arnaud Wattiez, Rudi Campo, Peter O'Donovan, Rudy Leon de Wilde
In laparoscopy, specimens have to be removed from the abdominal cavity. If the trocar opening or the vaginal outlet is insufficient to pass the specimen, the specimen needs to be reduced. The power morcellator is an instrument with a fast rotating cylindrical knife which aims to divide the tissue into smaller pieces or fragments. The Food and Drug Administration (FDA) issued a press release in April 2014 that discouraged the use of these power morcellators. This article has the objective to review the literature related to complications by power morcellation of uterine fibroids in laparoscopy and offer recommendations to laparoscopic surgeons in gynaecology...
2015: Gynecological Surgery
Antonio Toesca, Oreste Gentilini, Fedro Peccatori, Hatem A Azim, Frederic Amant
The management of patients with breast cancer during pregnancy is very demanding and it should be better performed in highly qualified and experienced centers. Referral to institutes and physicians trained in this special clinical scenario allows reducing the risk of both overtreating and undertreating the patients. Moreover, patients can receive appropriate information regarding safety of treatments without old-fashioned taboo. The purpose of the current paper is to discuss the main issues concerning surgical management and in general locoregional treatment of patients diagnosed with breast cancer and treated during gestation, focusing on those women who chose to continue their pregnancy...
2014: Gynecological Surgery
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