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Gynecological laparoscopy

M Ballester, H Roman
Deep endometriosis with colorectal involvement is considered one of the most severe forms of the disease due to its impact on patients' quality of life and fertility but also by the difficulties encountered by the clinicians when proposing a therapeutic strategy. Although the literature is very rich, evidence based medicine remains poor explaining the great heterogeneity concerning the management of such patients. Surgery therefore remains a therapeutic option. It improves the intensity of gynecological, digestive and general symptoms and the quality of life...
March 10, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Ricardo Dos Reis, Carlos E M C Andrade, Michael Frumovitz, Mark Munsell, Pedro T Ramirez
STUDY OBJECTIVE: The goal of our study is to compare outcomes of radical hysterectomy (RH) across age groups based on surgical approach. DESIGN: Cross-sectional study. CANADIAN TASK FORCE CLASSIFICATION: II-2 SETTING: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center. PATIENTS: We retrospectively reviewed patients with early-stage cervical cancer who underwent RH at a tertiary cancer center from 1990 to 2013...
March 9, 2018: Journal of Minimally Invasive Gynecology
A Tardieu, F Sire, T Gauthier
OBJECTIVE: To provide clinical practice guidelines from the French college of obstetrics and gynecology (CNGOF) with the Haute Autorité de santé (HAS), based on the best evidence available, concerning the diagnosis accuracy of endoscopy (laparoscopy, hysteroscopy, fertiloscopy, cystoscopy, colonoscopy) in case of endometriosis. MATERIAL AND METHODS: English and French review of literature about the diagnosis accuracy of endoscopy in case of endometriosis. RESULTS AND CONCLUSION: Laparoscopy is useful in case of suspected endometriosis in patients with symptoms or infertility when appropriate preoperative assessment is negative (grade C)...
March 9, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Kurt Barnhart, Linda Giudice, Steve Young, Tracey Thomas, Michael P Diamond, James Segars, Wahid A Youssef, Stephen Krawetz, Nanette Santoro, Esther Eisenberg, Heping Zhang
OBJECTIVE: Endometriosis is a chronic, estrogen dependent condition that affects 5-10% of reproductive aged women and is associated with pelvic pain and infertility. As the approach to therapy shifts from surgical ablation to pharmacological control, a non-surgical mode of diagnosis would be desirable. The ENDOmarker study was designed by the NICHD Reproductive Medicine Network (RMN) to obtain well characterized and phenotyped bio specimens in a standardized fashion from women with and without endometriosis...
March 7, 2018: Contemporary Clinical Trials
Julia Caroline Radosa, Marc Philipp Radosa, Pascal Albert Schweitzer, Ingolf Juhasz-Boess, Stefan Rimbach, Erich-Franz Solomayer
PURPOSE: The purpose of this survey was to assess the opinions of members of the German Society of Gynecologic Endoscopy (AGE) regarding the laparoscopic treatment of ovarian malignancies and current practice at their institutions. METHODS: Between February and October 2015, the AGE sent an anonymous online survey via mail to its members. The questionnaire solicited participants' opinions about the laparoscopic treatment of ovarian cancers according to T stage and borderline tumors, and information about current practice at their institutions...
March 8, 2018: Archives of Gynecology and Obstetrics
Valerio Celentano, Neil Smart, John McGrath, Ronan A Cahill, Antonino Spinelli, Andreas Obermair, Hirotoshi Hasegawa, Pawanindra Lal, Alex M Almoudaris, Charlotte R Hitchins, Gianluca Pellino, Matthew G Browning, Takashi Ishida, Federico Luvisetto, Pinar Cingiloglu, Katherine Gash, Rhiannon Harries, Deena Harji, Francesca Di Candido, Elisa Cassinotti, Frank D McDermott, James E A Berry, Nick J Battersby, Esther Platt, Nicholas J Campain, Barrie D Keeler, Luigi Boni, Sharmila Gupta, John P Griffith, Austin G Acheson, Tom D Cecil, Mark G Coleman
OBJECTIVE: Consensus statement by an international multispecialty trainers and trainees expert committee on guidelines for reporting of educational videos in laparoscopic surgery. SUMMARY OF BACKGROUND DATA: Instructive laparoscopy videos with appropriate exposition could be ideal for initial training in laparoscopic surgery, but there are no guidelines for video annotation or procedural educational and safety evaluation. METHODS: Delphi questionnaire of 45 statements prepared by a steering group and voted on over 2 rounds by committee members using an electronic survey tool...
March 5, 2018: Annals of Surgery
Roberto Tozzi, Jvan Casarin, Elizabeth Belcher, Riccardo Garruto Campanile, Lamiese Ismail, Hooman Soleymani Majd, Matteo Morotti, Marcello Desgro
STUDY OBJECTIVE: To describe the first case of a combined endoscopic management of a thoracic and abdominal recurrence of ovarian cancer. DESIGN: An instructive video showing the combined thoracic and abdominal surgical procedure. SETTING: Department of Gynecological Oncology, Churchill Hospital, Oxford University, UK. PATIENTS: A 64-year-old woman undergoing an endoscopic treatment for a third recurrence of ovarian cancer following a full surgical staging in 2007...
March 1, 2018: Journal of Minimally Invasive Gynecology
Jason D Wright, Laura J Havrilesky, David E Cohn, Yongmei Huang, Jill Rathbun, Laurel W Rice, Carol L Brown, Ronald D Alvarez, Emily M Ko
OBJECTIVE: To design an endometrial cancer (EC) alternative payment (ECAP) model focused on surgical management of EC, as well as identify drivers of cost in order to develop opportunities for cost-savings while maintaining quality of care. METHODS: National practice patterns and reimbursements were compared between private payers (MarketScan data, years 2009-13) and public payers (Medicare, year 2014) of EC patients who underwent hysterectomy. An episode of care for EC included the hysterectomy, stratified by surgical approach (laparotomy versus robotic versus laparoscopy), and in- and outpatient reimbursements from 30days preoperatively to 60days postoperatively...
February 26, 2018: Gynecologic Oncology
Ibrahim Alkatout
BACKGROUND: The removal of obstacles from the surgical field is a crucial aspect of any procedure in gynecological, urological or visceral laparoscopic surgery. Reliable instruments and skilled assistance are essential for the smooth execution of procedures. Blunt forceps are commonly used to keep tissue away from the operating field. The range of existing instruments has been enhanced by the introduction of laparoscopic retractors. However, no laparoscopic retractor can be used without causing tissue damage...
February 19, 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
Locke Uppendahl, Caitlin Chiles, Stephanie Shields, Fanglong Dong, Elizabeth Kraft, Jennifer Duong, James Delmore
BACKGROUND: The purpose of this study was to establish compliance with guidelines published by the American College of Obstetricians and Gynecologists (ACOG) regarding prophylactic antibiotic use in gynecologic surgery at our institution, and define areas of improvement to promote antibiotic stewardship. PATIENTS AND METHODS: This was a retrospective cohort study at a single, large tertiary care and teaching hospital in Kansas. Patients who underwent inpatient or outpatient gynecologic surgery during 2013 were included...
February 16, 2018: Surgical Infections
Ahmed M Soliman, Eric Surrey, Machaon Bonafede, James K Nelson, Jane Castelli-Haley
INTRODUCTION: The prevalence of endometriosis and the need for treatment in the USA has led to the need to explore the contemporary cost burden associated with the disease. This retrospective cohort study compared direct and indirect healthcare costs in patients with endometriosis to a control group without endometriosis. METHODS: Women aged 18-49 years with endometriosis (date of initial diagnosis = index date) were identified in the Truven Health MarketScan® Commercial database between 2010 and 2014 and female control patients without endometriosis were matched by age and index year...
February 15, 2018: Advances in Therapy
Ioannis Chatzipapas, Nikolaos Kathopoulis, Athanasios Protopapas, Dimitrios Loutradis
Laparoscopy has gradually expanded its use in gynecologic surgery over the last three decades. In this report, a new laparoscopic setup is presented using a mobile smartphone that allows for a low-cost, portable laparoscopic viewing system. The setup was created with the coupling of a rigid 0 degrees, 10-mm diameter laparoscope via a commercially available adaptor with a smartphone. The light source used was also a portable and rechargeable light-emitting diode (LED) cold light source. We completed 17 diagnostic laparoscopies for different pathologies such as ectopic pregnancy, ovarian torsion, luteal hemorrhagic cyst, and disseminated ovarian cancer...
February 6, 2018: Journal of Minimally Invasive Gynecology
Haruko Kunitomi, Kouji Banno, Hayato Iseki, Asako Sera, Azumi Miyauchi, Yusuke Kobayashi, Shigenori Hayashi, Eiichiro Tominaga, Aya Sasaki, Miho Kawaida, Kaori Kameyama, Daisuke Aoki
Angiosarcoma is a rare malignant tumor with an aggressive clinical course and a poor prognosis. Intraperitoneal angiosarcoma, especially originating from the omentum, is extremely rare. We report a case of radiation-induced angiosarcoma of the omentum that arose in a 38-year-old female seven years after concurrent chemoradiotherapy for cervical cancer. The primary tumor was unknown until diagnostic laparoscopy revealed an unresectable omental mass. Pathological examination revealed high-grade malignant cells positive for endothelial markers...
February 2018: Molecular and Clinical Oncology
Mariano Tamura Vieira Gomes, Andréa Maria Novaes Machado, Sérgio Podgaec, Gustavo Anderman Silva Barison
OBJECTIVE: This article presents the first series of robotic single-port hysterectomy cases performed at a hospital in Brazil. METHODS: From November 2014 to October 2016, 11 patients were indicated to undergo, and nine of them were submitted to single-port hysterectomy using da Vinci Single-Site® platform. However, in two patients, due to multiple previous abdominal surgeries, large uterine volume, and/or a uterus with no mobility, a pneumoperitoneum was performed with a Verres needle, and the pelvic cavity was assessed using a 5mm optics endoscope...
October 2017: Einstein
Alessia Aloisi, Yukio Sonoda, Ginger J Gardner, Kay J Park, Sarah L Elliott, Qin C Zhou, Alexia Iasonos, Nadeem R Abu-Rustum
BACKGROUND: Narrow band imaging (NBI) is an optic filtration enhancement for endoscopy that uses two wavelengths of light (415 and 540 nm) to highlight superficial microvascular patterns. It has been successfully utilized to improve identification of lesions with abnormal vasculature, which is associated with endometriosis and endometrial cancer. Case studies suggest it may also facilitate surgical staging of gynecologic cancer, which is critical in determining appropriate adjuvant therapies...
January 16, 2018: Annals of Surgical Oncology
Ana Gomes da Costa, Yves Borghesi, Delphine Hudry, Julie Faes, Lucie Bresson, Fabrice Narducci, Eric Leblanc
STUDY OBJECTIVE: The aim of this study was to evaluate the outcomes of extraperitoneal para-aortic lymphadenectomy by robot-assisted laparoscopy. DESIGN: A retrospective study (Canadian Task Force classification III). SETTING: An academic institution. PATIENTS: Twenty-three consecutive patients with gynecologic cancer who presented for para-aortic lymphadenectomy between March 2016 and May 2017 were reviewed retrospectively...
January 11, 2018: Journal of Minimally Invasive Gynecology
Floriana Mascilini, Lorena Quagliozzi, Francesca Moro, Maria Cristina Moruzzi, Valerio Gallotta, Salvatore Gueli Alletti, Giovanni Scambia, Antonia Carla Testa, Anna Fagotti
STUDY OBJECTIVE: To describe the potential role of intraoperative ultrasound (IOUS) in the detection and localization of recurrent disease in gynecological cancer patients during minimally invasive surgery (MIS). DESIGN: A prospective cohort study (Canadian Task Force II-1). SETTING: A University hospital. PATIENTS: From November 2015 to February 2017, 51 gynecological cancer patients with isolated recurrent disease and candidate for secondary cytoreductive surgery (SCS) were treated by MIS...
January 8, 2018: Journal of Minimally Invasive Gynecology
Heather J Baldwin, Jillian A Patterson, Tanya A Nippita, Siranda Torvaldsen, Ibinabo Ibiebele, Judy M Simpson, Jane B Ford
OBJECTIVE: To evaluate the association between prior invasive gynecologic procedures and the risk of subsequent abnormally invasive placenta (ie, placenta accreta, increta, and percreta). METHODS: We conducted a population-based data linkage study including all primiparous women who delivered in New South Wales, Australia, between 2003 and 2012. Data were obtained from linked birth and hospital admissions with a minimum lookback period of 2 years. Prior procedures invasive of the uterus were considered including gynecologic laparoscopy with instrumentation of the uterus; hysteroscopy, including operative hysteroscopy; curettage, including suction curettage and surgical termination; and endometrial ablation...
February 2018: Obstetrics and Gynecology
Joseph Nassif, Hasan Nahoul, Ali Mourad, Ryan Yammine, Sally Khoury, Ali Khalil
Nabothian cysts are mucinous retention cysts formed through the accumulation of cervical mucus inside blocked cervical crypts leading to non-neoplastic mucinous cystic lesion in relation to the uterine cervix. The formation of Nabothian cysts is a common gynecological benign condition in women of reproductive age. While the presence of small-sized Nabothian cysts is usually clinically asymptomatic and requires no treatment or intervention, the diagnosis of larger Nabothian cysts can be mistaken with malignant tumors, including mucin producing carcinomas such as Adenoma malignum...
December 22, 2017: Surgical Technology International
Serena H Chan, Eduardo Lara-Torre
It is important for practitioners to recognize that there are special considerations when performing gynecologic surgery in a pediatric or adolescent patient. A provider must be familiar with differences in anatomy, physiology, surgical technique, and psychosocial concerns. This can be challenging for a provider who does not routinely operate on patients in this population. A minimally invasive surgical approach is preferred in the pediatric and adolescent patient whenever possible. While a good command of laparoscopy in the adult patient is certainly a useful skill when operating on pediatric and adolescent patients, there are technical adaptations and challenges to consider...
October 17, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
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