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Updates Surg 2022 Jun 27. Epub 2022 Jun 27.

Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.

The purpose of this study is to assess the feasibility and the perioperative outcomes of laparoscopic gynecological surgery in regional anesthesia (RA) from the point of view of the surgeon, anesthesiologist and patient. This is a prospective cohort study comprising sixty-six women planned to undergo gynecologic laparoscopy surgery for benign pathology at tertiary care gynecolgical center of the University Federico II of Naples. Women were assigned, according to their preference, to either RA (Group A) or general anesthesia (GA) (Group B). Read More

J Minim Invasive Gynecol 2022 Jun 23. Epub 2022 Jun 23.

Department of Gynecologic Oncology, Oscar Lambret Cancer Centre, Lille, France.

Objective: In this video, we describe a five-step surgical technique allowing to safely incise and aspirate the content of large ovarian cysts through a single port laparoscopic incision. This allows performing laparoscopic oophorectomies instead of large xypho-pubic laparotomies.

Design: A Stepwise demonstration of the technique with narrated video footage. Read More

Int J Gynaecol Obstet 2022 Jun 24. Epub 2022 Jun 24.

Department of Obstetrics and Gynecology, Cholet Hospital, 49300, Cholet, France.

Objective: To analyze outcomes and postoperative complications in patients undergoing robot-assisted isthmocele repair.

Method: This retrospective cohort study included 33 patients who had robot-assisted laparoscopic surgical management of an isthmocele between September 2013 and August 2020 in two French university hospitals. All charts were reviewed to identify patient characteristics, pre- and postoperative anatomical findings, complications, and postoperative fertility and symptoms. Read More

Front Surg 2022 7;9:896452. Epub 2022 Jun 7.

Department of Anesthesiology, Shenzhen Maternity & Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, China.

The randomized controlled study investigated the impacts of immediate peri-operative Intermittent pneumatic compression (IPC) on hemodynamic indicators in patients undergoing laparoscopic gynecologic surgery. Patients scheduled for elective laparoscopic gynecologic surgery were randomized to control (IPC not used), pre-operative IPC, post-operative IPC, and peri-operative IPC (performed both before and after surgery) groups. Systolic blood pressure (SBP), mean blood pressure (MBP) cardiac output (CO), heart rate (HR) and systemic vascular resistance (SVR) were measured at different time points. Read More

Medicina (Kaunas) 2022 Jun 13;58(6). Epub 2022 Jun 13.

Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry Schola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy.

: To assess the use of near infrared radiation imaging after injection of indocyanine green (NIR-ICG) during laparoscopic treatment of benign gynecologic conditions. : A systematic review of the literature was performed searching 7 electronic databases from their inception to March 2022 for all studies which assessed the use of NIR-ICG during laparoscopic treatment of benign gynecological conditions. : 16 studies (1 randomized within subject clinical trial and 15 observational studies) with 416 women were included. Read More

J Clin Med 2022 Jun 10;11(12). Epub 2022 Jun 10.

Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", 90127 Palermo, Italy.

Aortic lymph node metastases are a relative common finding in locally advanced cervical cancer. Minimally invasive surgery is the preferred approach to perform para-aortic lymph nodal staging to reduce complications, hospital stay, and the time to primary treatment. This meta-analysis (CRD42022335095) aimed to compare the surgical outcomes of the two most advanced approaches for the aortic staging procedure: conventional laparoscopy (CL) versus robotic-assisted laparoscopy (RAL). Read More

J Minim Invasive Gynecol 2022 Jun 19. Epub 2022 Jun 19.

Endoscopica Malzoni, Center for Advanced Endoscopic Gynecologic Surgery, Avellino, Italy.

Study Objectives: To assess the value of combined transvaginal/transabdominal (TV/TA) ultrasonographic evaluation performed by experienced examiners for deep infiltrating endometriosis (DIE) lesions of the retrocervical (torus uterinus and uterosacral ligaments) and parametrial areas, and summarize the features and anatomical criteria for identification of these lesions and their extent in the above-mentioned pelvic compartments.

Design: Retrospective study.

Setting: A specialized endometriosis center in Avellino, Italy PATIENTS: A retrospective cohort of patients who underwent laparoscopic surgery for clinically suspected DIE between January 1, 2014, and December 31, 2018, with a dedicated ultrasound (US) evaluation performed no more than 1 month before the intervention. Read More

Gynecol Oncol 2022 Jun 17. Epub 2022 Jun 17.

Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy.

Objective: Sentinel lymph node mapping (SNM) has gained popularity in managing apparent early-stage endometrial cancer (EC). Here, we evaluated the long-term survival of three different approaches of nodal assessment.

Methods: This is a multi-institutional retrospective study evaluating long-term outcomes of EC patients having nodal assessment between 01/01/2006 and 12/31/2016. Read More

EJNMMI Res 2022 Jun 20;12(1):36. Epub 2022 Jun 20.

Division of Imaging and Oncology, Department of Gynecologic Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.

Background: Minimally invasive radioguided sentinel lymph node (SLN) procedures, increasingly performed with robot-assisted laparoscopy, can benefit from using a drop-in γ-probe instead of the conventional rigid laparoscopic γ-probe. We evaluated the safety and feasibility of a tethered drop-in γ-probe system for SLN detection in patients with early-stage cervical cancer.

Methods: Ten patients with FIGO stage IA - IB2 or IIA1 cervical cancer scheduled for robot-assisted laparoscopic SLN procedure were included. Read More

J Minim Invasive Gynecol 2022 Jun 13. Epub 2022 Jun 13.

University Hospitals of Strasbourg, Department of Gynecologic Surgery, Strasbourg, France.

Study Objective: To demonstrate a systematic approach to the laparoscopic en bloc pelvic resection with rectosigmoid resection and anastomosis as part of ovarian cancer treatment in a tertiary gynecologic surgery referral center.

Design: This video illustrates an en bloc pelvic resection performed par laparoscopy in 10 steps.

Setting: A 56-year-old patient with an advanced high-grade serous ovarian cancer extending into the rectum was amenable to primary debulking surgery in accordance with the French guidelines [1]. Read More

Int J Surg Pathol 2022 Jun 16:10668969221105618. Epub 2022 Jun 16.

Department of Pathology, 22208Kent Hospital, Warwick, Rhode Island, USA.

This was a 57-year-old woman who presented with mild discomfort in the right groin. Physical examination revealed a mass in the right groin, and by ultrasound, the mass was hypoechoic and solid with some internal vascularity. The clinical differential diagnosis included lymphoma and others. Read More

Reprod Fertil 2022 Apr 20;3(2):R91-R95. Epub 2022 Apr 20.

Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Endometriosis has a large impact on the lives of patients, affecting nearly 90% of women with chronic pelvic pain and infertility. Unfortunately, diagnosis for this condition is often delayed by an average of 7 years, with adolescent patients experiencing disproportionate delays. This is in part due to the use of an invasive procedure for primary diagnosis and limited access to subspecialty care. Read More

Fertil Steril 2022 Jun 9. Epub 2022 Jun 9.

Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas. Electronic address:

Objective: To describe a novel, minimally invasive technique for performing myomectomy, a fertility-sparing procedure.

Design: This technique was developed based on similar techniques for other surgeries that showed a benefit. Liu et al. Read More

Pak J Pharm Sci 2022 Mar;35(2(Special)):641-647

Department of Anesthesiology, Tangshan People's Hospital, Tangshan, Hebei, China.

To evaluate the efficacy of multimodal analgesia of flurbiprofen axetil, nalbuphine hydrochloride and patient controlled intravenous analgesia (PCIA) on inflammatory factor levels and stress response in patients after laparoscopic radical gynecological malignancy surgery. The data of 100 patients admitted to our hospital from May 2019 to May 2020 for laparoscopic radical gynecological malignancy surgery were retrospectively analyzed and they were assigned (1:1) to either an experimental group or a control group according to the alphabetical order of their initials. The experimental group was given preemptive analgesia with flurbiprofen axetil, postoperative analgesia with nalbuphine hydrochloride, and PCIA and the control group was given conventional analgesic measures. Read More

J Gynecol Obstet Hum Reprod 2022 Jun 3;51(7):102407. Epub 2022 Jun 3.

CHU Lille, Service de chirurgie gynécologique F-59000 Lille, France; Univ. Lille, CHU Lille, F-59000 Lille, France.

Because of the peak incidence of cervical cancer between the ages of 35 and 44 and the increasing age of first pregnancy, the issue of fertility preservation in cases of early-stage cervical cancer in women in this reproductive age category arises. Early-stage cervical cancer patients have a good prognosis and are surgically treated in cases of mildly aggressive human papillomavirus-related histological type (squamous cell carcinoma, adenocarcinoma), FIGO stage IA to IB1 (i.e. Read More

JSLS 2022 Apr-Jun;26(2)

Department of Gynecology, Virginia Mason Medical Center, Seattle, WA.

Three patients with abnormal uterine bleeding underwent uncomplicated minimally invasive total hysterectomy with routine cystoscopy. At time of cystoscopy, the patients had unexpected findings of bladder masses and postoperatively were expeditiously referred to urology. Final pathology for all revealed low-grade urologic carcinoma. Read More

J Minim Invasive Gynecol 2022 May 29. Epub 2022 May 29.

Bezmialem Vakıf University, Department of Obstetrics and Gynecology, Istanbul, Turkey.

Objective: This review aimed to compare isolated sciatic and sacral nerve root endometriosis in terms of anatomical distribution, patients' symptoms and history, diagnostics, treatments, and outcomes.

Data Source: We searched PubMed, MEDLINE, Web of Science, and EMBASE from inception to October 2021 using a combination of keywords including "sciatic nerve endometriosis'', ''sacral nerve root endometriosis'' and associated Medical Subject Headings. Relevant publications and references were also checked for further articles. Read More

Gynecol Oncol Rep 2022 Jun 19;41:100991. Epub 2022 May 19.

Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

In recurrent ovarian cancer patients the addition of surgical cytoreduction is associated with prolonged overall survival compared to chemotherapy treatment alone when complete cytoreduction is achieved (Harter et al., 2021, Shi et al., 2021, Coleman et al. Read More

Obstet Gynecol Clin North Am 2022 Jun;49(2):355-368

Division of Gynecologic Oncology, Levine Cancer Institute at Atrium Health, 1021 Morehead Medical Drive, Suite 2100, Charlotte, NC 28204, USA.

Gynecologic laparoscopy is a safe and effective route of surgery for many types of procedures. The potential for injury does exist, and prevention and timely recognition of complications are essential for maintaining the quality and safety of minimally invasive surgical procedures. Each facet of care, including preoperative preparation, appropriate patient positioning, trocar placement, and surgical technique, is reviewed, and recommendations are made to facilitate the performance of safe surgery and immediate recognition of complications if they do arise. Read More

Obstet Gynecol Clin North Am 2022 Jun;49(2):273-286

Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, 444 South San Vicente Boulevard #1003, Los Angeles, CA 90048, USA.

Since Food and Drug Administration approval in 2005, use of the robotic device in gynecologic surgery has continued to increase. There has been a growing number of applications in various surgical specialties including gynecology, and the surgical robot has been established as an additional surgical tool for performing minimally invasive gynecologic surgery. In this article, the authors review the development of robotic gynecologic surgery, clinical considerations, and future directions. Read More

J Invest Surg 2022 Jul 30;35(7):1604-1608. Epub 2022 May 30.

Department of Gynecologic Oncology, University of Health Sciences Turkey, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey.

Purpose: To evaluate the effects of mechanical bowel preparation (MBP) on the intraoperative visualization of the surgical field, bowel handling, intestinal load, and overall ease of surgery in patients undergoing elective laparoscopic gynecological surgeries.

Methods: The patients randomized to a MBP group and a no preparation (NMBP) group. The senior surgeon remained blinded to the bowel regimen used by the patient. Read More

Biology (Basel) 2022 May 18;11(5). Epub 2022 May 18.

Unit of Surgical Gynecol Oncology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy.

Endometrial cancer (EC) is the most common malignancy of the female genital tract in Western and emerging countries. In 2012, new cancer cases numbered 319,605, and 76,160 cancer deaths were diagnosed worldwide. ECs are usually diagnosed after menopause; 70% of ECs are diagnosed at an early stage with a favorable prognosis and a 5-year overall survival rate of 77%. Read More

Int J Gynaecol Obstet 2022 May 26. Epub 2022 May 26.

Department of Anesthesiology, Jiaxing Maternity and Children Health Care Hospital, Affiliated Women and Children Hospital, Jiaxing University, Jiaxing, Zhejiang, China.

Background: The proper time for removing the urinary catheter after gynecologic laparoscopy is unclear.

Objectives: To assess the feasibility of immediate catheter removal after benign gynecologic laparoscopy.

Search Strategy: PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Wanfang Data were searched from inception to November 30, 2021. Read More

Gynecol Oncol 2022 Jul 20;166(1):50-56. Epub 2022 May 20.

Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States of America. Electronic address:

Objective: To assess the impact of frailty in patients with ovarian cancer on surgical procedures and outcomes.

Methods: A retrospective review of patients with stage II-IV ovarian cancer from April 2013 to September 2017 was performed. Patients were triaged by laparoscopy to determine primary resectability. Read More

Obstet Gynecol 2022 May 5;139(5):922-932. Epub 2022 Apr 5.

Department of Urogynecology, Valley Medical Group/Valley Hospital, Ridgewood, New Jersey; and the Department of Urogynecology, Boston Urogynecology Associates/Mount Auburn Hospital, Cambridge, Massachusetts.

The past 4 years have been consequential in the world of surgery to correct pelvic organ prolapse. In 2018, results of a large, multicenter randomized trial demonstrated very disappointing cure rates of traditional native tissue repairs at 5 years or more. In 2019, a vaginal mesh hysteropexy kit was removed from the market by the U. Read More

Front Med (Lausanne) 2022 25;9:880681. Epub 2022 Apr 25.

Department of Medicine and Health Science, "V.Tiberio" Università Degli Studi del Molise, Campobasso, Italy.

Introduction: Ovarian cancer is the third most frequent gynecological cancer. In early stage ovarian cancer (ESOC) comprehensive surgical staging is recommended. Surgical staging is traditionally approached by laparotomy, although minimally invasive surgery can be a valid alternative in selected patients. Read More

Female Pelvic Med Reconstr Surg 2022 Jun 17;28(6):e215-e221. Epub 2022 May 17.

From the Georgetown University School of Medicine/MedStar Health, Washington, DC.

Importance: Data on long-term mesh hysteropexy outcomes are limited. This study provides 7-year data from the original VAULT (Vaginal and Laparoscopic Mesh Hysteropexy for Uterovaginal Prolapse Trial) study.

Objective: The aim of this study was to compare long-term outcomes and success for laparoscopic sacral hysteropexy (LSHP) and vaginal mesh hysteropexy (VMHP). Read More

JSLS 2022 Apr-Jun;26(2)

Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.

Background And Objectives: This study was designed to compare patients who have undergone conventional laparoscopic surgery with those who undergone multiport robot-assisted laparoscopic surgery for benign gynecological diseases regarding cosmetic results, patient satisfaction, and quality of life.

Methods: Sixty-four patients who underwent either robot-assisted or conventional laparoscopic surgery for benign gynecological diseases from July 1, 2019 to March 31, 2020 at Acibadem Mehmet Ali Aydinlar University Hospital were enrolled. Patients were evaluated using the Patient and Observer Scar Assessment Scale, visual analog scale for cosmetic satisfaction, body image questionnaire, and 12-item Short Form Survey six months postoperatively. Read More

J Minim Invasive Gynecol 2022 Apr 29. Epub 2022 Apr 29.

Department of Obstetrics and Gynecology (Drs. Ghirardi, Rosati, Ergasti, Gueli Alletti, Mascilini, Scambia, Fagotti), Università Cattolica del Sacro Cuore, Rome, Italy.; Division of Gynecologic Oncology (Drs. Ghirardi, Rosati, Ergasti, Alletti, Mascilini, Scambia, Fagotti), Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy.. Electronic address:

Study Objective: To identify preoperative/intraoperative patient and tumor characteristics associated with an increased risk of tumor spillage during minimally invasive surgery (MIS) for early-stage ovarian cancer (OC). The secondary end point was to develop a score system able to estimate the risk of tumor rupture during MIS.

Design: Retrospective observational study. Read More

J Minim Invasive Gynecol 2022 Apr 29. Epub 2022 Apr 29.

Division of Minimally Invasive Gynecologic Surgery, Baylor College of Medicine, Houston, Texas (Drs. Zi, Ding, Thigpen, and Guan). Electronic address:

Study Objective: To demonstrate tips and tricks for the successful use of single-site laparoscopic surgery for pedunculated myomectomy during pregnancy.

Design: Stepwise demonstration with narrated video footage.

Setting: An academic tertiary care hospital affiliated with Baylor College of Medicine. Read More