obstetrics,gynecology,minimally invasive surgery

The objective of this study is to report surgical and obstetric outcomes of patients following abdominal cerclage placement through either minimally invasive or open techniques. Subjects of this retrospective cohort study were patients at two referral centers specializing in high-risk pregnancy and minimally invasive gynecologic surgery. Electronic medical records of all patients who underwent abdominal cerclage placement between December 2011 and December 2015 at Yale New Haven Hospital and Bridgeport Hospital were reviewed...

OBJECTIVE: A comprehensive overview of the potential complications associated with vaginal tape operations, which are commonly used in the treatment of stress urinary incontinence in women. DESIGN: Review article. SETTING: Department of Obstetrics and Gynecology, Oblastní nemocnice Kolín, a.s. METHODS: Using medical databases were searched articles dealing with complications tension-free vaginal tape procedures. In individual cases, complications were observed their causes and solutions...

OBJECTIVE: Recent evidence has supported the concept that epithelial ovarian cancer (EOC) arises from the cells of the fallopian tube or endometrium. This study investigated current practice in Japan with respect to performing opportunistic bilateral salpingectomy (OBS) during gynecological surgery for benign disease for Ovarian Cancer Prevention. METHODS: We mailed a questionnaire to 767 hospitals and clinics, comprising 628 accredited training institutions of the Japan Society of Obstetrics and Gynecology (JSOG), Japan Society of Gynecologic Oncology (JSGO), or Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy (JSGOE) and 139 private institutions with at least one JSGOE-certified licensed gynecologic laparoscopist...

Biosurgical materials (biosurgicals) have a wide array of uses for providing hemostasis, including decreasing the risk of postoperative bleeding and, intraoperatively, controling bleeding. These materials are especially useful in situations where electrocautery, sutures, or clips are not feasible. Biosurgicals have long been used in general surgery and surgical subspecialties to provide hemostasis; however, they still are not commonly used during obstetric and gynecologic procedures. Three commonly used classes of biosurgicals will be discussed in this article: oxidized regenerated cellulose, flowables, fibrin sealants, and fibrin sealant patches...

OBJECTIVE: To assess the long-term outcomes of laparoscopic staging surgery (LSS) in treating patients with endometrial carcinoma. MATERIALS AND METHODS: Patients with endometrial cancer who underwent LSS between June 1995 and June 2014 were prospectively registered. Perioperative data, complications, disease recurrence, and long-term survival were measured. RESULTS: The study included 287 consecutive patients [mean age (± standard deviation), 53±10...

AIM: Radical trachelectomy (RT) is a widely used fertility-sparing treatment for patients with early cervical cancer (CCA). RT, however, is an investigational treatment, and its gynecological and obstetric efficacy are being investigated. We retrospectively assessed the efficacy of abdominal RT (ART) as a fertility-sparing surgery. METHODS: From 2010 to 2014, patients with stage IA2-IB1 CCA (tumor ≤2 cm) who wished to preserve their fertility underwent ART. The major outcomes were mortality, recurrence, pregnancy complications, and obstetric outcome...

IMPORTANCE: Obstetricians and gynecologists frequently deal with hemorrhage so they should be familiar with management of patients who refuse blood transfusion. Although there are some reports in the literature about management of Jehovah's Witness patients in obstetrics and gynecology, most of them are case reports, and a comprehensive review about these patients including ethicolegal perspective is lacking. OBJECTIVE: This review outlines the medical, ethical, and legal implications of management of Jehovah's Witness patients in obstetrical and gynecological settings...

OBJECTIVE: To evaluate the safety, efficacy, and feasibility of a minimally invasive vaginal approach for treating advanced utero-vaginal prolapse. METHODS: A prospective study enrolled consecutive patients attending the Gynecology and Obstetrics Department, Turin University for treatment of Pelvic Organ Prolapse Quantification (POP-Q) stage III of higher symptomatic utero-vaginal prolapse between February 1, 2013 and November 30, 2014. Participants underwent a combined sacrospinous hysteropexy and cystopexy procedure using a single anterior vaginal incision...

OBJECTIVES: Vulvar carcinoma is mainly treated surgically and has an overall good prognosis. Despite the development of minimally invasive surgical procedures in recent years, morbidity remains significant. The aim of the study was to determine the incidence and risk factors of erysipelas after surgical treatment for vulvar carcinoma. METHODS: This retrospective observational study was performed within the Comprehensive Cancer Centre South. The study included patients (N = 116) who underwent surgery for primary vulvar carcinoma between 2005 and 2012...

OBJECTIVE: To describe first two cases of robotic sacrocolpopexy in the Czech Republic. DESIGN: Two case reports with literature overview. SETTING: Department of Obstetrics and Gynaecology, Faculty of Medicine and Dentistry, Palacky University in Olomouc. CASE REPORT: Robotic sacrocolpopexy was performed in two patients of the age 36 and 59 at the department of obstetrics and gynecology in Olomouc in 2009. We describe vaginal prolapse treatment in one case, and supracervical hysterectomy with cervicosacropexy in the other...

AIM: This study investigates the pattern of disease recurrence and identifies the clinicopathologic prognostic factors for patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB and IIA cervical carcinoma treated with laparoscopic/robotic radical hysterectomy (LRH/RRH). METHODS: We conducted a retrospective analysis of 128 patients with FIGO stage IB and IIA cervical cancer. Preoperative examination did not uncover definitive evidence of parametrial invasion or lymph node metastasis in any of the patients; therefore, all patients underwent LRH/RRH with retroperitoneal lymphadenectomy between April 2006 and December 2013...

OBJECTIVE: To evaluate the impact of obesity on the outcomes of surgical treatment for endometrial cancer in general and also comparing laparoscopic and open abdominal approach. DESIGN: Retrospective case-control study (Canadian Task Force classification II-1). SETTING: Obstetrics and Gynecology Department, University of Insubria, Varese, Catholic University of the Sacred Heart, Rome, International School of Surgical Anatomy, Sacred Heart Hospital, Negrar, and Sant'Orsola-Malpighi Hospital, Bologna, Italy...

OBJECTIVE: To evaluate the perceptions of fellowship program directors of incoming clinical fellows for subspecialty training. METHODS: A validated survey by the American College of Surgeons was modified and distributed to all fellowship program directors in four subspecialties within obstetrics and gynecology: female pelvic medicine and reconstructive surgery, gynecologic oncology, maternal-fetal medicine, and reproductive endocrinology-infertility. The 59-item survey explored five domains concerning preparedness for fellowship: professionalism, independent practice, psychomotor ability, clinical evaluation, and academic scholarship...

OBJECTIVES: To evaluate the role of minimally invasive surgery (MIS) in gynecologic oncology fellowship training and fellows' predictions of their use of MIS in their future practice. METHODS: All fellows-in-training in American Board of Obstetrics and Gynecology-approved training programs were surveyed in 2012 through an online or mailed-paper survey. Data were analyzed and compared to results of a similar 2007 survey. RESULTS: Of 172 fellows, 69 (40%) responded...

INTRODUCTION: The goal of this study was to assess the effect of the addition of fellowship-trained faculty in minimally invasive gynecologic surgery to a community-based obstetrics and gynecology resident training program in an inner-city location. METHODS: A retrospective chart review was conducted from August 1, 2011, through August 25, 2014, to extract surgical cases covered by gynecology residents in an inner-city community teaching hospital. This includes total and supracervical hysterectomies performed through laparotomy and laparoscopy...

INTRODUCTION: Proper patient positioning is paramount to both patient safety and surgical efficacy. In laparoscopic surgery, the patient is subjected to steep Trendelenburg positioning and prolonged surgical times. These are significant risk factors in positioning-related nerve injuries. We developed a workshop integrating a classic didactic curriculum with a simulation component for residents to experience first hand the importance of proper laparoscopic positioning. METHODS: A 10-question preintervention assessment on "Laparoscopic positioning and nerve injury" based on a comprehensive review in the Journal of Minimally Invasive Gynecology was administered to 20 obstetrics and gynecology residents...

OBJECTIVE: To investigate patient knowledge and attitudes about surgical approaches in gynecology. METHODS: At an outpatient obstetrics and gynecology triage and clinic of an academic medical center in New York, a questionnaire was administered to 154 patients who were in triage or clinic to receive routine obstetrics and gynecology care. Each participant anonymously completed the institutional review board-approved questionnaire. MEASUREMENTS AND MAIN RESULTS: Ninety percent of respondents were younger than 39 years of age...

OBJECTIVE: The objective of this study was to evaluate the cure effect of a transurethral injection of Bulkamid® for recurrent female stress and mixed urinary incontinence in women who had undergone failed tape surgery. Our hypothesis was that cure effect of Bulkamid® is positive in patients when previous tape anti-incontinence surgery has been unsuccessful. DESIGN: Retrospective clinical study. SETTINGS: Department of Obstetrics and Gynecology, 1st Medical Faculty, Charles University and General Faculty Hospital in Prague...

OBJECTIVES: The objective of this study was to evaluate the morbidity and the oncologic outcomes of laparoscopic radical hysterectomy in treating early-stage cervical cancer. METHODS: We included all patients with early-stage cervical cancer (IA, IB1, IIA1, and IIB), as assessed by the Federation International of Gynecology and Obstetrics staging criteria, undergoing laparoscopic radical hysterectomy from January 1999 to December 2013 in our center. Morbidity was classified according to the Clavien and Dindo classification...

STUDY OBJECTIVE: To compare the perioperative outcomes of minimally invasive secondary cytoreduction surgery (SCS) plus hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) versus open surgery plus HIPEC in a group of platinum-sensitive patients with advanced epithelial ovarian cancer (AEOC) with isolated relapse. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy...