Search Our Scientific Publications & Authors

J Robot Surg 2019 Jan 21. Epub 2019 Jan 21.

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

Minimizing the number of port incisions during minimally invasive surgery is associated with improved outcomes and patient satisfaction. We designed this work to study the perioperative outcomes of robotic single-site myomectomy (RSSM) in comparison to robotic multiport myomectomy (RMM) in a certain subset of patients. The design of the study is a multicenter retrospective analysis (Canadian Task Force classification III). Read More

JSLS 2018 Oct-Dec;22(4)

Department of Obstetrics and Gynecology, University of Louisville Hospital, Louisville, KY, USA.

Background And Objectives: To perform a systematic review of articles evaluating hemostatic effectiveness and peri-operative outcomes when topical hemostatic agents (HA) are used in minimally invasive gynecologic surgeries (MIGS) for benign conditions.

Methods: Studies published through March 31, 2017 were retrieved through PubMed, EMBASE, Cochrane, and ClinicalTrials.gov to identify all eligible studies. Read More

J Minim Invasive Gynecol 2019 Jan 4. Epub 2019 Jan 4.

Departments of Obstetrics and Gynecology (Drs. Smith and Hoffman); Division of Gynecologic Subspecialties (Dr. Hoffman), University of Kentucky, Lexington, Kentucky.

Study Objective: To identify factors contributing to prolonged hospitalization for women undergoing myomectomy for uterine myomas.

Patients: Women undergoing myomectomy for uterine myomas during 2014 to 2016 were identified by the Current Procedural Terminology code.

Design: Retrospective population-based analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Read More

Eur J Obstet Gynecol Reprod Biol 2018 Dec 26;231:230-234. Epub 2018 Oct 26.

Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada; Department of Obstetrics and Gynaecology, Division of Gynaecologic Surgery and Pelvic Medicine, St. Michael's Hospital, Toronto, Ontario, Canada. Electronic address:

Objective To obtain expert consensus on the patient and fibroid characteristics that affect the complexity of laparoscopic myomectomy (LM) and to use these factors to create a grading tool for objective evaluation of LM procedures. Study design Modified Delphi Methodology Study (Canadian Task Force III). Setting included a series of online surveys via SurveyMonkey (SurveyMonkey Inc. Read More

J Minim Invasive Gynecol 2018 Nov 2. Epub 2018 Nov 2.

Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts (all authors). Electronic address:

Study Objective: To describe the perioperative outcomes of various modes of myomectomy (abdominal [AM], laparoscopic [LM], or robotic [RM]) in cases of extreme myoma burden.

Design: Retrospective cohort study (Canadian Task Force classification II-2).

Setting: A tertiary academic center in Boston, Massachusetts. Read More

J Minim Invasive Gynecol 2018 Oct 10. Epub 2018 Oct 10.

Department of Obstetrics and Gynecology, Inova Fairfax Hospital, Falls Church, VA (Dr. Awad).

Study Objective: To achieve tissue containment and extraction for numerous and large myomas in the complex minimally invasive difficult myomectomy setting via a surgical tutorial including technical pointers and suggestions DESIGN: A step-by-step explanation of the .surgery using video (instructive video) (Canadian Task Force classification III). Institutional review board approval was not required for this study. Read More

Obstet Gynecol 2018 Nov;132(5):1275-1284

Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Packard Children's Health Alliance, Stanford Medicine, Stanford, California; and the University of Massachusetts Memorial Medical Center, Worcester, Massachusetts.

Objective: To evaluate the incidence of postoperative venous thromboembolism after gynecologic surgery by mode of incision.

Methods: We conducted a retrospective cohort study of all patients who underwent gynecologic surgery from May 2006 to June 2015 at two tertiary care academic hospitals in Massachusetts. Billing and diagnosis codes were used to identify surgeries and cases of venous thromboembolism. Read More

J Minim Invasive Gynecol 2018 Sep 27. Epub 2018 Sep 27.

Department of Anesthesia (Dr. Brown), BC Women's Hospital, Vancouver, British Columbia, Canada; Department of Anesthesiology, Pharmacology and Therapeutics (Dr. Brown), University of British Columbia, Vancouver, British Columbia, Canada. Electronic address:

We present a case of severe hypokalemia, metabolic acidosis, and arrhythmia after absorption of 2500 mL normal saline during a hysteroscopic myomectomy. The patient was a 36-year-old woman with abnormal uterine bleeding caused by a submucosal leiomyoma. She received a total of 3500 mL normal saline (2500 mL was absorbed via the uterus and 1000 mL given intravenously) during hysteroscopy. Read More

Gynecol Minim Invasive Ther 2018 Jan-Mar;7(1):10-15. Epub 2018 Feb 16.

Department of Gynecology and Obstetrics, Tenth People's Hospital, Tongji University School of Medicine, Shanghai, P.R.China.

Study Objective: The aim of this study is to elaborate the changes of the surgical approach of treatment for uterine myomas in Yangpu Hospital in the past 15 years.

Design: This was retrospective cohort study.

Setting: Yangpu Hospital, Tongji University School of Medicine, Shanghai, China. Read More

Eur J Obstet Gynecol Reprod Biol 2018 Nov 13;230:85-89. Epub 2018 Sep 13.

Department of Surgical Pathology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China; Center for Uterine Cancer Diagnosis & Therapy of Zhejiang Province, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China. Electronic address:

Objectives: Our objective is to investigate the prevalence, pathology and prognosis of uterine sarcomas in laparoscopic hysterectomy/myomectomy with electric power morcellation for presumed leiomyomas.

Study Design: We retrospectively reviewed patients with laparoscopic power morcellation (LPM) for presumed leiomyomas in a Chinese tertiary institution by chart review from September 1, 2013 to December 31, 2016.

Results: Twenty-four in 4478 patients (0. Read More

Turk J Obstet Gynecol 2018 09 3;15(3):193-199. Epub 2018 Sep 3.

Koç University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey.

Gelatin-thrombin matrix (GTM) is a hemostatic sealant consisting of bovine-derived gelatin matrix and human-derived thrombin, combining both mechanical and active mechanisms to achieve hemostasis. It was approved by the Food and Drug Administration in 1999. GTM has been used by several surgical specialties; however, it is a possibly an under-used tool in obstetrics and gynecology. Read More

J Minim Invasive Gynecol 2018 Aug 28. Epub 2018 Aug 28.

Department of Obstetrics and Gynecology (Drs. Nguyen, Salyer, and Zaritsky), Kaiser Permanente Northern California, Oakland, California. Electronic address:

Study Objective: To investigate rates of utilization of alternative treatments before hysterectomy for benign gynecologic indications within a large integrated health care system.

Design: Retrospective cohort study of patients who underwent hysterectomies for benign gynecologic conditions between 2012 and 2014 (Canadian Task Force classification II-2).

Setting: Kaiser Permanente Northern California, a community-based integrated health system. Read More

Gynecol Oncol Rep 2018 Nov 2;26:17-20. Epub 2018 Jul 2.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, San Antonio Military Medical Center, United States.

Background: Sex cord tumors with annular tubules (SCTAT) are a rare (2%) subtype of ovarian sex cord-stromal tumor. SCTATs are usually cured at time of diagnosis by surgical resection with an oophorectomy. SCTATs have a 100%(disease related) five-year survival. Read More

J Obstet Gynaecol Res 2018 Nov 20;44(11):2067-2076. Epub 2018 Aug 20.

Tottori University Faculty of Medicine, Yonago, Japan.

Aim: Since 2014, Japan Society of Gynecologic and Obstetric Endoscopy and minimally invasive therapy (JSGOE) conducted a nationwide survey on gynecologic endoscopic surgery. We aimed to evaluate the current status and complications associated with endoscopic surgery by Japan gynecologic and obstetric endoscopy-database registry system (JOE-D).

Methods: Electrical medical records concerning the endoscopic surgery were generated from the daily use of reporting system. Read More

Obstet Gynecol 2018 Aug;132(2):519

Department of Obstetrics and Gynecology, Center for Cancer Care, NYU Winthrop Hospital, Mineola, New York Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina Stanford Women's Cancer Center, Stanford Cancer Institute, Stanford, California.

Obstet Gynecol 2018 Aug;132(2):518-519

Yardley, Pennsylvania.

Surg Endosc 2018 Jul 9. Epub 2018 Jul 9.

Department of Gynecology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.

Background: To assess potential risks of new surgical procedures and devices before their introduction into daily practice, a prospective risk inventory (PRI) is a required step. This study assesses the applicability of the Health Failure Mode and Effects Analysis (HFMEA) as part of a PRI of new technology in minimally invasive gynecologic surgery.

Methods: A reference case was defined of a patient with presumed benign leiomyoma undergoing a laparoscopic hysterectomy or myomectomy including in-bag power morcellation; however, pathology defined a stage I uterine leiomyosarcoma. Read More

Curr Opin Obstet Gynecol 2018 08;30(4):243-251

Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.

Purpose Of Review: Submucosal uterine leiomyomas are a common benign pelvic tumor that can cause abnormal uterine bleeding and may contribute to infertility and miscarriage. Hysteroscopic myomectomy is the treatment of choice to alleviate bleeding from these myomas and to normalize the uterine cavity. This review discusses the techniques and recent evidence for hysteroscopic myomectomy and examines the two primary surgical tools employed today: the bipolar resectoscope and hysteroscopic mechanical morcellator. Read More

Eur J Obstet Gynecol Reprod Biol 2018 Sep 5;228:1-5. Epub 2018 Jun 5.

Comprehensive Gynecologic Cancer Center,CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.

Objectives: The present study aimed to analyze the clinicopathologic features and treatment of uSTUMP in a single institution. In addition, we described the obstetric outcomes after uterine-preserving surgery for uSTUMP.

Methods And Materials: A retrospective chart review was performed of patients diagnosed with uSTUMP between January 2000 and February 2018 at the Comprehensive Gynecologic Cancer Center, CHA Bundang Medical Center. Read More

Gynecol Oncol 2018 10 8;151(1):6-9. Epub 2018 Jun 8.

University of Alabama at Birmingham, Department of Pathology, United States.

A 32 year-old nulligravid woman with a uterine mass underwent exploratory laparotomy with myomectomy. Final pathology revealed a low-grade endometrial stromal sarcoma (ESS) with positive margins. She subsequently underwent definitive robotic hysterectomy and bilateral salpingectomy with ovarian preservation. Read More

J Minim Invasive Gynecol 2018 May 18. Epub 2018 May 18.

Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, Athens, Greece.

Study Objective: Τo investigate whether the use of vasopressin played an important role in the safe expansion of the indications of laparoscopic myomectomy in our practice.

Design: A retrospective comparison of prospectively collected data (Canadian Task Force classification II2).

Setting: A gynecologic endoscopy unit in a tertiary university hospital. Read More

Med Sci Monit 2018 May 9;24:3042-3049. Epub 2018 May 9.

Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China (mainland).

BACKGROUND The aim of this study was to evaluate the safety and efficacy of a 'baseball' suture technique for uterine myomectomy incision closure in laparoscopic surgical enucleation of uterine leiomyoma (fibroid). MATERIAL AND METHODS The study included 20 patients who underwent laparoscopic myomectomy with a 'baseball' suture technique, compared with 20 patients who underwent laparoscopic myomectomy with a standard suture method. Clinical characteristics, perioperative and follow-up data were compared between the two groups. Read More

Gynecol Obstet Invest 2018 12;83(6):521-532. Epub 2018 Apr 12.

Department of Obstetrics and Gynaecology, University of Pavia, Fondazione IRCCS Policlinico, Pavia, Italy.

Background: This work analyzes the feasibility and effectiveness of barbed suture during laparoscopic myomectomy.

Methods: Eight works have been carefully examined for the meta-analysis from all papers published online until November 2017.

Results: Barbed suture proved to be superior to traditional suture technique in blood loss in laparoscopic myomectomy (Standardized Mean Difference [SMD] -0. Read More

J Minim Invasive Gynecol 2019 Jan 28;26(1):31. Epub 2018 Mar 28.

Nezhat Surgery for Gynecology/Oncology, Weill Cornell Medical College of Cornell University, Stony Brook University School of Medicine, Minimally Invasive Gynecologic Surgery and Robotics, NYU Winthrop Hospital, New York, New York. Electronic address:

Study Objective: To illustrate a robotic-assisted laparoscopic resection for cervicovaginal myomectomy.

Design: Step-wise instruction using video and case report (Canadian Task Force classification III).

Setting: A tertiary referral center. Read More

Obstet Gynecol Sci 2018 Mar 2;61(2):267-273. Epub 2018 Feb 2.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.

Objective: This study introduces and evaluates the feasibility, safety, and surgical outcomes of the in-bag power morcellation technique during single-port assisted (SPA) laparoscopic myomectomy in comparison with manual scalpel morcellation.

Methods: This is a retrospective review of a total of 58 patients who underwent SPA laparoscopic myomectomy employing in-bag power morcellation (n=27) or manual scalpel morcellation (n=31), performed between December 2014 and December 2016. Surgical outcomes, including total operation time, estimated blood loss, postoperative hemoglobin changes, postoperative hospital stay, postoperative pain (visual analog scale), perioperative and postoperative complications were evaluated. Read More

Obstet Gynecol 2018 Apr;131(4):642-651

Departments of Obstetrics, Gynecology and Reproductive Sciences and Internal Medicine and the Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale School of Medicine, New Haven, Connecticut; the Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York; and the Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut.

Objective: To estimate the prevalence of corpus uteri, cervix uteri, and ovarian malignancy in women undergoing hysterectomy or myomectomy for presumed benign indications.

Methods: We conducted a secondary analysis of data from the 2014-2015 American College of Surgeons National Surgical Quality Improvement Program. Adult women undergoing hysterectomies and myomectomies without evidence for known or suspected cancer at the beginning of surgery were identified from the database. Read More

J Gynecol Obstet Hum Reprod 2018 Jun 3;47(6):247-252. Epub 2018 Mar 3.

Department of Gynecology and Obstetrics, Centre Hospitalier de Versailles, 78157 Le Chesnay Cedex, France; Department of Gynecology and Obstetrics, Hôpital Bicêtre, GHU Sud, AP-HP, 94276 Le Kremlin-Bicêtre, France. Electronic address:

Objective: The objective was to compare results of two groups of population (novices and experts) on a virtual reality simulator of hysteroscopy resection for different metrics and for a multimetric score to assess its construct validity.

Materials And Methods: Nineteen gynecologist who had at least 5 years of experience with hysteroscopy and self-evaluated their expertise at 4/5 or 5/5 were included as expert population. Twenty first-year gynecology residents in Paris were included as novice population. Read More

Surg Infect (Larchmt) 2018 May/Jun;19(4):397-402. Epub 2018 Feb 16.

5 Department of Obstetrics and Gynecology, University of Kansas School of Medicine-Wichita , Wichita, Kansas.

Background: The purpose of this study was to establish compliance with guidelines published by the American College of Obstetricians and Gynecologists (ACOG) regarding prophylactic antibiotic use in gynecologic surgery at our institution, and define areas of improvement to promote antibiotic stewardship.

Patients And Methods: This was a retrospective cohort study at a single, large tertiary care and teaching hospital in Kansas. Patients who underwent inpatient or outpatient gynecologic surgery during 2013 were included. Read More

J Minim Invasive Gynecol 2018 Sep - Oct;25(6):959-960. Epub 2018 Feb 2.

Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Baylor College of Medicine, Houston, Texas. Electronic address:

Study Objective: Transvaginal surgery is the most minimally invasive surgery for a gynecologic procedure, but it has the limitation of lack of exposure and limited surgical space when using traditional vaginal surgical instrumentation, such as in a hysterectomy for a uterus without descent or for a myomectomy. Transvaginal natural orifice transluminal endoscopic surgery (NOTES) offers similar benefits of traditional vaginal surgery but also expands the horizon of transvaginal surgery by allowing the surgeon to perform procedures that are typically limited to an abdominal approach. The advantages of NOTES may include no incisional pain as well as a better cosmetic outcome. Read More

Med J Aust 2018 02;208(2):90-95

Royal Women's Hospital, Melbourne, VIC.

Abnormal uterine bleeding refers to any change in the regularity, frequency, heaviness or length of menstruation. There are several potential causes for bleeding disturbance, the two most common being primary endometrial dysfunction and fibroids. Management of abnormal uterine bleeding involves both medical and surgical options and will largely depend on a patient's fertility plans. Read More

J Minim Invasive Gynecol 2018 Sep - Oct;25(6):1024-1030. Epub 2018 Jan 31.

Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts. Electronic address:

Study Objective: To compare outcomes following umbilical minilaparotomy and suprapubic minilaparotomy for tissue extraction.

Design Classification: Retrospective cohort study (Canadian Task Force classification II-2).

Setting: Two large academic medical centers. Read More

Int J Med Sci 2018 1;15(2):124-128. Epub 2018 Jan 1.

Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.

Uterine leiomyomas are one of the most common benign gynecologic tumors, but the exact causes are not completely understood. In 2011, through DNA sequencing, mutation was discovered in approximately 71% of uterine leiomyomas. Several recent studies confirmed the high frequency of mutation in uterine leiomyoma. Read More

Curr Opin Obstet Gynecol 2018 Feb;30(1):75-80

Department of Reproductive Medicine, UC San Diego School of Medicine, San Diego, California, USA.

Purpose Of Review: Minimally invasive gynecologic procedures, in particular laparoscopic hysterectomy and myomectomy, often require tissue morcellation.

Recent Findings: Whether morcellated or not, myometrial cells can be found in the abdomen and pelvis after either laparoscopic or open myomectomy. Following morcellation, careful inspection for and removal of tissue fragments and copious irrigation and suctioning of fluid can remove residual tissue and cells without the use of containment bags. Read More

Curr Opin Obstet Gynecol 2018 Feb;30(1):89-95

Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Purpose Of Review: As the Food and Drug Administration raised concern over the power morcellator in 2014, the field has seen significant change, with patients and physicians questioning which procedure is safest and most cost-effective. The economic impact of these decisions is poorly understood.

Recent Findings: Multiple new technologies have been developed to allow surgeons to continue to afford patients the many benefits of minimally invasive surgery while minimizing the risks of power morcellation. Read More

J Korean Med Sci 2018 Jan 8;33(2):e12. Epub 2018 Jan 8.

Department of Biomedical Engineering, Gachon University, Incheon, Korea.

Background: Uterine myoma is the most common benign gynecologic tumor in reproductive-aged women. During myomectomy for women who want to preserve fertility, it is advisable to detect and remove all myomas to decrease the risk of additional surgery. However, finding myomas during surgery is often challenging, especially for deep-seated myomas. Read More

Eur J Obstet Gynecol Reprod Biol 2018 Jan 7;220:30-38. Epub 2017 Nov 7.

Department of Obstetrics & Gynecology, Nova Medical School - Faculdade de Ciências Médicas, Nova University of Lisbon, Lisbon, Portugal; Department of Obstetrics & Gynecology, Hospital S. Francisco Xavier -- CHLO, Lisbon, Portugal. Electronic address:

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. A literature search within the Medline/PubMed and Cochrane Database was carried out using keywords "morcellation", "uterine fibroids", "uterine sarcoma", "myomectomy" and "hysterectomy". Read More

J Minim Invasive Gynecol 2018 May - Jun;25(4):679-683. Epub 2017 Nov 13.

Department of Gynecology and Human Reproduction Physiopathology, Il Dipartimento di Scienze Mediche e Chirurgiche, S Orsola Hospital, University of Bologna, Bologna, Italy.

Study Objective: To determine the accuracy of pelvic ultrasonography (US) in preoperative evaluation before laparoscopic myomectomy.

Design: A prospective cohort study (Canadian Task Force classification II-2).

Setting: A tertiary level referral center of minimally invasive gynecologic surgery, Sant'Orsola University Hospital, Bologna, Italy. Read More

J Chin Med Assoc 2018 02 9;81(2):178-182. Epub 2017 Nov 9.

Division of Gynecologic Endoscopy, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC. Electronic address:

Background: To compare conventional electrosurgery, LigaSure (Valleylab, Boulder, CO), and Harmonic scalpel (Ethicon Endosurgery, Cincinnati, OH) in terms of perioperative and postoperative outcomes during laparoscopic myomectomy (LM).

Methods: We retrospectively studied 817 women with symptomatic fibroids who underwent LM between January 1997 and September 2015. Three different instruments were used separately during surgery. Read More

Best Pract Res Clin Obstet Gynaecol 2018 Jan 16;46:12-30. Epub 2017 Oct 16.

St. George's University of London Medical School, Nicosia University, 93 Agiou Nikolaou Street, Engomi 2408, Nicosia, Cyprus. Electronic address:

The diagnosis of a uterine myoma size and location can be very precise when a 3D sonograph and knowledge are available. The majority of fibroids are asymptomatic, and expectant management is recommended. In young patients, fibroids cause infertility and in middle-aged women, abnormal uterine bleedings. Read More

Obstet Gynecol 2017 12;130(6):1251-1260

Center for Minimally Invasive Gynecologic Surgery, Cedars-Sinai Medical Center, Los Angeles, California; and the Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts.

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. Read More

Best Pract Res Clin Obstet Gynaecol 2018 Jan 29;46:99-112. Epub 2017 Sep 29.

Northwestern University, Feinberg School of Medicine, Division of Minimally Invasive Gynecology, 250 E Superior, Suite 03-2303, Chicago, IL 60611, USA.

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. Read More

J Minim Invasive Gynecol 2018 Mar - Apr;25(3):491-497. Epub 2017 Oct 20.

Department of Obstetrics and Gynecology, Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York.

Study Objective: To compare the incidence of unsuspected uterine sarcoma based on surgical approach, open versus minimally invasive, for myomectomy and hysterectomy.

Design: Retrospective chart review of demographic data, preoperative characteristics, operative details, and pathology results from the electronic medical record (Canadian Task Force classification II-3).

Setting: A large, urban, academic medical center. Read More

Acta Obstet Gynecol Scand 2017 Dec;96(12):1446-1452

Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA.

Introduction: Operative morbidity of laparoscopic myomectomy largely relates to the potential for intraoperative blood loss. We sought to determine whether blood loss varies according to the menstrual cycle.

Material And Methods: A retrospective study of 268 women who underwent a laparoscopic myomectomy from 2007 to 2012. Read More

Minerva Ginecol 2018 Feb 3;70(1):84-88. Epub 2017 Oct 3.

Joan and Sanford I. Weill Medical College, The Graduate School of Medical Sciences, New York, NY, USA -

In April 2014, the United States of America Food and Drug Administration (FDA) published a safety communication warning of the risk of an unsuspected uterine sarcoma being morcellated during a laparoscopic procedure, and advised against the use of power morcellation. In November of the same year, this agency stated: 1) laparoscopic power morcellators are contraindicated for removal of uterine tissue containing suspected fibroids in patients who are peri- or postmenopausal, or are candidates for "en bloc" tissue removal; 2) laparoscopic power morcellators are contraindicated in gynecologic surgery in which the tissue to be morcellated is known or suspected to contain malignancy. In addition, the FDA warned that uterine tissue may contain unsuspected cancer, and the use of laparoscopic power morcellators during fibroid surgery may spread cancer, and decrease the long-term survival of patients. Read More

Arch Gynecol Obstet 2017 Dec 27;296(6):1167-1173. Epub 2017 Sep 27.

Department of Woman and Child Health, Università di Padova, Padua, Italy.

Purpose: Laparoscopic myomectomy is the uterus-preserving surgical approach of choice in case of symptomatic fibroids. However, it can be a difficult procedure even for an experienced surgeon and can result in excessive blood loss, prolonged operating time and postoperative complications. A combined approach with laparoscopic uterine artery occlusion and simultaneous myomectomy was proposed to reduce these complications. Read More

BMJ Open 2017 Sep 3;7(9):e015571. Epub 2017 Sep 3.

Cemka-Eval,boulevard Maréchal-Joffre, Bourg-la-Reine, France.

Objective: To assess the budget impact of using ulipristal acetate (UPA) 5 mg to treat women with uterine fibroids (UF) causing moderate to severe symptoms.

Design: We modelled trends in the number of surgical procedures for symptomatic UF, with and without the use of UPA for preoperative or intermittent treatment and assessed the budget impact of UPA use from the French national healthcare insurance system perspective.

Setting: A French national hospital database (PMSI) that records admissions and relative procedures to public and private hospitals. Read More

Scand J Pain 2017 04 19;15:44-52. Epub 2016 Dec 19.

Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Denmark; Pain Research Group, Pain Center South, Odense University Hospital, Odense, Denmark. Electronic address:

Background: Pain after surgery is not uncommon with 30% of patients reporting moderate to severe postoperative pain. Early identification of patients prone to postoperative pain may be a step forward towards individualized pain medicine providing a basis for improved clinical management through treatment strategies targeting relevant pain mechanisms in each patient. Assessment of pain processing by quantitative sensory testing (QST) prior to surgery has been proposed as a method to identify patients at risk for postoperative pain, although results have been conflicting. Read More

J Minim Invasive Gynecol 2017 Nov - Dec;24(7):1104-1110. Epub 2017 Aug 24.

The Advanced Gynecologic Surgery Institute, Naperville, Illinois. Electronic address:

Resectoscopic surgery is routinely performed to remove endometrial polyps and uterine myomas. A search of Medline, PubMed, and the Cochrane Library was conducted through November 2016 for studies written in English, regardless of sample size or study type. The studies were then filtered by selecting those evaluating resectoscopic surgery. Read More

Int J Biomed Sci 2017 Jun;13(2):119-121

Gynecologist & Obstetrician, Mehr General Hospital, Tehran, Iran.

Myomectomy is the most common surgery with cesarean section. There is controversy between obstetricians about doing myomectomy with cesarean section. A 29 years old primigravida patient presented with a large lower segment myoma (20 cm. Read More

Arch Gynecol Obstet 2017 Oct 17;296(4):709-720. Epub 2017 Aug 17.

Clinic for Gynecology, Obstetrics and Gynecological Oncology at Pius Hospital, University Hospital for Gynecology Carl von Ossietzky University Medical School, Georgstrasse 12, 26121, Oldenburg, Germany.

Purpose: Uterine myomas are the main cause of benign uterine diseases in premenopausal women. Objective of the present paper is to investigate the current best treatment modalities of myomas, depending on age of the patient and her desire to preserve fertility, as well as on clinical presentation of this pathology, such as size, number, and location of fibroids and, furthermore, on surgical experience of the gynecologist.

Methods: The design of our work is a systematic literature review of existing studies, reviews, and meta-analysis conducted in PubMed and Cochrane Library to identify relevant literature. Read More