Journal of minimally invasive gynecology最新文献

{"title":"Board Of Directors-Ed Calendar","authors":"","doi":"10.1016/S1553-4650(24)01535-8","DOIUrl":"10.1016/S1553-4650(24)01535-8","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 1","pages":"Page A1"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104636","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}

{"title":"A Rare Case of Uterine Cornual Necrosis","authors":"Thomas Gallant DO, Cara King DO, MS","doi":"10.1016/j.jmig.2024.07.016","DOIUrl":"10.1016/j.jmig.2024.07.016","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 1","pages":"Pages 7-8"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759286","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}

{"title":"Reproductive Outcomes After Hysteroscopic Adhesiolysis in Patients Experiencing Recurrent Pregnancy Loss and Intrauterine Adhesions","authors":"Xinyu Qiao MD ,&nbsp;Dong Liu MD ,&nbsp;Chang Liu MD ,&nbsp;Tianjiao Pei MD, PhD ,&nbsp;Yunwei Ouyang MD, PhD","doi":"10.1016/j.jmig.2024.09.009","DOIUrl":"10.1016/j.jmig.2024.09.009","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate the reproductive outcomes after hysteroscopic adhesiolysis in patients experiencing recurrent pregnancy loss (RPL) combined with intrauterine adhesions (IUA).</div></div><div><h3>Design</h3><div>Single-center retrospective cohort study.</div></div><div><h3>Setting</h3><div>International referral hospital for women with IUA and RPL.</div></div><div><h3>Patients</h3><div>Between January 2018 and June 2022, a cohort of 64 women diagnosed with RPL and IUA were studied, with a follow-up period of at least one year after hysteroscopic adhesiolysis.</div></div><div><h3>Interventions</h3><div>All patients had a diagnosis of IUA from the diagnostic hysteroscopy and were treated with hysteroscopic adhesiolysis, utilizing intraoperative ultrasound monitoring as required.</div></div><div><h3>Main Measurements</h3><div>Live birth rate and menstrual pattern change (subjective assessment) after hysteroscopic adhesiolysis.</div></div><div><h3>Results</h3><div>In our cohort, 59.38% (38/64) achieved pregnancy following hysteroscopic adhesiolysis, with 92.11% (35/38) conceiving within two years of the procedure. The miscarriage rate was recorded at 17.19% (11/64), and the live birth rate stood at 42.19% (27/64). Throughout the extended follow-up period, 64.06% (41/64) of the patients reported increased menstrual blood volume and improvements in menstrual patterns posthysteroscopic adhesiolysis. Univariate analysis indicated that being aged ≥35 years (<em>p</em> = .026), having a history of infertility (<em>p</em> = .003), the presence of moderate or severe IUA (<em>p</em> = .023), and experiencing menstrual improvements postsurgery (<em>p</em> = .001) were independent predictors of live birth. Multivariate analysis further identified that women with a history of infertility had a reduced chance of live birth following hysteroscopic adhesiolysis (<em>p</em> = .008), while those who reported menstrual pattern improvements postoperatively had an increased probability of achieving a live birth (<em>p</em> = .031).</div></div><div><h3>Conclusions</h3><div>Our findings indicate that RPL and IUA patients without prior infertility and showing menstrual pattern improvement after hysteroscopic adhesiolysis, are more likely to achieve live births. Standardized hysteroscopic treatment, postoperative anti-adhesion care, and early pregnancy planning are key to improving fertility outcomes in these patients.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 1","pages":"Pages 57-63"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257614","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}

{"title":"Surgical Anatomy and Intrapelvic Course of Obturator Nerve","authors":"Merve Didem Eşkin Tanrıverdi MD ,&nbsp;Ayhan Cömert MD ,&nbsp;Zekiye Gözde Kara MD ,&nbsp;Nevriye Tezer MD ,&nbsp;Mustafa Erkan Sarı MD ,&nbsp;Halil İbrahim Açar MD","doi":"10.1016/j.jmig.2024.09.006","DOIUrl":"10.1016/j.jmig.2024.09.006","url":null,"abstract":"<div><h3>Study Objective</h3><div>The aim of this study is to reveal the anatomy of the obturator nerve (ON) and its important relationship in pelvic surgery with the surrounding anatomical structures.</div></div><div><h3>Design</h3><div>Prospective observational study.</div></div><div><h3>Interventions</h3><div>Parameters from the left and right ON's to relevant anatomical landmarks were measured and statistical analysis was performed.</div></div><div><h3>Setting</h3><div>The current study was planned in Department of Anatomy Ankara University School of Medicine and then conducted at the Forensic Medicine Institute, Ankara Group Presidency after receiving the approval of the Institute for Forensic Medicine.</div></div><div><h3>Participants</h3><div>The study was performed in 40 fresh or fresh-frozen and female cadavers bilaterally.</div></div><div><h3>Measurements and Main Results</h3><div>The mean distances of the midpoint of the left ON to the highest point of the fundus of uterus and isthmus of the uterus, cervico-uterine junction, and highest point of the promontory were 55.1 ± 10.4, 52.9 ± 12.4, 54.8 ± 11.3, and 58.5 ± 15.2 mm, respectively, and 58.7 ± 8.1, 52.5 ± 13.1, 61.4 ± 17.8, and 62.2 ± 19.7 mm on the right side, respectively (p &gt; .05 for all values). The mean distance between the nerve root of the left ON and highest point of the promontory was 59.1 ± 28.4 mm, it was 59.7 ± 26.2 mm on the right side (p &gt; .05). There were significant positive correlations between the distance between the left and right anterior superior iliac spines and the distances between the midpoint of the ON to the isthmus of the uterus on both the left and right sides of the pelvis (<em>r</em> = 0.546, p = .019, <em>r</em> = 0.896, p &lt; .001, respectively).</div></div><div><h3>Conclusions</h3><div>Intraoperative ON injury in gynecological procedures is a complication that may be minimized with good anatomical knowledge. Careful dissection should be performed to decrease the ON injury. The safe surgical zone was established for pelvic procedures by creating a topographical map of the ON. This research may improve pelvic surgery precision, aiding the development of better treatments and reducing ON-related complications.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 1","pages":"Pages 31-38"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257654","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}

{"title":"Cross Sectional Survey of Ob/Gyn Residents’ Graduated Experience With Robotic Surgery","authors":"Alexandra E. Snyder MD ,&nbsp;Lauren E. Farmer MD ,&nbsp;Morgan L. Cheeks MD ,&nbsp;Erin J. Caraher MD ,&nbsp;Jasmine Correa MD ,&nbsp;Natalia S. Parra MD ,&nbsp;Julia J. Wainger MD ,&nbsp;Ayesha I. Yakubu MD ,&nbsp;Samantha D. Buery-Joyner MD","doi":"10.1016/j.jmig.2024.09.008","DOIUrl":"10.1016/j.jmig.2024.09.008","url":null,"abstract":"<div><h3>Study Objective</h3><div>Obstetrics and gynecology (Ob/Gyn) resident experience with robotic gynecologic surgery has been evaluated at time of graduation, but no specific surgical procedures were identified to differentiate the experiences of residents at each level. This study proposes to determine which factors are correlated with more hands-on robotic surgery experience and resident satisfaction.</div></div><div><h3>Design</h3><div>An Investigational Review Board-approved, 15-question survey was distributed electronically. Ninety-eight responses were received for a rate of 44%. Linear regression and Analysis of Variance statistical analysis were performed.</div></div><div><h3>Setting</h3><div>Current residents at 8 Ob/gyn residency programs in the US were surveyed.</div></div><div><h3>Patients</h3><div>N/A.</div></div><div><h3>Interventions</h3><div>Survey administration.</div></div><div><h3>Measurement and Main Results</h3><div>The majority of respondents were satisfied (48%) or had neutral feelings (20%) with regard to their robotic surgery experience. All respondents reported experience with uterine manipulation or bedside assistance by postgraduate year (PGY) 2. Earliest experience performing hysterectomy was most common in PGY2 or PGY3.</div><div>Seventy-six percent of PGY3 or PGY4 residents report operating on the console for some or all major robotic surgeries, with 69% having participated in greater than 20 robotic surgery cases during residency. Only exposure to Minimally Invasive Gynecologic Surgery faculty is significantly associated with high robotic surgery experience (p = .022).</div><div>Overall satisfaction with robotic surgery experience increased significantly with higher level of participation (p &lt;.0001), particularly operating at the console during some or most of the surgery; longitudinal experiences with hysterectomy, myomectomy, and salpingectomy/oophorectomy (p &lt;.05); but not with sole bedside assisting or vaginal cuff closure. Factors limiting robotic console experience included case time constraints, lack of first assists, case complexity, and attending comfort.</div></div><div><h3>Conclusions</h3><div>Ob/Gyn resident satisfaction with training is significantly related to level and duration of robotic surgery participation. Minimally Invasive Gynecologic Surgery faculty contribute to more resident experience, and limiting factors include time constraints, case complexity, and lack of first assists. These results can provide a framework for structuring resident training in robotic surgery.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 1","pages":"Pages 49-56"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289333","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}

{"title":"Regarding “Outcomes of Vaginal Repair and Vaginal Repair Combined With GnRHa Administration in the Treatment of Cesarean Section Scar Defects: A Randomized Clinical Trial”","authors":"Junfei Li MD,&nbsp;Dan Liao MD","doi":"10.1016/j.jmig.2024.08.023","DOIUrl":"10.1016/j.jmig.2024.08.023","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 1","pages":"Page 72"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348445","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}

{"title":"Vaginal-Assisted Laparoscopic Sacrocolpopexy (VALS) With Advanced Pelvic Organ Prolapse","authors":"Eva K. Welch MD, MS ,&nbsp;Katherine L. Dengler MD ,&nbsp;Jordan Gisseman MD ,&nbsp;Daniel D. Gruber MD, MS","doi":"10.1016/j.jmig.2024.07.015","DOIUrl":"10.1016/j.jmig.2024.07.015","url":null,"abstract":"<div><h3>Objective</h3><div>To review advances of the sacrocolpopexy procedure and demonstrate the Vaginal-Assisted Laparoscopic Sacrocolpopexy approach.</div></div><div><h3>Design</h3><div>Participants who underwent the Vaginal-Assisted Laparoscopic Sacrocolpopexy approach and consented to intra-operative video documentation were included.</div></div><div><h3>Setting</h3><div>This research was conducted at a single academic institution.</div></div><div><h3>Interventions</h3><div>Sacrocolpopexy is an abdominal apical suspension that involves placement of mesh between the vaginal apex and anterior longitudinal ligament overlying the S1-S2 vertebrae. Vaginal Assisted Laparoscopic Sacrocolpopexy (VALS), is a modified approach to sacrocolpopexy. After the hysterectomy, the mesh is attached vaginally to the anterior and posterior vaginal walls. Vaginal dissection of the vesicovaginal and rectovaginal spaces by hand is quick and efficient and allows for palpation of needle depth, which can prevent suture tearing and inadequate mesh attachment with non-tactile placement. The surgeon then transitions back to laparoscopy to complete the remainder of the procedure. Recent literature demonstrates similar rates of mesh complications and reoperation for prolapse with concurrent total hysterectomy versus supracervical hysterectomy given the transition to type I polypropylene mesh and reduction in permanent suture use for vaginal mesh attachment. We anticipate an increase in utilization of the VALS technique given multiple benefits of total hysterectomy, including reduced risk of postoperative menses in premenopausal patients, less postoperative pain and better cosmetic outcomes without need for mini-laparotomy or port-site extension for uterine morcellation, and decreased cervical and endometrial cancer risk. Surgical benefits of the VALS technique include shorter anesthesia and operative time and reduces the need for higher level assistance intraoperatively. VALS is also more ergonomic for the surgeon, promoting use of different muscles throughout the case, thus decreasing muscle fatigue and risk of repetitive motion injury.</div></div><div><h3>Conclusion</h3><div>Laparoscopic sacrocolpopexy utilizing transvaginal mesh attachment is another tool in the myriad of techniques to treat advanced pelvic organ prolapse. This technique reduces operative and anesthesia time, minimizes mesh complications while maintaining successful outcomes for patients.</div></div><div><h3>Video Abstract</h3><div><span><span><span><span><video><source></source></video></span><span><span>Download: <span>Download video (156MB)</span></span></span></span></span></span></div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 1","pages":"Pages 12-13"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759288","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}

{"title":"Segmental Bowel Resection for Rectal Endometriosis Using the da Vinci SP","authors":"Kiyoshi Kanno MD,&nbsp;Masaaki Andou MD, PhD,&nbsp;Mari Sawada MD,&nbsp;Shiori Yanai MD","doi":"10.1016/j.jmig.2024.08.005","DOIUrl":"10.1016/j.jmig.2024.08.005","url":null,"abstract":"<div><h3>Objective</h3><div>The da Vinci SP Surgical System (SP) received regulatory approval for use in gynecological surgeries in Japan in 2023. Given the advantages of the precision of a robot, less pain, and the cosmesis of single-port surgery, the da Vinci SP is expected to be further used for minimally invasive surgeries. To the best of our knowledge, this is the first report of the use of SP for the treatment of rectal endometriosis with segmental bowel resection.</div></div><div><h3>Setting</h3><div>An urban general hospital. Stepwise demonstration of the technique with narrated video footage.</div></div><div><h3>Participants</h3><div>The patient was a 46-year-old woman presented with chronic pelvic pain, pain on defecation, and constipation. Magnetic resonance imaging showed uterine large fibroid, left ovarian endometrioma, and 38 mm of rectal endometriosis, with complete cul-de-sac obliteration.</div></div><div><h3>Interventions</h3><div>We made a 30-mm vertical incision at the umbilicus, then placed the access port, and inserted three articulating instruments and a camera. An assistant port was placed in the right lower quadrant for using the linear stapler. The surgical steps were completely identical to conventional multiport laparoscopic robotic surgery. This suggests that conventional laparoscopic or robotic skills are highly transferrable to SP. SP offer several advantages, including high-resolution three-dimensional visualization, articulating instruments, and improved dexterity and range of motion. In addition, the umbilical access port was particularly useful for proximal bowel resection, specimen retrieval, and anvil positioning during bowel resection. The total operative time was 216 minutes. The estimated blood loss was 100 ml without any complications. The uterine weight was 800 g. The postoperative course was uneventful, with no perioperative complications, including no postoperative bladder dysfunction or low anterior resection syndrome [<span><span>1</span></span>,<span><span>2</span></span>].</div></div><div><h3>Conclusion</h3><div>The use of SP with the access port for segmental bowel resection for rectal endometriosis is technically safe and feasible, with good cosmesis and less pain.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 1","pages":"Page 14"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988174","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}

{"title":"International Societies","authors":"","doi":"10.1016/S1553-4650(24)01536-X","DOIUrl":"10.1016/S1553-4650(24)01536-X","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 1","pages":"Page A2"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104637","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}

{"title":"TOC","authors":"","doi":"10.1016/S1553-4650(24)01538-3","DOIUrl":"10.1016/S1553-4650(24)01538-3","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 1","pages":"Pages A4-A5"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104639","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}