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https://www.readbyqxmd.com/read/29205507/current-status-of-holmium-laser-enucleation-of-the-prostate
#1
REVIEW
Katsumi Shigemura, Masato Fujisawa
There are several options for the surgical management of benign prostatic hyperplasia representatively from transurethral resection of the prostate. Holmium laser enucleation of the prostate is one of those options, and many institutions and urologists have initiated this technique, and most of them have accomplished better outcomes compared with transurethral resection of the prostate. In contrast to transurethral resection of the prostate, which requires a similar procedure to transurethral resection of bladder tumors, holmium laser enucleation of the prostate requires a special surgical technique: enucleation and morcellation with around 10 years' history of experience, even in Japan...
December 3, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/29203157/-anticoagulation-impact-on-bleeding-risk-during-holep-monocentric-study-of-156-patients
#2
P Neuville, R Codas, E Ravier, D Maucort-Boulch, L Badet, H Fassi-Fehri
OBJECTIVE: Compare the length of hospital stay and the complications after HoLEP between three groups of patients: a control group, a group with antiplatelet therapy, a group with anticoagulation therapy. MATERIALS: Retrospective cohort study that included all consecutive patients who underwent HoLEP for prostatic hyperplasia in our center from may 2013 to may 2016. Anticoagulated patients and patients under clopidogrel had respectively a relay with heparine and aspirine...
December 1, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/29200989/pushing-the-boundaries-of-laparoscopic-myomectomy-a-comparative-analysis-of-peri-operative-outcomes-in-323-women-undergoing-laparoscopic-myomectomy-in-a-tertiary-referral-centre
#3
Rebecca Mallick, Funlayo Odejinmi
Background: The aim of this study was to analyse the demographic data and peri-operative outcomes of women undergoing a laparoscopic myomectomy and assess what factors, if any, precluded using the laparoscopic approach. Methods: A single surgeon observational study of 323 patients undergoing a laparoscopic myomectomy was undertaken. Data was collected prospectively over a 12-year period and analysed using SPSS. Surgical outcomes included operating time, estimated blood loss, conversion to laparotomy, intraoperative and postoperative complications and duration of inpatient stay...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/29194076/morcellation-equipment-past-present-and-future
#4
Charles E Miller
PURPOSE OF REVIEW: This review was written in an effort to describe the evolution of power morcellation equipment from their creation to their current state. In addition, this review addresses the continuously evolving equipment involved with power morcellation and looks to describe where the field is headed in the future. In addition, recent professional and federal recommendations have changed the way power morcellation is being approached and has led to the development of contained morcellation systems, which, although in their infancy, are also being proven to be well tolerated options...
November 30, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29181031/laparoscopic-supracervical-hysterectomy-with-in-bag-morcellation-in-very-large-uterus
#5
Harald Krentel, Rudy Leon De Wilde
Laparoscopic supracervical hysterectomy (LASH) is a safe and fast minimally invasive approach in hysterectomy. In order to extract the uterine body from the abdominal cavity, one condition for LASH is the morcellation of the tissue. The intra-abdominal dissemination of benign and occult malignant uterine cells is a possible risk of this method, which can be avoided by the use of special bags for laparoscopic in-bag morcellation. We present a case of laparoscopic supracervical hysterectomy with in-bag morcellation in a uterus of more than 1400 g...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29161905/a-focused-review-on-the-effects-of-preoperative-5%C3%AE-reductase-inhibitors-treatment-in-patients-undergoing-holmium-laser-enucleation-of-the-prostate-what-do-we-know-so-far
#6
Panagiotis Dimopoulos, Panagiotis Christopoulos, Spyridon Kampantais
INTRODUCTION: The effects of medical therapy with finasteride or dutasteride during transurethral enucleation of prostate and tissue morcellation are not well defined. In theory, the risk of prostatic fibrosis versus the potential benefit of reduced intraoperative bleeding have been addressed as potential competing factors. The aim of this review was to provide evidence if 5a-reductase inhibitors put the surgeon at a disadvantage or impacts on patient outcomes. MATERIAL AND METHODS: We performed a literature search of PubMed, Scopus and Web of science databases...
November 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29161797/electromechanical-morcellators-black-box-warning-tribulations-expectations-and-solutions
#7
Papri Sarkar, Emad Mikhail, Lenox Hoyte, Shayne Plosker, Anthony Imudia
Laparoscopic minimally invasive gynecologic surgery (MIGS) for benign conditions results in decreased morbidity, and faster recovery, compared with laparotomy. Tissue fragmentation by electromechanical morcellation permits the removal of large specimens through small laparoscopic incisions. Since the US Food and Drug Administration (FDA) published its safety warning about the risk of power morcellators spreading cancer during fibroid surgery in 2014, power morcellation has become rare. MIGS for fibroids and other large tissue specimens has declined...
November 21, 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/29149644/assessing-the-risk-of-laparoscopic-morcellation-of-occult-uterine-sarcomas-during-hysterectomy-and-myomectomy-literature-review-and-the-isge-recommendations
#8
REVIEW
Ornella Sizzi, Lucia Manganaro, Alfonso Rossetti, Matteo Saldari, Giuseppe Florio, Alessandro Loddo, Robert Zurawin, Bruno van Herendael, Dusan Djokovic
OBJECTIVE: This project of the International Society for Gynecologic Endoscopy (ISGE) had the objective to review the literature and provide recommendations on the occult sarcoma risk assessment in patients who are candidates for minimally invasive gynecological surgery involving intra-abdominal electromechanical tissue morcellation. STUDY DESIGN: The ISGE Task Force for Estimation of the Risk in Endoscopic Morcellation initially defined key topics and clinical questions which may guide a comprehensive preoperative patient assessment...
November 7, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29138602/improved-adequacy-of-endometrial-tissue-sampled-from-postmenopausal-women-using-the-myosure-lite-hysteroscopic-tissue-removal-system-versus-conventional-curettage
#9
Peter Rosenblatt, Sara Barcia, Anthony DiSciullo, Hussein Warda
Objective: To compare the diagnostic suitability of endometrial tissues obtained from postmenopausal women using the MyoSure Lite tissue removal system versus conventional curettage. Materials and methods: Endometrial tissue was sampled in hysteroscopically normal extirpated uteri from seven postmenopausal women (65.9±6.6 years old) using both hysteroscopicguided morcellation and curettage (two quadrants/uterus with each method). Endometrial sampling was performed immediately after hysterectomy for benign reasons unrelated to uterine pathology...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/29135414/retroperitoneoscopic-nephrectomy-for-huge-autosomal-dominant-polycystic-kidney-disease-using-morcellator
#10
Dong Sup Lee, Hee Youn Kim, Seung-Ju Lee
No abstract text is available yet for this article.
November 17, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29133752/proportion-of-uterine-malignant-tumors-in-patients-with-laparoscopic-myomectomy-a-national-multicenter-study-in-china
#11
Hua Yang, Xiao-Chuan Li, Chen Yao, Jing-He Lang, Hang-Mei Jin, Ming-Rong Xi, Gang Wang, Lu-Wen Wang, Min Hao, Yan Ding, Jie Chen, Jian-Qing Zhang, Lu Han, Cheng-Xiu Guo, Xiang Xue, Yan Li, Jian-Hua Zheng, Man-Hua Cui, Huai-Fang Li, Guang-Shi Tao, Long Chen, Su-Min Wang, An-Wei Lu, Ze-Hua Huang, Qing Liu, Ya-Li Zhuang, Xiang-Hua Huang, Gen-Hai Zhu, Ou-Ping Huang, Li-Na Hu, Mu-Jun Li, Hong-Lin Zhou, Jing-Hui Song, Lan Zhu
BACKGROUND: The Food and Drug Administration recently announced that the use of morcellation may cause fibroids or pelvic dissemination and metastasis of uterine sarcoma; therefore, the use of morcellation is limited in the USA. A large sample study is necessary to assess the proportion of uterine malignant tumors found in patients with laparoscopic myomectomy. METHODS: A national multicenter study was performed in China. From 2002 to 2014, 33,723 cases were retrospectively selected...
November 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29128980/reducing-the-spread-of-occult-uterine-sarcoma-at-the-time-of-minimally-invasive-gynecologic-surgery
#12
Marron Wong, Rudy Leon De Wilde, Keith Isaacson
PURPOSE: This review covers the most recent evidence to discuss the incidence of occult uterine sarcoma, whether morcellation increases tumor dissemination or mortality, and whether there is a difference between different types of morcellation. We will also discuss techniques to reduce the spread of an undiagnosed uterine sarcoma. METHOD: A comprehensive literature search was made in Pubmed, Medline, the Cochrane Library, and Google Scholar for articles related to the incidence of occult uterine sarcoma after morcellation...
November 11, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29112659/tissue-extraction-techniques-for-leiomyomas-and-uteri-during-minimally-invasive-surgery
#13
Matthew T Siedhoff, Sarah L Cohen
Fragmented tissue extraction (morcellation) of uterine and leiomyoma tissue in gynecologic surgery has been performed for decades, but recent years have seen a vast expansion of techniques to address risks associated with tissue dispersion. Use of power, or electromechanical, morcellation has largely been replaced by manual morcellation with a scalpel. Morcellation can take place through a laparoscopic incision, a minilaparotomy incision, or through a colpotomy. Containment systems are now available for both power and manual morcellation, allowing tissue fragmentation to take place within an enclosed specimen bag...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29089662/morcellation-for-testes-extraction-in-horses-undergoing-standing-laparoscopic-cryptorchidectomy
#14
Lucas Nolazco Sassot, Claude A Ragle, Kelly D Farnsworth, Caleb M Lund
The major objective of this study was to describe the use of morcellation for standing laparoscopic cryptorchidectomy in 30 client-owned horses. A second objective was to describe a laparoscopic-assisted standing scrotal technique for removal of a descended testis in unilateral cryptorchids. Morcellation for extraction of abdominal testes is effective, efficient, and well-tolerated. Morcellation enabled safe and straightforward extraction of testes from the abdomen through an approximately 13- to 20-mm incision using a 2-portal technique...
November 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/29079466/laparoscopic-promontofixation-in-10-steps
#15
Oana Madalina Acsinte, Benoit Rabischong, Nicolas Bourdel, Michel Canis, Revaz Botchorishvili
STUDY OBJECTIVE: Laparoscopic promontofixation has all the advantages of minimally invasive approach for the treatment of urogenital prolapse. The standardization and the description of the technique was the main objective of this video. We described the complete procedure in 10 steps, which could help to understand and perform this procedure simply, easily and safely. DESIGN CLASSIFICATION: Step-by-step video demonstration of the technique. SETTING: A University tertiary care hospital...
October 24, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29078975/laparoscopic-myomectomy-and-morcellation-a-review-of-techniques-outcomes-and-practice-guidelines
#16
REVIEW
Laura M Glaser, Jaclyn Friedman, Susan Tsai, Angela Chaudhari, Magdy Milad
Laparoscopic myomectomy is a minimally invasive surgical approach to treat symptomatic uterine fibroids in women wishing for a uterine-sparing procedure. With careful patient selection, these procedures are associated with favorable reproductive outcomes and low perioperative morbidity. Current available methods for specimen retrieval include power and hand morcellation. The 2014 FDA safety warnings regarding power morcellation arose from concerns about the spread of occult malignancy and prompted widespread use of containment systems that may limit spread of myometrial cells...
September 29, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29061369/unsuspected-uterine-sarcoma-in-an-urban-hospital-does-surgical-approach-matter
#17
Marianne N DiNapoli, Mireille D Truong, Johanna K Halfon, William M Burke
STUDY OBJECTIVE: To compare the incidence of unsuspected uterine sarcoma based on surgical approach: open versus minimally invasive approaches for myomectomies and hysterectomies. DESIGN: Retrospective chart review of demographic data, preoperative characteristics, operative details, and pathology results from the electronic medical record. DESIGN: Classification: II-3 SETTING: A large, urban, academic medical center. PATIENTS: All women undergoing myomectomy or hysterectomy performed for benign indications by a benign gynecologic surgery between 2010 and 2014...
October 20, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29032253/laparoscopic-dissection-of-extensive-secondary-disseminated-peritoneal-leiomyomatosis-dpl
#18
Karicha Mairaing, Kuan-Gen Huang
STUDY OBJECTIVE: To demonstrate a minimal invasive surgical (MIS) technique for curative excision of extensive secondary disseminated peritoneal leiomyomatosis (DPL). SETTING: In MIS, the myoma has to be divided into small fragments for piecemeal retrieval through a small incision [1], a widely used technique is morcellation (confined or unconfined) [2]. Disseminated peritoneal leiomyomatosis (DPL) is a rare sequel following laparoscopic morcellation. Since this entity is rarely reported, this video demonstrates laparoscopic technique for safe removal of DPL post laparoscopic myomectomy and morcellation...
October 12, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29030074/a-survey-of-morcellator-preference-and-cost-comparison-of-the-lumenis-versacut-and-wolf-piranha-morcellators
#19
Marcelino E Rivera, James E Lingeman, Kevin Heinsimer, Nadya E York, Amy E Krambeck
OBJECTIVE: To evaluate operating room (OR) costs associated with the 2 available morcellators in the United States in a matched cohort and to determine benign prostatic hyperplasia surgeon's morcellator preference. MATERIALS AND METHODS: Patients from 2013, the last year our institution exclusively used the VersaCut device, were matched 1:1 with the most recent patient cohort, utilizing the Wolf Piranha morcellator. Cost of morcellation including the expense of OR time and disposable instrument costs were calculated...
October 10, 2017: Urology
https://www.readbyqxmd.com/read/29016511/change-in-surgical-practice-for-women-with-leiomyomas-after-the-u-s-food-and-drug-administration-morcellator-safety-communication
#20
Nina M Clark, Michael Schembri, Vanessa L Jacoby
OBJECTIVE: To evaluate the association between the U.S. Food and Drug Administration (FDA) communication discouraging use of power morcellators on changes in surgical practice for women with uterine leiomyomas. METHODS: This is a cross-sectional study using data from 2013 to 2014 in the Healthcare Cost and Utilization Project State Inpatient and State Ambulatory Surgical Databases from Arizona, Florida, Kentucky, and New Jersey. Women with a diagnosis of leiomyomas who underwent hysterectomy or myomectomy were included in the analysis...
November 2017: Obstetrics and Gynecology
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