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https://www.readbyqxmd.com/read/28636771/is-transvaginal-contained-tissue-extraction-for-everyone
#1
Charles Miller
Professor Ghezzi, et al. should be congratulated for their excellent manuscript "Transvaginal Contained Tissue Extraction After Laparoscopic Myomectomy: A Cohort Study". This is a well-conceived, well-written retrospective cohort study describing operative and peri-operative outcomes for patients who have undergone transvaginal morcellation via a posterior colpotomy. Given the continued controversy regarding electronic power morcellation leading to restriction of use in certain areas, this study is not only impactful, in that it describes an alternative technique with data accumulated over a decade of experience, but it describes a technique of contained morcellation that is neither based on the controversial power morcellation, nor the mini-laparotomy (https://www...
June 21, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28599164/impact-of-power-morcellator-removal-on-hysterectomy-practice-patterns
#2
Adrianne Wesol, Shauna Woolley
OBJECTIVE: This study was a quality improvement project investigating patterns of hysterectomy practice including changes in surgical techniques and patient outcomes after manufacturer withdrawal of a laparoscopic power morcellator from our hospitals in July 2014. STUDY DESIGN: This time-series pre and post retrospective review examined data from electronic health records, comparing one year when a laparoscopic power morcellator was available (Year 1, mid-2013 to mid-2014) to one year after withdrawal (Year 2, mid-2014 to mid-2015)...
May 21, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28586771/can-in-bag-manual-morcellation-represent-an-alternative-to-uncontained-power-morcellation-in-laparoscopic-myomectomy-a-randomized-controlled-trial
#3
Clarissa Frascà, Eugenia Degli Esposti, Alessandro Arena, Gianmarco Tuzzato, Elisa Moro, Valentina Martelli, Renato Seracchioli
AIMS: The study aimed to evaluate feasibility and safety of in-bag manual morcellation compared to uncontained power morcellation during laparoscopic myomectomy. METHODS: A total of 72 women undergoing laparoscopic myomectomy were randomized into 2 treatment groups: 34 patients underwent in-bag manual morcellation (experimental group) and 38 were submitted to uncontained power morcellation (control group). The primary end point was the comparison of morcellation operative time (MOT)...
June 7, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28586247/holmium-laser-enucleation-of-the-prostate-after-prostatic-urethral-lift-surgery-feasibility-and-technical-considerations-from-a-multi-institutional-case-series
#4
Sean B McAdams, Joel Funk, Andrew Navetta, Marawan El Tayeb, Mitchell R Humphreys
INTRODUCTION AND OBJECTIVE: Prostatic urethral lift (PUL) is gaining popularity for the treatment of symptomatic benign prostatic hyperplasia (BPH). We describe the feasibility and considerations of performing holmium laser enucleation of the prostate (HoLEP) as a salvage therapy after previous PUL. METHODS: Men who have undergone HoLEP after PUL were retrospectively identified from three institutions with surgeons experienced in HoLEP. Subjects were characterized by age, time from PUL procedure (months) to HoLEP surgery, indication for retreatment, and pre-operative prostate volume by ultrasound...
June 6, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28580061/disseminated-peritoneal-leiomyomatosis-status-post-laparoscopic-hysterectomy-with-morcellation
#5
Neil Anand, Marci Handler, Ahsan Khan, Allison Wagreich, Sean Calhoun
Uterine leiomyomas (fibroids) are common benign neoplasms, which develop from the muscular tissue of the uterus with an estimated incidence of 20-40% in women of reproductive age. In the early nineties, power morcellators were introduced and became commonly used during hysterectomy for symptomatic fibroids. However, if all fragments are not removed, they may parasitize to other blood supply and present as abdominal or pelvic masses. Unfortunate cases have also been reported in which uterine sarcomas seeded throughout the abdomen and pelvis secondary to morcellation...
December 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/28576422/a-bicentric-comparative-and-prospective-study-between-classic-photovaporization-and-anatomical-greenlight-laser-vaporization-for-large-volume-prostatic-adenomas
#6
G Hibon, G Léonard, A Franceschi, V Misrai, F Bruyère
OBJECTIVE: Long-term outcome after prostate photovaporization (PVP) remains largely unknown, especially when performed on enlarged prostates. However, new vaporisation techniques (e.g., laser enucleation) are increasingly used. Our aim was to compare postoperative results after standard PVP to those of an anatomical technique. MATERIALS AND METHODS: This bicentric prospective study included males treated for enlarged prostate caused by benign prostatic hyperplasia using a GreenLight laser...
June 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28560234/robotic-single-site-supracervical-hysterectomy-with-manual-morcellation-preliminary-experience
#7
Dah-Ching Ding, Mun-Kun Hong, Tang-Yuan Chu, Yu-Hsun Chang, Hwan-Wun Liu
AIM: To evaluate the feasibility, safety and peri- and postoperative outcomes of robotic single-site supracervical hysterectomy (RSSSH) for benign gynecologic disease. METHODS: We report 3 patients who received RSSSH for adenomyosis of the uterus from November 2015 to April 2016. We evaluated the feasibility, safety and outcomes among these patients. RESULTS: The mean surgical time was 244 min and the estimated blood loss was 216 mL, with no blood transfusion necessitated...
May 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28552622/minilaparotomy-versus-laparoscopic-myomectomy-after-cessation-of-power-morcellation-rate-of-wound-complications
#8
Ariel K Dubin, Julia Wei, Shannon Sullivan, Natalia Udaltsova, Eve Zaritsky, Miya P Yamamoto
STUDY OBJECTIVE: After the FDA statement warning against electronic morcellation devices, gynecologic surgeons are performing laparoscopic and robotic myomectomies with minilaparotomy incisions for tissue morcellation and removal. No data exists focusing on the superficial wound complications as a result of these larger incisions. The objective of this study is to compare the rate of wound complications for myomectomy via minilaparotomy vs laparoscopic or robotic myomectomy. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2)...
May 25, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28537350/should-we-abandon-the-gynecologic-resectoscope-in-favor-of-hysteroscopic-morcellators
#9
Morris Wortman
The treatment of intrauterine masses, such as endometrial polyps and leiomyomas, has undergone a technological revolution in the past few decades. Gynecologists may now choose from a variety of unipolar and bipolar resectoscopes as well as an assortment of both mechanical and bipolar hysteroscopic morcellators. We present a comparison of these technologies to better practitioners understanding of the strengths and limitations of these devices.
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28532766/morcellation-efficiency-in-holmium-laser-enucleation-of-the-prostate-oscillating-morcellator-outperforms-reciprocating-morcellator-with-no-apparent-learning-curve
#10
Sean McAdams, Rafael Nunez-Nateras, Christopher J Martin, Stephen Cha, Mitchell R Humphreys
OBJECTIVE: To compare the morcellation efficiency of the Wolf® Piranha™ oscillating morcellator to the Lumenis® VersaCut™ reciprocating morcellator. METHODS: After IRB approval, we conducted a retrospective analysis of patients undergoing HoLEP for symptomatic benign prostatic hyperplasia. The first 41 cases of HoLEP with morcellation performed with the oscillating morcellator were matched by weight of resected tissue to 41 control patients from our historic data set that underwent morcellation with the reciprocating system...
May 19, 2017: Urology
https://www.readbyqxmd.com/read/28500861/overview-of-high-risk-medical-device-recalls-in%C3%A2-obstetrics%C3%A2-and-gynecology-from-2002-through-2016-%C3%A2-implications-for-device-safety
#11
Timothy M Janetos, Comeron W Ghobadi, Shuai Xu, Jessica R Walter
The field of women's health has endured numerous recent controversies involving medical devices such as pelvic meshes, laparoscopic morcellators, and a hysteroscopic sterilization device. With the recent passage of the 21st Century Cures Act, new legislation will change how the Food and Drug Administration regulates medical devices. Given these controversies and new changes, we investigated high-risk, class I recalls in women's health from 2002 through 2016. Class I recalls for medical devices are defined by the Food and Drug Administration as the most serious recall events and are designated for situations when there is a reasonable probability of serious adverse health consequences or death...
April 29, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28498262/sarcoma-risk-in-uterine-surgery-in-a-tertiary-university-hospital-in-germany
#12
Sudip Kundu, Manuel Zachen, Hermann Hertel, Peter Hillemanns, Philipp Soergel
OBJECTIVES: There is a risk to incidentally spread uterine malignancies, especially sarcoma, if tissue is morcellated during hysterectomy or myoma enucleation. In the last years, a worldwide discussion has been started about this problem. However, the risk seems to be very small in recent studies. This study aims at further investigating the risk of disseminating uterine malignancy during uterine surgery in a tertiary university hospital in Germany. METHODS: In a retrospective setting, all cases of uterine myometrial surgery (hysterectomies and myomectomies) in our clinic during a period of 10 years were identified using clinical databases...
June 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28497447/holmium-laser-enucleation-of-the-prostate-holep-for-small-large-and-giant-prostatic-hyperplasia-tips-and-tricks
#13
Petr V Glybochko, Leonid M Rapoport, Mikhail E Enikeev, Dmitry V Enikeev
INTRODUCTION: Holmium laser enucleation of the prostate (HoLEP) allows to treat extremely large prostates (>200 cm3). The aim of the study was to compare the efficiency of HoLEP for prostates of different sizes. METHODS: Four hundred and fifty-nine patients were divided into three groups: group 1 included 278 patients (<100 cm3); group 2 included 169 patients (100-200 cm3); group 3 included 12 patients (>200 cm3). RESULTS: The duration of enucleation in group 1 was 56...
May 10, 2017: Urologia
https://www.readbyqxmd.com/read/28486377/on-the-road-to-safer-morcellation
#14
William W Hurd
No abstract text is available yet for this article.
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28486371/trends-in-mode-of-hysterectomy-after-the-u-s-food-and-drug-administration-power-morcellation-advisory
#15
Helga Ottarsdottir, Sarah L Cohen, Mary Cox, Allison Vitonis, Jon I Einarsson
OBJECTIVE: To evaluate the trends in mode of surgery for benign hysterectomy after the 2014 U.S. Food and Drug Administration (FDA) morcellation guidelines. METHODS: This is a retrospective review of all patients who underwent a hysterectomy for benign indications, specifically for leiomyomas, at Brigham and Women's Hospital from 2013 to 2015. The rates of abdominal, vaginal, laparoscopic, and robotic-assisted laparoscopic hysterectomy as well as the perioperative outcomes were compared over the study period...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28486366/changes-in-myomectomy-practice-after-the-u-s-food-and-drug-administration-safety-communication-on-power-morcellation
#16
Natalie C Stentz, Laura G Cooney, Mary Sammel, Divya K Shah
OBJECTIVE: To examine the association between the 2014 U.S. Food and Drug Administration (FDA) safety communication on power morcellation and surgical approach and morbidity after myomectomy. METHODS: In this retrospective cohort study, data were abstracted from the American College of Surgeons National Surgical Quality Improvement Program database on 3,160 myomectomies between April 2012 and December 2013 (pre-FDA) and 4,378 between April 2014 and December 2015 (post-FDA)...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28486359/minimally-invasive-hysterectomy-and-power-morcellation-trends-in-a-west-coast-integrated-health-system
#17
Eve Zaritsky, Lue-Yen Tucker, Romain Neugebauer, Tatiana Chou, Tracy Flanagan, Andrew J Walter, Tina Raine-Bennett
OBJECTIVE: To examine trends in minimally invasive hysterectomy and power morcellation use over time and associated clinical characteristics. METHODS: We conducted a trend analysis and retrospective cohort study of all women 18 years of age and older undergoing hysterectomy for benign conditions at Kaiser Permanente Northern California collected from electronic health records. Generalized estimating equations and Cochran-Armitage testing were used to assess the primary outcomes, hysterectomy incidence, and proportion of hysterectomies by surgical route and power morcellation...
June 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28483662/the-management-of-polyps-in-female-reproductive-organs
#18
REVIEW
Vasilios Tanos, Kelsey Elizabeth Berry, Jaana Seikkula, Elissa Abi Raad, Andreas Stavroulis, Zaki Sleiman, Rudi Campo, Stephan Gordts
Polyps of the lower reproductive tract are found in 7.8-50% of women. It has been hypothesized that cytogenetic modifications on chromosomes 6, 7 and 12 as well as epigenetic factors involving enzyme and metabolic activities may cause polyps to develop. Cervical polyps found in 2-5% of cases are of low clinical significance and can cause, although rarely, post coital bleedings. Cervical polyps grow during pregnancy and mucorrhoea. Trans vaginal ultrasound (TVU) provides an excellent diagnostic technique to diagnose the size and the anatomic location of endometrial polyps (EPs)...
May 5, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28483536/comparison-of-morcellation-techniques-at-time-of-laparoscopic-hysterectomy-and-myomectomy
#19
Elsemieke A I M Meurs, Luiz Gustavo Brito, Mobolaji Ajao, Emily R Goggins, Allison F Vitonis, Jon I Einarsson, Sarah L Cohen
STUDY OBJECTIVE: To compare perioperative outcomes associated with the use of three techniques for tissue removal at the time of laparoscopic hysterectomy and myomectomy. DESIGN: Retrospective cohort study. DESIGN CLASSIFICATION: II-2 SETTING: Academic hospital in Boston, MA PATIENTS: Women who underwent a laparoscopic or robot-assisted laparoscopic hysterectomy or myomectomy involving tissue morcellation in 2014. INTERVENTIONS: One of three morcellation techniques: electronic power morcellation (PM), manual morcellation via vagina (VM) or manual morcellation via minilaparotomy (ML)...
May 5, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28467660/transvaginal-contained-tissue-extraction-after-laparoscopic-myomectomy-a-cohort-study
#20
Fabio Ghezzi, Jvan Casarin, Giuseppe De Francesco, Paolo Puggina, Stefano Uccella, Maurizio Serati, Antonella Cromi
OBJECTIVE: To describe the technique and report perioperative outcomes of transvaginal contained extraction of surgical specimens at laparoscopic myomectomy. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Two Italian referral centres for gynaecological minimally invasive surgery. POPULATION: Consecutive patients who underwent laparoscopic myomectomy. METHODS: Tissue extraction was accomplished following laparoscopic myomectomy in a specimen retrieval bag via a posterior colpotomy incision...
May 3, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
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