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Curr Opin Obstet Gynecol 2021 Jun 18. Epub 2021 Jun 18.

Minimally Invasive Gynecological Surgery Program, Hospital BP - A Beneficência Portuguesa de São Paulo Gynecologic Division Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

Purpose Of Review: Laparoscopic myomectomy is a common surgical procedure for symptomatic myomas. However, bleeding control during surgery may pose a challenge. Therefore, the aim of this study was to review recent evidence regarding interventions to control bleeding during laparoscopic myomectomy. Read More

Zhonghua Fu Chan Ke Za Zhi 2021 May;56(5):341-348

Department of Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

To investigate the occurrence and influencing factors of perioperative complications after robotic gynecologic surgery. The clinical data and occurrence of perioperative complications in 1 000 cases robotic surgery completed in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. (1) Clinical data: the average age of the patients was (50. Read More

Zhonghua Fu Chan Ke Za Zhi 2021 May;56(5):328-334

UT Southwestern Medical Center, Dallas, USA.

To evaluate the indications, surgical skills and clinic outcomes of abdominal minimal incision sacrocolpopexy (AMISC) for treatment of advanced pelvic organ prolapse (POP). The retrospective study analyzed 30 women with advanced POP who underwent AMISC between June 2016 and October 2019, including 9 cases of recurrent prolapse and 10 cases of vault prolapse. AMISC was especially applicable to: (1) patients with several medical complications who was unable to tolerate general anesthesia or laparoscopic surgery, but able to tolerate combined spinal-epidural anesthesia and open surgery; (2) other abdominal procedures were indicated to perform with AMISC simultaneously, such as myomectomy, subtotal hysterectomy etc, the specimens were easy to get out of the abdominal cavity and morcellation was avoided; (3) surgeons preferring open surgery to laparoscopic surgery or skilled in open surgery; (4) patients with prior pelvic operations, presenting severe abdominal and pelvic adhesions. Read More

Curr Opin Obstet Gynecol 2021 May 19. Epub 2021 May 19.

Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA.

Purpose Of Review: To review current US literature and describe the extent, source, and impact of disparities that exist among Black, Indigenous, and people of color (BIPOC) in surgical route and outcomes for hysterectomy, myomectomy, and endometriosis surgery.

Recent Findings: Despite the nationwide trend toward minimally invasive surgery (MIS), BIPOC women are disproportionally less likely to undergo MIS hysterectomy and myomectomy and have higher rates of perioperative complications. African American women, in particular, receive significantly disparate care. Read More

CVIR Endovasc 2021 May 20;4(1):42. Epub 2021 May 20.

Department of Interventional Radiology, Hopital Paris Saint-Joseph, Paris, Ile-de-France, France.

Purpose: Abdominal myomectomy can be a challenging procedure, with elevated intraoperative blood loss and post-operative complications such as the need for blood transfusion and hemostasis with sometimes hysterectomy. Previous studies suggested that preemptive uterine artery embolization (PUAE) might reduce intraoperative blood loss.

Materials And Methods: We reviewed all cases of abdominal myomectomy in our institution between January 2016 and June 2018. Read More

Eur J Obstet Gynecol Reprod Biol 2021 May 4;262:62-67. Epub 2021 May 4.

Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address:

Study Objective: To identify factors that prolong total operative time (TOT) in robotic-assisted laparoscopic myomectomy (RALM).

Design: Retrospective cohort study.

Setting: Tertiary university hospital. Read More

Surg Technol Int 2021 05 4;38. Epub 2021 May 4.

Clinical Associate Professor of Gynecology, University of Rochester Medical Center, Rochester, New York.

The introduction of the continuous flow gynecologic resectoscope (CFGR) in 1989 revolutionized minimally invasive gynecologic surgery (MIGS) by introducing such intrauterine procedures as hysteroscopic myomectomy, polypectomy, and endometrial ablation. However, with the subsequent introduction of global endometrial ablation (GEA) devices and hysteroscopic morcellators (HMs), the CFGR has fallen into relative disuse-a regrettable situation since it remains ideally suited for accomplishing many procedures that are otherwise not achievable with these newer technologies. Procedures which involve greater precision and control-endomyometrial resection (EMR), hysteroscopic metroplasty, the correction of isthmoceles, the resection of intramural myomas, and the management of late-onset endometrial ablation failure-are only possible with the CFGR. Read More

Am J Case Rep 2021 Apr 26;22:e931051. Epub 2021 Apr 26.

Department of Obstetrics and Gynecology, Dr. Soetomo General Academic Hospital, Medical Faculty, Universitas Airlangga, Surabaya, Indonesia.

BACKGROUND No standard guidelines have been specified for a cesarean myomectomy, and several centers remain divided on the justification to perform this procedure, especially for large fibroids. Only a few case reports have been published of cesarean myomectomy for large fibroids. Here, we report 2 cases of successful cesarean myomectomies for large fibroids (>15 cm) during the 38th week of pregnancy. Read More

Asian J Endosc Surg 2021 Mar 28. Epub 2021 Mar 28.

Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.

Introduction: We aimed to identify the characteristics of cases involving postoperative bleeding after laparoscopic gynecologic surgery, and to clarify the optimal cutoff value of postoperative drainage and vital sign trends for predicting the need for re-laparoscopy.

Methods: Of 6366 patients with gynecologic benign pathologies who underwent laparoscopic surgery at our institution between 2009 and 2018, 13 (0.2%) required re-laparoscopy for postoperative bleeding. Read More

J Gynecol Obstet Hum Reprod 2021 Mar 26;50(8):102126. Epub 2021 Mar 26.

Department of Obstetrics and Gynecology, The George Washington University Hospital, 900 23rd Street NW, Washington, DC 20037, USA. Electronic address:

Objective: Clarify the normal patterns of voiding after minimally invasive hysterectomy. We also aim to identify perioperative factors associated with delayed time to void immediately following hysterectomy.

Design: Retrospective cohort study SELECTION: Women undergoing laparoscopic hysterectomy between September 2012 to October 2018 at a single academic university hospital. Read More

Gynecol Oncol Rep 2021 May 4;36:100741. Epub 2021 Mar 4.

Chief of Peritoneal Surface Malignancy Program and Director of the Center for Gastrointestinal Malignancies, MedStar Washington Cancer Institute, Washington, DC, USA.

Uterine leiomyosarcoma (uLMS) is a rare aggressive malignant mesenchymal tumor with high risk of recurrence and poor prognosis regardless of stage. It is often diagnosed postoperatively following myomectomy, hysterectomy or supracervical hysterectomy for presumed benign disease. Primary surgery at the diagnosis of uLMS is considered to affect outcomes. Read More

Gynecol Minim Invasive Ther 2021 Jan-Mar;10(1):1-9. Epub 2021 Jan 30.

Division of Urogynecology, Department of Obstetrics and Gynecology, Chi Mei Medical Center, Tainan, Taiwan.

With the advance of minimally invasive surgery (MIS), the surgical trends of hysterectomy changed significantly during past 2 decades. Total number (age-standardized) of all types of hysterectomy decreased, which may be due to the availability of some other alternatives, e.g. Read More

J Minim Invasive Gynecol 2021 Mar 18. Epub 2021 Mar 18.

Department of Obstetrics and Gynecology (Drs. Marfori, Barnes, and Moawad); The Center for Endometriosis and Advanced Pelvic Surgery (Dr. Moawad), Washington, District of Columbia.

Study Objective: We sought to identify the variables independently associated with intra/postoperative blood transfusion at the time of myomectomy. We further hoped to develop an accurate prediction model using preoperative variables to categorize an individual's risk of blood transfusion during myomectomy.

Design: Case-control study. Read More

Int J Surg Case Rep 2021 Apr 11;81:105745. Epub 2021 Mar 11.

Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC. Electronic address:

Introduction: Leiomyomatosis peritonealis disseminata (LPD) is a rare clinical condition that can be challenging to diagnose because its clinical features mimic other conditions. We present a case of LPD mimicking peritoneal carcinomatosis 13 years after laparoscopic uterine myomectomy using a power morcellator. The aim of this paper is to report a rare case which surgeons can learn from and to provide more clinical information for further studies to investigate LPD. Read More

J Pediatr Adolesc Gynecol 2021 Mar 3. Epub 2021 Mar 3.

Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas. Electronic address:

Background: Single-incision laparoscopic surgery (SILS) is an exciting new modality in the field of minimal access surgery. This case illustrates the feasibility of single-incision laparoscopic surgery for uterine pathology in the pediatric and adolescent population.

Case: A 19-year-old girl presented with pelvic pain. Read More

J Robot Surg 2021 Feb 26. Epub 2021 Feb 26.

Department of Obstetrics and Gynecology, Lebanese American University Medical Center, Beirut, Lebanon.

The Unites States spends on healthcare, with women's health being included, more than what middle-to-low-income countries, such as Lebanon, do. Compared to the United States, Lebanon has negligible data on the amounts spent on healthcare including female health services. In this study, we try to assess the cost differences of common gynecologic procedures between Lebanon and the United States, trying to fill the gap of missing data in Lebanon and identifying potential factors that can lead to high healthcare cost in the United States. Read More

Ginekol Pol 2021 Feb 12. Epub 2021 Feb 12.

2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.

The prevalence of clinically symptomatic cervical leiomyomas in pregnancy is lower than 0.1%. Surgical intervention is necessary in extremely rare cases and only few are described in the literature. Read More

Surg Innov 2021 Feb 8:1553350620988227. Epub 2021 Feb 8.

Metaxa Memorial Cancer Hospital, Piraeus, Greece.

To review the existing studies on single-site robotic myomectomy and test the safety and feasibility of this innovative minimally invasive technique. PubMed, Scopus, Google Scholar (from their inception to October 2019), as well as Clinicaltrials.gov databases up to April 2020. Read More

J Gynecol Obstet Hum Reprod 2021 Feb 3;50(8):102077. Epub 2021 Feb 3.

Department of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. Electronic address:

Aim: To perform a systematic review and meta-analysis of all randomized controlled trials that examined the efficacy of intraoperative local injection of the uterosacral ligaments with ropivacaine on postoperative pain and opioids consumption in patients undergoing uterine surgery for hysterectomy/myomectomy.

Methods: PubMed, Scopus, Web of Science and Cochrane Library databases were screened from inception to September 5th, 2020. We appraised the risk of bias using the Cochrane's risk of bias tool. Read More

Adv Urol 2021 20;2021:8838146. Epub 2021 Jan 20.

Aix-Marseille Université, Marseille, France.

Objective: To compare the sociodemographic, clinical, and therapeutic characteristics of obstetric urogenital fistulas (OF) and iatrogenic urogenital fistulas (IF) treated in seven centers in Burkina Faso. . We carried out a cross-sectional study over a seven years' period (January 1, 2010 to December 31, 2016). Read More

J Turk Ger Gynecol Assoc 2021 02 4;22(1):53-57. Epub 2021 Jan 4.

Department of Gynecologic Oncology, Acıbadem University Faculty of Medicine, İstanbul, Turkey

Morcellation allows the removal of a large uterus and fibroids through small incisions with minimally invasive surgery. It helps to prevent the complications associated with large incisions in both hysterectomy and myomectomy operations. Currently, there is much debate regarding the use of power morcellation in laparoscopic hysterectomy and myomectomy, mainly due to the risk of peritoneal dissemination of undiagnosed uterine sarcomas. Read More

Fertil Steril 2021 Feb 4;115(2):522-524. Epub 2020 Dec 4.

InSer, Instituto de Fertilidad Humana, Medellín, Colombia. Electronic address:

Objective: To introduce a new double-lumen intracervical cannula designed to allow a single-step hysteroscopic myomectomy with nonfragmented complete fibroid extraction after cold enucleation of submucosal type 2 fibroids, avoiding complications related to the use of energy and hypo-osmolar solutions.

Design: Video article depicting the use of a new double-lumen intracervical cannula for single-step hysteroscopic cold myomectomy, according to our institutional care guidelines and after obtaining the patient's informed consent. (The publication of this video has been authorized by the Institutional Ethics Committee of CES University in Medellín, Colombia. Read More

Tzu Chi Med J 2020 Oct-Dec;32(4):398-400. Epub 2019 Dec 5.

Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.

Leiomyomas are the most common benign gynecologic tumors and the most common surgical indication for hysterectomy or myomectomy. Recurrent pelvic leiomyomas or vaginal leiomyomas are rare. We report the case of a 60-year-old woman with a history of a cesarean total hysterectomy 25 years before presenting to us, who developed a pelvic leiomyoma arising from the vaginal cuff. Read More

J Minim Invasive Gynecol 2020 Nov 2. Epub 2020 Nov 2.

Department of Pathology, Arash Women's Hospital, Tehran University of Medical Sciences (Dr. Seifollahi).

Study Objective: This study evaluated peritoneal washings for the detection of spindle cells (SCs) in laparoscopic and open myomectomies.

Design: Prospective, nonrandomized clinical trial.

Setting: An academic tertiary referral center. Read More

Gynecol Minim Invasive Ther 2020 Jul-Sep;9(3):179-181. Epub 2020 Aug 1.

Department of Obstetrics and Gynecology, Army Hospital Research and Referral, New Delhi, India.

Transvaginal surgery is the most minimally invasive surgery for a gynecologic procedure. A 67-year-old woman who had four children with vaginal deliveries and one abortion, with no underlying disease and a body mass index of 22.4 kg/m, came to the hospital due to menorrhagia. Read More

JSLS 2020 Oct-Dec;24(4)

Mercy Research, 615 S. New Ballas Rd, Ste 2010, St. Louis, Missouri.

Background And Objective: The purpose of this study was to evaluate the impact of using electrostatic precipitation to manage the surgical plume during low pressure laparoscopic gynecologic procedures.

Methods: This was a prospective, blinded, randomized controlled study of women with a clinical indication for laparoscopic hysterectomy (n = 30) or myomectomy (n = 5). Patients were randomized to either use electrostatic precipitation (EP) during the procedure, or not (No EP, hysterectomy group only). Read More

J Obstet Gynaecol Res 2021 Jan 15;47(1):329-336. Epub 2020 Oct 15.

Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Aim: We aimed to evaluate regional disparities in the proportion of the three main laparoscopic surgeries for benign gynecological diseases among 47 prefectures in Japan and their correlation with the number of laparoscopy-qualified gynecologists per population.

Methods: In this retrospective ecological study, we collected the data of patients from 47 prefectures in 2017 using "The National Database of Health Insurance Claims and Specific Health Checkups of Japan" Open Data from the Ministry of Health, Labor and Welfare in Japan. The primary outcome of the study was the proportion of laparoscopic surgeries conducted for benign gynecologic diseases (hysterectomy, myomectomy and surgery for the benign ovarian diseases). Read More

J Int Med Res 2020 Sep;48(9):300060520959494

Department of Anesthesiology and Pain Medicine, Daejoen Eulji Medical Center, Eulji University, Daejeon, Korea.

Vasopressin local infiltration is useful in gynecological surgery because it can reduce hemorrhage. Depending on the activities of the sympathetic system and the renin-angiotensin system, reactions to vasopressin may differ and predicting its systemic effects is difficult. Because life-threatening complications can occur, infiltration with vasopressin should be administered with caution. Read More

J Minim Invasive Gynecol 2020 Sep 19. Epub 2020 Sep 19.

Gynecologic Oncology Unit, MD Anderson Cancer Center (Dr. Santiago), Madrid, Spain.

Study Objective: To show 3 different techniques for achieving an endobag morcellation without adding extra time and cost to the surgery.

Design: Stepwise demonstration of the 3 techniques with narrated video footage.

Setting: Morcellation is a useful procedure for fragmenting and extracting specimens during laparoscopic surgery without the need to perform a laparotomy. Read More

J Gynecol Obstet Hum Reprod 2021 Jan 12;50(1):101911. Epub 2020 Sep 12.

Department of Gynecologic Oncology - AC Camargo Cancer Center, Brazil.

VNOTES is a novel technique that allows access to the pelvic-abdominal cavity through the vagina. Myomectomy can be performed by vNOTES even through anterior cul-de-sac incision and for selected cases of uterine malformation. Here we present a 29-years-old patient with a complaint about pelvic discomfort. Read More