: The introduction of laparoscopic surgery in the early 1990’s presented an improved alternative to laparotomy, slowly shifting the surgical treatment for Endometrial Cancer (EC) toward minimally invasive surgery (MIS), with equivalent oncologic outcome and reduced perioperative morbidity. Robotic assisted surgery (RAS) introduced multiple technical improvements to straight stick laparoscopy (LS), associated with improved perioperative outcome including reduced blood loss, fewer conversions to laparotomy and shorter hospital stay, whereas other perioperative outcomes appear similar. Due to its technical advantages, adaptation of RAS involves a shorter learning curve than LS and offers improved ergonomics compared to straight stick instrumentation. The advantages of RAS are more pronounced in patients with increased body mass index (BMI). Both LS and RAS have been shown to be safe in elderly patients and although available data shows benefit compared to laparotomy, it does not suggest superiority of one MIS approach over the other. Even though RAS and LS have comparable oncologic outcomes, the integration of RAS facilitated the shift toward MIS, where LS had failed to significantly reduce the rate of laparotomy. This shift to MIS was associated with reduced postoperative length of stay and complication rates, offsetting the increased costs involved with RAS. By introducing a computer interface, RAS is allowing augmented reality and digital analysis, leading surgery towards precision surgery and a high-tech future.
{"title":"Minimally invasive approach for endometrial cancer: robotic assisted vs. straight stick laparoscopy","authors":"O. Raban, Y. Bukhari, W. Gotlieb","doi":"10.21037/GPM-21-1","DOIUrl":"https://doi.org/10.21037/GPM-21-1","url":null,"abstract":": The introduction of laparoscopic surgery in the early 1990’s presented an improved alternative to laparotomy, slowly shifting the surgical treatment for Endometrial Cancer (EC) toward minimally invasive surgery (MIS), with equivalent oncologic outcome and reduced perioperative morbidity. Robotic assisted surgery (RAS) introduced multiple technical improvements to straight stick laparoscopy (LS), associated with improved perioperative outcome including reduced blood loss, fewer conversions to laparotomy and shorter hospital stay, whereas other perioperative outcomes appear similar. Due to its technical advantages, adaptation of RAS involves a shorter learning curve than LS and offers improved ergonomics compared to straight stick instrumentation. The advantages of RAS are more pronounced in patients with increased body mass index (BMI). Both LS and RAS have been shown to be safe in elderly patients and although available data shows benefit compared to laparotomy, it does not suggest superiority of one MIS approach over the other. Even though RAS and LS have comparable oncologic outcomes, the integration of RAS facilitated the shift toward MIS, where LS had failed to significantly reduce the rate of laparotomy. This shift to MIS was associated with reduced postoperative length of stay and complication rates, offsetting the increased costs involved with RAS. By introducing a computer interface, RAS is allowing augmented reality and digital analysis, leading surgery towards precision surgery and a high-tech future.","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44930126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: Ovarian cancer (OC) is the fifth most common cancer-related cause of death in women and the most lethal gynecologic malignancies in developed countries. In more than two thirds of the cases it is diagnosed as an advanced stage disease. The treatment requires a surgical step, aiming to remove the macroscopically visible disease, either as a primary debulking surgery or interval debulking surgery (IDS) after neoadjuvant chemotherapy (NACT). In both cases radical, complex and invasive surgical procedures are needed in order to achieve complete resection of the tumor, frequently involving bowel surgery. Considering the spread of the disease in the abdominal cavity, involvement of multiple bowel segments is common. Multiple bowel resections (MBR) are often needed to a complete cytoreduction but are linked to a higher rate of bowel diversion and postoperative morbidity, including severe postoperative complications, as anastomotic leakage (AL), and even death. These complications not only affect short term morbidity but may even postpone the administration of adjuvant chemotherapy, thus significantly affecting the outcomes of the treatment. NACT may help reducing the aggressiveness of debulking surgery and therefore the rate of its complications. This strategy represents a valid therapeutic option, especially in fragile patients, reducing the surgical related morbidity and the risk of bowel resections, without affecting the overall survival.
{"title":"The role of multiple bowel resections in advanced ovarian cancer: survival and surgical outcomes—a narrative review","authors":"J. Casarin, V. Artuso, A. Cromi, F. Ghezzi","doi":"10.21037/GPM-20-63","DOIUrl":"https://doi.org/10.21037/GPM-20-63","url":null,"abstract":": Ovarian cancer (OC) is the fifth most common cancer-related cause of death in women and the most lethal gynecologic malignancies in developed countries. In more than two thirds of the cases it is diagnosed as an advanced stage disease. The treatment requires a surgical step, aiming to remove the macroscopically visible disease, either as a primary debulking surgery or interval debulking surgery (IDS) after neoadjuvant chemotherapy (NACT). In both cases radical, complex and invasive surgical procedures are needed in order to achieve complete resection of the tumor, frequently involving bowel surgery. Considering the spread of the disease in the abdominal cavity, involvement of multiple bowel segments is common. Multiple bowel resections (MBR) are often needed to a complete cytoreduction but are linked to a higher rate of bowel diversion and postoperative morbidity, including severe postoperative complications, as anastomotic leakage (AL), and even death. These complications not only affect short term morbidity but may even postpone the administration of adjuvant chemotherapy, thus significantly affecting the outcomes of the treatment. NACT may help reducing the aggressiveness of debulking surgery and therefore the rate of its complications. This strategy represents a valid therapeutic option, especially in fragile patients, reducing the surgical related morbidity and the risk of bowel resections, without affecting the overall survival.","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42340181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Department of Operative Gynecology and Oncogynecology with day hospital, Moscow Regional Scientific Research Institute of Obstetrics and Gynecology, Moscow, Russian Federation; Private Clinic Moscvorechye, Moscow, Russian Federation; Urology Department, Moscow State University of Medicine and Dentistry, Moscow, Russian Federation Contributions: (I) Conception and design: A Popov, K Abramyan; (II) Administrative support: A Popov, G Kasyan; (III) Provision of study materials or patients: A Popov, G Kasyan; (IV) Collection and assembly of data: K Abramyan, I Klyushnikov; (V) Data analysis and interpretation: I Klyushnikov, K Abramyan; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Karina Abramyan. Private Clinic Moscvorechye, Moscvorechye st. 16, Moscow, 115409, Russian Federation. Email: gyn_endoscopy@mail.ru.
{"title":"Mesh vaginal colpopexy complications analysis—multicenter study results","authors":"A. Popov, K. Abramyan, I. Klyushnikov, G. Kasyan","doi":"10.21037/gpm-21-19","DOIUrl":"https://doi.org/10.21037/gpm-21-19","url":null,"abstract":"Department of Operative Gynecology and Oncogynecology with day hospital, Moscow Regional Scientific Research Institute of Obstetrics and Gynecology, Moscow, Russian Federation; Private Clinic Moscvorechye, Moscow, Russian Federation; Urology Department, Moscow State University of Medicine and Dentistry, Moscow, Russian Federation Contributions: (I) Conception and design: A Popov, K Abramyan; (II) Administrative support: A Popov, G Kasyan; (III) Provision of study materials or patients: A Popov, G Kasyan; (IV) Collection and assembly of data: K Abramyan, I Klyushnikov; (V) Data analysis and interpretation: I Klyushnikov, K Abramyan; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Karina Abramyan. Private Clinic Moscvorechye, Moscvorechye st. 16, Moscow, 115409, Russian Federation. Email: gyn_endoscopy@mail.ru.","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49205729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Professor of Anaesthesia, University of Oxford, Oxford, UK Contributions: (I) Conception and design: JJ Pandit; (II) Administrative support: JJ Pandit; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: None; (VI) Manuscript writing: Both authors; (VII) Final approval of manuscript: Both authors. Correspondence to: Jaideep J. Pandit. Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Email: jaideep.pandit@sjc.ox.ac.uk.
英国牛津大学医院NHS基金会纳菲尔德麻醉科;牛津大学麻醉学教授，牛津，英国贡献:(1)构思与设计:JJ Pandit;(二)行政支持:JJ Pandit;(三)提供研究材料或患者:无;(四)数据收集和汇编:无;(五)数据分析和解释:无;(六)稿件撰写:双方作者;(七)稿件最终审定:两位作者。通讯:Jaideep J. Pandit。英国牛津大学医院NHS基金会纳菲尔德麻醉科。电子邮件:jaideep.pandit@sjc.ox.ac.uk。
{"title":"A narrative review of the role of anaesthesia and peri-operative medicine in improving outcomes after surgery for advanced ovarian cancer","authors":"Aimee Manicom, J. Pandit","doi":"10.21037/gpm-21-28","DOIUrl":"https://doi.org/10.21037/gpm-21-28","url":null,"abstract":"Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Professor of Anaesthesia, University of Oxford, Oxford, UK Contributions: (I) Conception and design: JJ Pandit; (II) Administrative support: JJ Pandit; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: None; (VI) Manuscript writing: Both authors; (VII) Final approval of manuscript: Both authors. Correspondence to: Jaideep J. Pandit. Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Email: jaideep.pandit@sjc.ox.ac.uk.","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42643089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: Upper abdominal debulking procedures represent an indispensable part of cytoreduction for advanced ovarian cancer. As a genuinely peritoneally disseminated malignancy, more than 70% of the patients will present in an advanced stage with tumor involvement of the upper abdominal organs, especially liver-and splenic capsule, lesser sac, Morrisons pouch and diaphragm. Studies have clearly shown the maximal survival benefit being derived from maximal effort surgery achieving total macroscopic tumor clearance. For that reason, gynecological oncology teams need to master the dissection techniques in the upper abdomen and also be able to handle the associated complications. We will review here the key issues around upper abdominal cytoreduction and focus on the spleen, liver, and stomach/lesser sac. Diaphragmatic surgery will be addressed in a separate, especially dedicated chapter. Safety and feasibility of complex oncologic upper abdominal dissections for advanced and relapsed ovarian cancer are based on the fundamental knowledge of anatomy, principles of peritonectomy techniques, as well as infrastructural support and collective knowledge and education of the entire team. Surgical and infrastructural expertise are of paramount importance to achieve best possible oncologic outcomes with an acceptable morbidity profile even for those patients with high burden disease.
{"title":"The principles of safe and efficacious upper abdominal surgery","authors":"C. Fotopoulou, Ç. Taşkıran","doi":"10.21037/GPM-21-3","DOIUrl":"https://doi.org/10.21037/GPM-21-3","url":null,"abstract":": Upper abdominal debulking procedures represent an indispensable part of cytoreduction for advanced ovarian cancer. As a genuinely peritoneally disseminated malignancy, more than 70% of the patients will present in an advanced stage with tumor involvement of the upper abdominal organs, especially liver-and splenic capsule, lesser sac, Morrisons pouch and diaphragm. Studies have clearly shown the maximal survival benefit being derived from maximal effort surgery achieving total macroscopic tumor clearance. For that reason, gynecological oncology teams need to master the dissection techniques in the upper abdomen and also be able to handle the associated complications. We will review here the key issues around upper abdominal cytoreduction and focus on the spleen, liver, and stomach/lesser sac. Diaphragmatic surgery will be addressed in a separate, especially dedicated chapter. Safety and feasibility of complex oncologic upper abdominal dissections for advanced and relapsed ovarian cancer are based on the fundamental knowledge of anatomy, principles of peritonectomy techniques, as well as infrastructural support and collective knowledge and education of the entire team. Surgical and infrastructural expertise are of paramount importance to achieve best possible oncologic outcomes with an acceptable morbidity profile even for those patients with high burden disease.","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44377264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luca Guaraldi, P. Pastina, P. Tini, M. Crociani, S. Marsili, V. Nardone
Adenocarcinoma of uterine cervix is usually treated with concurrent chemotherapy and external beam radiotherapy (EBRT), eventually followed by brachytherapy that can provide a good tumor control rate, although approximately one-third of the patients can develop further recurrence. The most common recurrence sites are the pelvis and the para-aortic nodes, with few patients having a single metastatic deposit. In this regard, precise definitions of recurrences and optimal treatment strategies are still to be clearly defined and currently there are no guidelines for the treatment of patients with oligometastatic cervical cancer. We present a case of an 81 years old patient with Stage IIB adenocarcinoma of uterine cervix, that was successfully treated with concurrent chemoradiotherapy with definitive intent. Six months later, she developed a solitary abdominal nodule for which she underwent resection followed by chemotherapy. At the present time there are no signs of local recurrence or distant metastasis after 3 years. In the case reported, the use of different strategies (radiotherapy, chemotherapy and surgery), as well as the correct choice and the timing of the different approaches has provided a great benefit for the patient. The use of surgery and chemotherapy in patients with recurrent cervical cancer is safe even in older patients with atypical
{"title":"Locally advanced cervical cancer treated with chemo-radiotherapy: a case report of a particular recurrence","authors":"Luca Guaraldi, P. Pastina, P. Tini, M. Crociani, S. Marsili, V. Nardone","doi":"10.21037/GPM-20-49","DOIUrl":"https://doi.org/10.21037/GPM-20-49","url":null,"abstract":"Adenocarcinoma of uterine cervix is usually treated with concurrent chemotherapy and external beam radiotherapy (EBRT), eventually followed by brachytherapy that can provide a good tumor control rate, although approximately one-third of the patients can develop further recurrence. The most common recurrence sites are the pelvis and the para-aortic nodes, with few patients having a single metastatic deposit. In this regard, precise definitions of recurrences and optimal treatment strategies are still to be clearly defined and currently there are no guidelines for the treatment of patients with oligometastatic cervical cancer. We present a case of an 81 years old patient with Stage IIB adenocarcinoma of uterine cervix, that was successfully treated with concurrent chemoradiotherapy with definitive intent. Six months later, she developed a solitary abdominal nodule for which she underwent resection followed by chemotherapy. At the present time there are no signs of local recurrence or distant metastasis after 3 years. In the case reported, the use of different strategies (radiotherapy, chemotherapy and surgery), as well as the correct choice and the timing of the different approaches has provided a great benefit for the patient. The use of surgery and chemotherapy in patients with recurrent cervical cancer is safe even in older patients with atypical","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46118116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Q. Hu, Tao Wang, Yueyue Chen, Dongmei Wei, Tao Cui, L. Mei, Lin Zhang, Xiaoyu Niu
Laboratory of Molecular Translational Medicine, Centre for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Clinical Research Center for Birth Defects of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China; Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China Contributions: (I) Conception and design: All authors; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Xiaoyu Niu. Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China. Email: niuxy@scu.edu.cn; Lin Zhang. Laboratory of Molecular Translational Medicine, Centre for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Clinical Research Center for Birth Defects of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu 610041, China. Email: zhanglin@scu.edu.cn.
{"title":"Medicine and engineering collaboration in urogynecology: a narrative review","authors":"Q. Hu, Tao Wang, Yueyue Chen, Dongmei Wei, Tao Cui, L. Mei, Lin Zhang, Xiaoyu Niu","doi":"10.21037/gpm-21-41","DOIUrl":"https://doi.org/10.21037/gpm-21-41","url":null,"abstract":"Laboratory of Molecular Translational Medicine, Centre for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Clinical Research Center for Birth Defects of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, China; Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China Contributions: (I) Conception and design: All authors; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Xiaoyu Niu. Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China. Email: niuxy@scu.edu.cn; Lin Zhang. Laboratory of Molecular Translational Medicine, Centre for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Clinical Research Center for Birth Defects of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu 610041, China. Email: zhanglin@scu.edu.cn.","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44016400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: Urinary incontinence is a medical condition that decreases the quality of life of more than 35% of women worldwide and its incidence increases with age. Since their introduction in 1996, the transvaginal midurethral slings have become the treatment of choice for patients with stress urinary incontinence. In recent years the restriction of the United States Food and Drugs Administration over the transvaginal meshes for prolapse has generated considerable tension and debate over the synthetic protheses, applied to the patients via transvaginal route either for prolapse, or incontinence. Due to growing concerns over a complete ban of transvaginal tapes for incontinence in the future, gynecologists have rediscovered the Burch colposuspension for treatment of patients with incontinence. The procedure is living its renaissance and the goal of this article is to present our modification of the classical technique that we call TOT-like Burch colposuspension using a state-of-art laparoscopic approach. One of the drawbacks of the classic Burch procedure is the high rate of dysuric symptoms postoperatively, which in our modification is overcome, as the suspension of the bladder neck and the urethra includes also the pubourethral ligaments and the arcus tendinous fascia pelvis with a single suture, which provides the tension-free support resembling the effect of the TOT-tapes. The corresponding video is divided in different steps in order to make the procedure more comprehensive and reproducible. 5
{"title":"Laparoscopic TOT-like Burch colposuspension: a modification of the original to adapt to the future","authors":"R. Botchorishvili, A. Aleksandrov","doi":"10.21037/gpm-21-21","DOIUrl":"https://doi.org/10.21037/gpm-21-21","url":null,"abstract":": Urinary incontinence is a medical condition that decreases the quality of life of more than 35% of women worldwide and its incidence increases with age. Since their introduction in 1996, the transvaginal midurethral slings have become the treatment of choice for patients with stress urinary incontinence. In recent years the restriction of the United States Food and Drugs Administration over the transvaginal meshes for prolapse has generated considerable tension and debate over the synthetic protheses, applied to the patients via transvaginal route either for prolapse, or incontinence. Due to growing concerns over a complete ban of transvaginal tapes for incontinence in the future, gynecologists have rediscovered the Burch colposuspension for treatment of patients with incontinence. The procedure is living its renaissance and the goal of this article is to present our modification of the classical technique that we call TOT-like Burch colposuspension using a state-of-art laparoscopic approach. One of the drawbacks of the classic Burch procedure is the high rate of dysuric symptoms postoperatively, which in our modification is overcome, as the suspension of the bladder neck and the urethra includes also the pubourethral ligaments and the arcus tendinous fascia pelvis with a single suture, which provides the tension-free support resembling the effect of the TOT-tapes. The corresponding video is divided in different steps in order to make the procedure more comprehensive and reproducible. 5","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41552692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Morotti, G. Valenti, V. Mavroeidis, Tingyan Shi
Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, UK; Department of Gynaecology, University Hospital (CHUV), Lausanne, Switzerland; Department of General Surgery and Medical-Surgical Specialties, Institute of Obstetrics and Gynecology, University of Catania, Catania, Italy; Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK; Division of Gynecological Oncology, Fudan University Zhongshan Hospital, Shanghai, China Contributions: (I) Conception and design: M Morotti, T Shi; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: M Morotti, G Valenti; (V) Data analysis and interpretation: M Morotti, VK Mavroeidis, T Shi; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. These authors contributed equally to this work. Correspondence to: Matteo Morotti. Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, UK. Email: drmorottimatteo@gmail.com.
{"title":"The role of exploratory laparoscopy in surgical planning for ultra- radical surgery for ovarian cancer: a narrative review","authors":"M. Morotti, G. Valenti, V. Mavroeidis, Tingyan Shi","doi":"10.21037/gpm-21-25","DOIUrl":"https://doi.org/10.21037/gpm-21-25","url":null,"abstract":"Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, UK; Department of Gynaecology, University Hospital (CHUV), Lausanne, Switzerland; Department of General Surgery and Medical-Surgical Specialties, Institute of Obstetrics and Gynecology, University of Catania, Catania, Italy; Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK; Division of Gynecological Oncology, Fudan University Zhongshan Hospital, Shanghai, China Contributions: (I) Conception and design: M Morotti, T Shi; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: M Morotti, G Valenti; (V) Data analysis and interpretation: M Morotti, VK Mavroeidis, T Shi; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. These authors contributed equally to this work. Correspondence to: Matteo Morotti. Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, UK. Email: drmorottimatteo@gmail.com.","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49339144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: Endometrial carcinoma is one of the most common cancers in the female reproductive tract, which affects women’s health seriously. It is of vital important for patients of endometrial carcinoma to undergo surgery treatment, since most patients are in the early stages of the disease when they are first diagnosed with good prognosis. At present, the commonly used surgical methods for endometrial cancer include traditional open surgery, laparoscopic surgery, single-hole endoscopic surgery, and robot surgery system, which brings new hope for the disease treatment. As a new advanced technology, robot-assisted surgery (RAS) has shown a few of advantages over traditional surgery, especially it can not only overcome complex anatomy, low exposure, surgical precision, and fixing lymph node, but also decrease the incidence of postoperative complication. We reported a 52-year-old patient with endometrial carcinoma complained of 2-month history of vaginal bleeding. After undergoing endometrial sampling with hysteroscopy, the patient was diagnosed that the mass was located in the border of cervix and uterus cavity. Successfully, the patient was preoperative diagnosed as endometrial carcinoma (type II, stage II) and accepted radical hysterectomy (type II), omentum resection, pelvic and abdominal para-aortic lymphadenectomy with DA Vinci robotic surgical system. The aim of this video is to describe the use of this kind of surgery, and share our experience of DA Vinci robotic surgical system.
{"title":"A case report of endomrtrial carcinoma by DA Vinci robotic surgical system","authors":"Ai-ming Lin, Xin-Sheng Lyu, Xiaojie Wang","doi":"10.21037/GPM-21-2","DOIUrl":"https://doi.org/10.21037/GPM-21-2","url":null,"abstract":": Endometrial carcinoma is one of the most common cancers in the female reproductive tract, which affects women’s health seriously. It is of vital important for patients of endometrial carcinoma to undergo surgery treatment, since most patients are in the early stages of the disease when they are first diagnosed with good prognosis. At present, the commonly used surgical methods for endometrial cancer include traditional open surgery, laparoscopic surgery, single-hole endoscopic surgery, and robot surgery system, which brings new hope for the disease treatment. As a new advanced technology, robot-assisted surgery (RAS) has shown a few of advantages over traditional surgery, especially it can not only overcome complex anatomy, low exposure, surgical precision, and fixing lymph node, but also decrease the incidence of postoperative complication. We reported a 52-year-old patient with endometrial carcinoma complained of 2-month history of vaginal bleeding. After undergoing endometrial sampling with hysteroscopy, the patient was diagnosed that the mass was located in the border of cervix and uterus cavity. Successfully, the patient was preoperative diagnosed as endometrial carcinoma (type II, stage II) and accepted radical hysterectomy (type II), omentum resection, pelvic and abdominal para-aortic lymphadenectomy with DA Vinci robotic surgical system. The aim of this video is to describe the use of this kind of surgery, and share our experience of DA Vinci robotic surgical system.","PeriodicalId":92781,"journal":{"name":"Gynecology and pelvic medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46872349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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