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https://www.readbyqxmd.com/read/28537350/should-we-abandon-the-gynecologic-resectoscope-in-favor-of-hysteroscopic-morcellators
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28463949/characterization-and-preoperative-risk-analysis-of-leiomyosarcomas-at-a-high-volume-tertiary-care-center
#13
Ann Peters, Amanda M Sadecky, Daniel G Winger, Richard S Guido, Ted T M Lee, Suketu M Mansuria, Nicole M Donnellan
INTRODUCTION: Uterine morcellation in minimally invasive surgery has recently come under scrutiny because of inadvertent dissemination of malignant tissue, including leiomyosarcomas commonly mistaken for fibroids. Identification of preoperative risk factors is crucial to ensure that oncologic care is delivered when suspicion for malignancy is high, while offering minimally invasive hysterectomies to the remaining patients. OBJECTIVES: The aim of this study was to characterize risk factors for uterine leiomyosarcomas by reviewing preoperative, intraoperative, and postoperative data with an emphasis on the presence of concurrent fibroids...
May 2, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28456634/does-the-surgeon-s-experience-affect-operation-times-adverse-events-and-continence-outcomes-in-holep-a-review-of-over-1000-cases
#14
Katsumi Shigemura, Fukashi Yamamichi, Koichi Kitagawa, Masuo Yamashita, Yasuhiko Oka, Hirokazu Tanaka, Masato Fujisawa
PURPOSE: Holmium Laser Enucleation of the Prostate (HoLEP) has become an increasingly common surgical therapy for benign prostate hyperplasia. However, the relationship between the surgeon's experience and surgical outcomes have not yet been fully investigated. In this study, we investigated how the surgeons' experience in HoLEP affected operation times, adverse events and outcomes related to urination. MATERIALS AND METHODS: We gathered 1,113 HoLEP cases from 5 different hospitals in Hyogo prefecture, Japan, including data on the surgeon's HoLEP experience, operation time, enucleation time, morcellation time, patient's age, surgery-related complications (peri- and post-operative) and outcomes related to urination...
April 26, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28446940/a-case-of-disseminated-peritoneal-leiomyomatosis-after-two-laparoscopic-procedures-due-to-uterine-fibroids
#15
Michał Ciebiera, Aneta Słabuszewska-Jóźwiak, Kornelia Zaręba, Grzegorz Jakiel
Disseminated peritoneal leiomyomatosis (DPL) is a rare disorder characterized by the presence of multifocal nodules and tumors composed of proliferating smooth muscle tissue, spread throughout the peritoneum. Estrogens and progesterone are considered to be the main factors initiating the formation of disseminated leiomyomatosis. Disseminated peritoneal leiomyomatosis is often asymptomatic, and acyclic vaginal bleeding or pain in the lower abdomen is associated with leiomyomatous rebuilt uterus corpus. Disseminated peritoneal leiomyomatosis can have other ambiguous presentation...
2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/28435788/laparoscopic-repair-of-a-vesicosigmoid-fistula-secondary-to-holmium-laser-enucleation-of-the-prostate-holep
#16
JiHun Kang, EuiChul Jung, YeonJin Jeon, InKyu Park, Hyeong Gon Lee
Holmium Laser Enucleation of the Prostate (HoLEP) is a safe and effective treatment option for benign prostatic hyperplasia. However, in some cases, it can lead to life-threatening complications. In particular, morcellation of the resected adenoma may be a very dangerous procedure when performed without clear visualization. We describe the first reported case of a vesicosigmoid fistula secondary to a morcellation injury during HoLEP.
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28406878/bone-loss-in-revision-total-knee-arthroplasty-evaluation-and-management
#17
Neil P Sheth, Marcelo Batista Bonadio, Marco Kawamura Demange
With the increasing number of total knee arthroplasty (TKA) procedures being performed annually, the burden of revision surgery is also expected to increase. Addressing bone loss during revision TKA is a considerable challenge that requires proper preoperative evaluation and surgical planning. In addition to an assessment of femoral and tibial bone loss, a systematic approach to the management of bone loss associated with TKA includes careful implant selection, adherence to the general principles of revision TKA, and an understanding of the available reconstruction options...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28400352/frequency-of-uterine-sarcomas-in-patients-admitted-for-uterine-fibroids-surgery
#18
Liselotte Mettler, Nicolai Maass, Khulkar Abdusattarova, Astrid Dempfle, Ibrakhim Alkatout
OBJECTIVE: To estimate the frequency of unsuspected uterine sarcoma identified postoperatively in women undergoing surgery for presumed benign uterine fibroids at the single-center university hospital. MATERIAL AND METHODS: This was a retrospective single-center study; the records of all 2,275 patients with uterine fibroids and uterine sarcomas from 2003 to 2015 were reviewed. Descriptive statistics were used to analyze demographic and clinical characteristics. To calculate confidence intervals (CIs), the exact Clopper-Pearson method was applied...
February 7, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28392430/-prospective-evaluation-of-the-direct-costs-of-prostate-enucleation-by-the-holep-%C3%A2-laser-during-the-learning-curve-period
#19
M Roger, M Goris-Gbenou, A Guillermet, R Vial, N Cunin, J Tomas, L Bourgue, M Combe, J-G Lopez, C Combe
OBJECTIVE: Holmium laser enucleation of the prostate (HoLEP) has been shown to be effective in treating large prostates compared to prostate transurethral resection (TURP). There are no published data evaluating specifically the impact of the learning curve on the direct costs of HoLEP. The objective of this study was to evaluate the direct costs generated by the use of HoLEP laser during the learning curve period. METHOD: The costs of all medical devices (DM) and drugs used, pre- and post-operative parameters during surgery have been prospectively collected between March and October 2016...
April 6, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28383375/comparison-of-vaginal-hysterectomy-techniques-and-interventions-for-benign-indications-a-systematic-review
#20
Peter C Jeppson, Sunil Balgobin, David D Rahn, Kristen A Matteson, Alexis A Dieter, David R Ellington, Sarit O Aschkenazi, Cara Grimes, Mamta M Mamik, Ethan M Balk, Miles Murphy
OBJECTIVE: To create evidence-based clinical practice guidelines based on a systematic review of published literature regarding the risks and benefits of available preoperative, intraoperative, and postoperative technical steps and interventions at the time of vaginal hysterectomy for benign indications. DATA SOURCES: We systematically searched the literature to identify studies that compared technical steps or interventions during the preoperative, intraoperative, and postoperative periods surrounding vaginal hysterectomy...
May 2017: Obstetrics and Gynecology
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