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Cystic Leiomyoma Mimicking Complex Adnexal Mass. 模仿复杂附件肿块的囊性子宫肌瘤
IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-08 DOI: 10.1016/j.jmig.2024.09.001
Amanda Tower,Rebecca Rohrer,Rupal Parmar
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引用次数: 0
Primary endometriosis of the perineum: An uncommon site for a common disease. 会阴部原发性子宫内膜异位症:常见疾病的不常见部位
IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-07 DOI: 10.1016/j.jmig.2024.08.020
Houyu Yang,Yuanjunzi Shi,Gang Ji
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引用次数: 0
Multiple Accessory Ovaries Combined with Paroophoritic Cyst. 多发性附属卵巢合并副卵巢囊肿
IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-07 DOI: 10.1016/j.jmig.2024.08.022
Qinhua Li,Yuhan Liu,Hong Ye
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引用次数: 0
Catamenial pneumothorax with diaphragmatic endometriosis: view from the thoracoscope. 伴有横膈膜子宫内膜异位症的卡他气胸:胸腔镜下的视角。
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-06 DOI: 10.1016/j.jmig.2024.08.021
Ching-Hui Chien, Ming-Ju Hsieh, Chih-Wei Wang, Chin-Chieh Hsu
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引用次数: 0
Assessment of Education and Management of Endometriosis Among Colorectal Surgeons and Residents. 评估结直肠外科医生和住院医生对子宫内膜异位症的教育和管理。
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-06 DOI: 10.1016/j.jmig.2024.08.009
Gabriella Rivera Ortiz, Gabriela C Poles, Janet A Foote, Ashley Gubbels

Study objective: To identify the type of endometriosis education and surgical training colorectal surgery residents are exposed to during training. To determine the current surgical management of endometriosis among recently graduated colorectal surgeons and their level of comfort.

Design: A qualitative cross-sectional study was performed. An anonymous questionnaire was emailed to colorectal surgery residents of 2023 and recent graduates for completion. Data was then extracted and analyzed from REDCap. A chi-square test was performed on the primary outcome variables.

Setting: A REDCap electronic survey was administered through email to each participant.

Patients: All colorectal surgery residents in 2023 and recent graduates from Colon and Rectal Surgery subspecialty from 2012 to 2022.

Interventions: A 17-item anonymous questionnaire was sent via email through REDCap.

Measurements and main results: The survey was completed by 70 participants. Most respondents (58.5%) did not receive formal education on bowel endometriosis. Forty percent of participants (28/70) did not feel they received adequate training for surgical management of bowel endometriosis. In terms of surgical exposure, 3.8% (2) responded they had been involved in >15 bowel endometriosis cases and 18 (25.7%) had been exposed to 1-5 cases during colorectal training. Factors that predicted feeling adequately trained in managing endometriosis included formal endometriosis education (OR 4.70, 95% CI 1.37-16.12, p-value .027) and surgical exposure during training (OR 4.38, 95% CI 1.18-16.26, p-value .014). Additionally, the number of cases exposed during training is highly correlated with feeling adequately trained.

Conclusion: More than half of colorectal surgeons did not receive formal education on bowel endometriosis and the majority had only been exposed to 1-5 cases during their colorectal training. An overwhelming majority were interested in further education. This study highlights opportunities for improvement in the exposure to education and surgical management of endometriosis among colorectal surgery trainees.

研究目的:a 确定结直肠外科住院医生在培训期间所接受的子宫内膜异位症教育和手术培训的类型 b 确定新近毕业的结直肠外科医生目前对子宫内膜异位症的手术治疗情况及其舒适程度:设计:进行了一项定性横断面研究。通过电子邮件向 2023 年结肠直肠外科住院医生和应届毕业生发送匿名问卷,要求他们填写。然后从 REDCap 中提取数据并进行分析。对主要结果变量进行了卡方检验:通过电子邮件向每位参与者发送 REDCap 电子调查问卷:所有 2023 年结肠直肠外科住院医师和 2012 年至 2022 年结肠直肠外科亚专业应届毕业生:测量和主要结果:70 名参与者完成了调查。大多数受访者(58.5%)没有接受过有关肠道子宫内膜异位症的正规教育。40%的参与者(28/70)认为他们没有接受过足够的肠道子宫内膜异位症手术治疗培训。在手术经验方面,3.8%(2 人)回答他们参与过超过 15 例肠道子宫内膜异位症病例,18 人(25.7%)在结直肠培训期间接触过 1-5 例病例。预测在处理子宫内膜异位症方面是否接受过充分培训的因素包括正规的子宫内膜异位症教育(OR 4.70,95% CI 1.37-16.12,p 值 .027)和培训期间的手术接触(OR 4.38,95% CI 1.18-16.26,p 值 .014)。此外,培训期间接触的病例数与是否感觉受过充分培训高度相关:结论:一半以上的结直肠外科医生没有接受过有关肠道子宫内膜异位症的正规教育,大多数人在接受结直肠培训期间只接触过 1-5 个病例。绝大多数人对进一步的教育感兴趣。这项研究强调了结直肠外科学员在接受教育和手术治疗子宫内膜异位症方面需要改进的地方。
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引用次数: 0
Tissue Retrieval of Laparoscopically Excised Adnexal Specimens in Gynecologic Surgery: Posterior Culdotomy versus Abdominal Extraction. 妇科手术中腹腔镜切除附件标本的组织检索:后阴道切开术与腹腔抽取术。
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-04 DOI: 10.1016/j.jmig.2024.08.019
Toni S Horton, Hannah S Palin, Melinda H Chai, Emily C Craver, Aakriti R Carrubba

Objective: The objective of this study is to compare intraoperative and postoperative outcomes in women undergoing removal of adnexal structures by either posterior culdotomy or abdominal extraction.

Design: This is a retrospective cohort study conducted via medical record review. Demographic, clinical, and operative variables were abstracted from the medical records. Statistical analysis consisted of descriptive statistics, Fisher's exact tests, Wilcoxon rank sum tests, and multivariable logistic regression models.

Setting: Single academic tertiary care center between 2010 and 2022.

Participants: A total of 718 patients were identified and included in our analysis who underwent minimally invasive ovarian cystectomy or oophorectomy. Patients were excluded if they underwent concomitant hysterectomy.

Interventions: Patients underwent minimally invasive oophorectomy or ovarian cystectomy, and specimens were extracted by either abdominal extraction (AE) or culdotomy extraction (CE).

Measurements and main results: Of the 718 patients who met inclusion criteria, 127 (17.7%) underwent CE, and 591 (82.3%) underwent abdominal extraction. The CE group had longer operative times (113 minutes vs 96 minutes, p <.001) and higher estimated blood loss (25 mL vs 10 mL, p <.001) compared to the abdominal extraction group. There were more malignancies in the CE than the abdominal extraction group (15.7% vs 8.1%, respectively, p <.001). After adjusting for potential confounders, those who underwent CE were more likely to have 2 or more clinic visits (OR 2.89; 95% confidence interval, 1.66-5.03; p <.001) and call or message the clinic (OR 2.08; 95% confidence interval, 1.35-3.20; p <.001). There were no incidences of cuff dehiscence, cuff cellulitis, or pelvic abscess in either group.

Conclusion: Removal of adnexal specimens via abdominal port site or posterior culdotomy incision is a feasible option for specimen extraction and can be individualized based on patient and surgeon preference and patient factors. Those undergoing CE may require more preoperative counseling due to higher rate of postoperative messages seen in our cohort.

研究目的本研究旨在比较通过后涵道切开术或腹腔抽取术切除附件结构的妇女的术中和术后结果:这是一项通过病历审查进行的回顾性队列研究。人口统计学、临床和手术变量均摘自病历。统计分析包括描述性统计、费雪精确检验、Wilcoxon 秩和检验和多变量逻辑回归模型:2010年至2022年期间的单一学术三级医疗中心:共有 718 名患者接受了微创卵巢囊肿切除术或卵巢切除术,并纳入了我们的分析。如果患者同时接受了子宫切除术,则排除在外:干预措施:患者接受微创输卵管切除术或卵巢囊肿切除术,标本通过腹腔取材或肛门取材的方式提取:在符合纳入标准的718名患者中,127人(17.7%)接受了蝶窦切开取材术,591人(82.3%)接受了腹腔取材术。脐带切开取石术组的手术时间更长(113 分钟 vs 96 分钟,P=0.05),而腹腔取石术组的手术时间更短:通过腹腔端口部位或后方 culdotomy 切口取出附件标本是一种可行的标本取出方法,可根据患者和外科医生的偏好以及患者因素进行个性化选择。在我们的队列中,由于术后出现信息的比例较高,因此接受肛秆切开术取出标本的患者可能需要更多的术前咨询。
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引用次数: 0
Bladder Compliance Dynamics of Pelvic Organ Prolapse in Women Undergoing Robotic-assisted Sacrocolpopexy. 接受机器人辅助骶骨整形术的女性盆腔器官脱垂的膀胱顺应性动态变化。
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-02 DOI: 10.1016/j.jmig.2024.08.017
Hui-Hsuan Lau, Tsung-Hsien Su, Jie-Jen Lee, Dylan Chou, Ming-Chun Hsieh, Cheng-Yuan Lai, Hsien- Yu Peng, Tzer-Bin Lin

Study objective: Although mean/static compliance of bladder filling can be readily assayed via cystometry, a protocol measuring compliance dynamics at a specific stage of bladder filling has not been established in human patients. For patients with pelvic organ prolapse (POP), the objective benefits of robotic-assisted sacrocolpopexy (RSCP) surgical intervention for restoring bladder functions, primarily urine storage, have yet to be established. Also, bladder compliance is a viscoelastic parameter that crucially defines the storage function. Therefore, we aimed to investigate the impact of RSCP on bladder compliance of POP patients using a pressure-volume analysis (PVA), which graphically illustrates bladder compliance.

Design: A retrospective pre and postoperative study.

Setting: Multiple hospitals in Taiwan.

Patients: Twenty seven female POP patients (stage ≥ II).

Intervention: RSCP for POP repair.

Measurements and main results: We retrospectively reviewed the pre- and postoperative PVAs for women with POP who underwent RSCP. The mean compliance of the entire (Cm), the early half (C1/2), and the late half (C2/2) of bladder filling were analyzed as primary outcomes. Changes in intravesical volume (ΔVive) and detrusor pressure (ΔPdet) of bladder filling, ΔPdet in the early (ΔPdet1/2) and late (ΔPdet2/2) filling, and postvoiding residual volume (Vres) were analyzed as secondary outcomes. Compared with the preoperative control, RSCP increased Cm (p = .010, N = 27) and C2/2 (p <.001, N = 27) but negligibly affected C1/2 (p = .457, N = 27). Mechanistically, RSCP decreased ΔPdet (p = .0001, N = 27) without significantly affecting ΔVive (p = .863, N = 27). Furthermore, RSCP decreased the ΔPdet2/2 (p <.001, N = 27) but not ΔPdet1/2 (p = .295, N = 27).

Conclusions: This is the first report on applying PVA in assaying dynamics of bladder compliance in patients with POP. Our results suggest that RSCP improved bladder storage in women with POP since it increased bladder compliance, particularly in the late filling, possibly by restoring the anatomical location and geometric conformation for bladder expansion.

研究目的虽然膀胱充盈的平均/静态顺应性可通过膀胱测量法轻松测定,但在人类患者中尚未建立起在膀胱充盈的特定阶段测量顺应性动态的方案。对于盆腔器官脱垂(POP)患者,机器人辅助骶尾部结肠切除术(RSCP)手术干预对恢复膀胱功能(主要是尿液储存)的客观益处尚未确定。此外,膀胱顺应性是一个粘弹性参数,对储尿功能起着至关重要的作用。因此,我们旨在使用压力-容积分析(PVA)来研究 RSCP 对 POP 患者膀胱顺应性的影响:背景:台湾多家医院:背景:台湾多家医院:患者:27 名女性 POP 患者(≥ II 期):干预措施:RSCP 修复 POP:我们回顾性地检查了接受RSCP的女性POP患者术前和术后的PVA。作为主要结果,我们分析了膀胱充盈时整个膀胱(Cm)、早半膀胱(C1/2)和晚半膀胱(C2/2)的平均顺应性。膀胱充盈时的膀胱内容量(ΔVive)和逼尿肌压力(ΔPdet)、充盈早期(ΔPdet1/2)和充盈晚期(ΔPdet2/2)的ΔPdet以及排尿后残余容量(Vres)的变化作为次要结果进行分析。与术前对照组相比,RSCP 增加了 Cm(p=0.010,N=27)和 C2/2(p结论:这是第一份应用 PVA 评估 POP 患者膀胱顺应性动态的报告。我们的结果表明,RSCP 增加了膀胱顺应性,尤其是在充盈晚期,可能是通过恢复膀胱扩张的解剖位置和几何形状,从而改善了 POP 女性患者的膀胱储存功能:本研究已在 ClinicalTrials.gov (https://clinicaltrials.gov/study/NCT05682989) 注册;注册号为 NCT05682989:NCT05682989 于 2022 年 12 月 28 日提交。
{"title":"Bladder Compliance Dynamics of Pelvic Organ Prolapse in Women Undergoing Robotic-assisted Sacrocolpopexy.","authors":"Hui-Hsuan Lau, Tsung-Hsien Su, Jie-Jen Lee, Dylan Chou, Ming-Chun Hsieh, Cheng-Yuan Lai, Hsien- Yu Peng, Tzer-Bin Lin","doi":"10.1016/j.jmig.2024.08.017","DOIUrl":"10.1016/j.jmig.2024.08.017","url":null,"abstract":"<p><strong>Study objective: </strong>Although mean/static compliance of bladder filling can be readily assayed via cystometry, a protocol measuring compliance dynamics at a specific stage of bladder filling has not been established in human patients. For patients with pelvic organ prolapse (POP), the objective benefits of robotic-assisted sacrocolpopexy (RSCP) surgical intervention for restoring bladder functions, primarily urine storage, have yet to be established. Also, bladder compliance is a viscoelastic parameter that crucially defines the storage function. Therefore, we aimed to investigate the impact of RSCP on bladder compliance of POP patients using a pressure-volume analysis (PVA), which graphically illustrates bladder compliance.</p><p><strong>Design: </strong>A retrospective pre and postoperative study.</p><p><strong>Setting: </strong>Multiple hospitals in Taiwan.</p><p><strong>Patients: </strong>Twenty seven female POP patients (stage ≥ II).</p><p><strong>Intervention: </strong>RSCP for POP repair.</p><p><strong>Measurements and main results: </strong>We retrospectively reviewed the pre- and postoperative PVAs for women with POP who underwent RSCP. The mean compliance of the entire (Cm), the early half (C1/2), and the late half (C2/2) of bladder filling were analyzed as primary outcomes. Changes in intravesical volume (ΔVive) and detrusor pressure (ΔPdet) of bladder filling, ΔPdet in the early (ΔPdet1/2) and late (ΔPdet2/2) filling, and postvoiding residual volume (Vres) were analyzed as secondary outcomes. Compared with the preoperative control, RSCP increased Cm (p = .010, N = 27) and C2/2 (p <.001, N = 27) but negligibly affected C1/2 (p = .457, N = 27). Mechanistically, RSCP decreased ΔPdet (p = .0001, N = 27) without significantly affecting ΔVive (p = .863, N = 27). Furthermore, RSCP decreased the ΔPdet2/2 (p <.001, N = 27) but not ΔPdet1/2 (p = .295, N = 27).</p><p><strong>Conclusions: </strong>This is the first report on applying PVA in assaying dynamics of bladder compliance in patients with POP. Our results suggest that RSCP improved bladder storage in women with POP since it increased bladder compliance, particularly in the late filling, possibly by restoring the anatomical location and geometric conformation for bladder expansion.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Successful Robotic Transabdominal Re-Cerclage After Laparoscopic Abdominal Cerclage Failure: Suture Material Matters 腹腔镜腹腔环扎术失败后,机器人经腹再环扎术获得成功:缝合材料很重要
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-01 DOI: 10.1016/j.jmig.2024.05.020
{"title":"Successful Robotic Transabdominal Re-Cerclage After Laparoscopic Abdominal Cerclage Failure: Suture Material Matters","authors":"","doi":"10.1016/j.jmig.2024.05.020","DOIUrl":"10.1016/j.jmig.2024.05.020","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Board Of Directors-Ed Calendar 董事会-教育日历
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-01 DOI: 10.1016/S1553-4650(24)00328-5
{"title":"Board Of Directors-Ed Calendar","authors":"","doi":"10.1016/S1553-4650(24)00328-5","DOIUrl":"10.1016/S1553-4650(24)00328-5","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142135896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Robot-Assisted Partial Cystectomy for Deep Infiltrating Endometriosis of the Bladder With the Hugo RAS System "利用Hugo RAS系统进行机器人辅助膀胱部分切除术治疗膀胱深部浸润性子宫内膜异位症"。
IF 3.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-01 DOI: 10.1016/j.jmig.2024.04.012
<div><h3>Objective</h3><p><span><span>Involvement of the lower urinary tract is found in 0.2 to 2.5% of all deep infiltrating </span>endometriosis (DIE) [</span><span><span>1</span></span>,<span><span>2</span></span><span>]. The bladder is the most affected organ with a prevalence of up to 80% of cases [</span><span><span>3</span></span><span>]. Patients with bladder endometriosis are often symptomatic (dysuria, hyperactive bladder, recurrent urinary tract infections, and hematuria). Surgery is the gold standard treatment for this condition when medical therapy fails [</span><span><span>1</span></span>,<span><span>2</span></span>]. Several studies have shown the feasibility, effectiveness, and safety of the laparoscopic approach [<span><span>4</span></span><span>] but data about robotic-assisted approach are missing in literature. Currently, novel platforms are entering the market and the Hugo™RAS (Medtronic, Minneapolis, USA) is a new system (HRS) consisting of an open console with 3D-HD screen and a multimodular bedside units. Even if some series are already available for radical cystectomies for oncologic purposes [</span><span><span>5</span></span>], a full description of DIE surgery performed with HRS is still lacking. Aim of this video-article is to show our technique and surgical setup to carry out a complex case of anterior compartment DIE.</p></div><div><h3>Design</h3><p>A step-by-step explanation of surgical technique with narrated video footage.</p></div><div><h3>Setting</h3><p>Tertiary Level Academic Hospital “IRCCS Azienda Ospedaliero—Universitaria di Bologna” Bologna, Italy.</p></div><div><h3>Intervention</h3><p><span><span><span>A 36-year-old nulliparous woman affected by DE was referred to our center due to severe </span>dyspareunia<span>, dysuria with </span></span>hematuria<span> and postvoiding pain not responsive to oral progestins<span><span>. The preoperative work up consisted of a gynecological examination, pelvic ultrasound and MRI that showed the presence of an endometriotic nodule of the </span>bladder base<span>. All possible therapeutic strategies and related complications have been discussed with the patient before the signature of the informed consent. To carry out the procedure a “straight” port placement in a “compact” docking configuration [</span></span></span></span><span><span>6</span></span><span>] was installed. After developing the paravesical spaces bilaterally, the bladder nodule was approached in a latero-medial direction then a partial cystectomy with macroscopical free margins was performed. A double layer horizontal running suture<span> with barbed thread was used to repair the bladder wall.</span></span></p></div><div><h3>Conclusion</h3><p>To the best of our knowledge, this is the first case of bladder endometriotic nodule excision performed with HRS. We explained our technique and robotic set-up to successfully manage a compelx case of DIE of the bladder.</p></div><div><h3>Video Abstract</h3><p><span
目的在所有深部浸润性子宫内膜异位症(DIE)中,有0.2%至2.5%的病例会累及下尿路[1,2]。膀胱是受影响最大的器官,发病率高达 80% [3]。膀胱子宫内膜异位症患者通常有症状(排尿困难、膀胱活动过度、反复尿路感染和血尿)。当药物治疗无效时,手术是治疗这种疾病的金标准[1,2]。多项研究表明,腹腔镜方法具有可行性、有效性和安全性[4],但文献中缺少有关机器人辅助方法的数据。目前,新型平台正在进入市场,Hugo™RAS(美敦力,美国明尼阿波利斯)是一种新型系统(HRS),由带有 3D 高清屏幕的开放式控制台和多模块床旁装置组成。尽管目前已有一些肿瘤根治性膀胱切除术的案例[5],但仍缺乏使用 HRS 进行 DIE 手术的完整描述。本视频文章旨在展示我们在进行一例复杂的前室DIE手术时所采用的技术和手术设置。背景意大利博洛尼亚的 "IRCCS Azienda Ospedaliero-Universitaria di Bologna "三级学术医院。干预一位36岁的无子宫女性因严重的排尿困难、排尿困难伴血尿以及口服孕激素无效的排尿后疼痛而被转诊至本中心。术前检查包括妇科检查、盆腔超声和核磁共振成像,结果显示膀胱底部存在子宫内膜异位结节。在签署知情同意书之前,已与患者讨论了所有可能的治疗策略和相关并发症。手术采用 "紧凑 "对接配置[6]的 "直 "端口置入。在开拓双侧膀胱旁间隙后,从侧内侧方向接近膀胱结节,然后进行膀胱部分切除术,并在大体上游离膀胱边缘。结论 据我们所知,这是首例使用 HRS 进行的膀胱子宫内膜异位结节切除术。我们介绍了成功处理一例膀胱 DIE 的技术和机器人设置。视频摘要下载:下载视频 (142MB)
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引用次数: 0
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Journal of minimally invasive gynecology
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