Journal of minimally invasive gynecology最新文献

{"title":"Uterus-Preserving Cold-Knife Adenomyomectomy within a Three-Stage Treatment Strategy for Severe Diffuse Adenomyosis and Its effect on IVF/ICSI and Perinatal Outcomes.","authors":"Zhi Zeng, Rui Xiang, Yingying Liu, Jintao Peng, Manchao Li, Panyu Chen, Jingjie Li, Weie Zhao, Xiaolan Li, Yujie Li, Qian Li, Haitao Zeng, Xiaoyan Liang","doi":"10.1016/j.jmig.2026.08.024","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.08.024","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of a three-stage treatment strategy featured by cold-knife adenomyomectomy, enhanced endometrial protection and postoperative uterine monitoring for severe diffuse adenomyosis on IVF/ICSI and perinatal outcomes.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Tertiary reproductive center.</p><p><strong>Participants: </strong>This study included 221 infertile women with diffuse adenomyosis treated from January 2021 to October 2025, comprising 125 patients with medically refractory disease or recurrent implantation failure who underwent three-stage treatment (surgery group) and 96 patients without these indications who received GnRHa-only therapy (control group). In the surgery group, 32 patients haven't completed uterine monitor, and 12 patients haven't made embryo transfer decision.</p><p><strong>Interventions: </strong>A three-stage protocol: (1) extensive energy-free cold-knife debulking; (2) multi-layer tension-balanced uterine reconstruction preserving a 5-mm myometrial-endometrial buffer zone; and (3) postoperative sequential MRI, diagnostic hysteroscopy and/or 3D transvaginal ultrasound screening before embryo transfer.</p><p><strong>Results: </strong>Uterine dimensions were significantly reduced after surgery in 93 patients with postoperative MRI assessments. Among 78 patients who proceeded with embryo transfer and definitive outcome (explicitly excluding two spontaneous conceptions and one ongoing pregnancy), the cumulative clinical pregnancy rate was 62.82% (49/78) and the cumulative live birth rate was 41.03% (32/78). Doubly robust AIPW estimation across 142 first embryo transfer cycles (46 from surgery and 96 from control group) revealed that the three-stage strategy was associated with a markedly reduced miscarriage risk (RR = 0.18; 95% CI, 0.05-0.67; P = 0.011), whereas clinical pregnancy and live-birth rates did not differ significantly between groups. Three third-trimester uterine ruptures occurred, corresponding to 8.8% (3/34) of women who delivered. All 3 patients required emergency cesarean delivery, including 1 woman underwent peripartum hysterectomy. All live-born neonates were discharged in good health.</p><p><strong>Conclusion: </strong>This fertility-sparing, non-thermal three-stage cold-knife technique reduces uterine size and appears to optimize reproductive outcomes in severe adenomyosis by reducing miscarriage. Doubly robust analysis reinforces the reliability of these findings, pending confirmation in larger cohorts. Strict single-embryo transfer, serial monitoring of the reconstructed myometrium and amniotic fluid, and planned cesarean delivery are mandatory to minimize uterine rupture risk.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891913","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":"Authors reply.","authors":"Paulina Garcia de Alba Graue, Eva Suarthana, Togas Tulandi","doi":"10.1016/j.jmig.2026.08.027","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.08.027","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891931","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":"Endometrial Polyp Recurrence After Hysteroscopic Polypectomy: A Systematic Review and Meta-analysis by Surgical Instrument.","authors":"Giuseppe Caruso, Nataša Kenda Šuster, Marco Palumbo","doi":"10.1016/j.jmig.2026.08.028","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.08.028","url":null,"abstract":"<p><strong>Objective: </strong>To characterize endometrial polyp recurrence after hysteroscopic removal according to surgical instrument and assess direct comparative evidence without treating instrument-specific single-arm proportions as comparative effects.</p><p><strong>Data sources: </strong>PubMed, Scopus, Web of Science Core Collection, and Cochrane CENTRAL were searched through July 18, 2026. Trial registries and citations were assessed. The review was prospectively registered (PROSPERO CRD420261335015).</p><p><strong>Methods of study selection: </strong>Randomized and nonrandomized studies with at least 10 patients, a histologically confirmed index polyp, hysteroscopic removal, and recurrence assessment at 6 months or later were eligible. Two reviewers independently screened records and assessed full texts; extraction, report linkage, instrument classification, and risk-of-bias judgments were independently verified and finalized by consensus. Cointerventions were analyzed separately or in sensitivity analyses.</p><p><strong>Tabulation, integration, and results: </strong>Of 1,221 records, 777 were screened and 69 reports were assessed; 38 reports representing 34 studies were included. Strict 12-month single-arm pools were estimable for tissue removal systems (6.3%; 95% CI, 3.3%-11.7%) and electrosurgery (13.5%; 95% CI, 11.6%-15.7%). A strict mechanical/cold pool was not retained after full-text re-verification identified selective sharp curettage in a contributing cold-knife arm. These proportions are descriptive, not comparative effects. Direct comparisons remained sparse and very low certainty. In 2 nonrandomized cohorts, postoperative levonorgestrel-releasing intrauterine systems were associated with lower recurrence (pooled risk ratio, 0.36; 95% CI, 0.23-0.57); certainty was very low.</p><p><strong>Conclusion: </strong>Comparative evidence is insufficient to determine whether hysteroscopic instrument choice independently affects recurrence. Case mix, recurrence ascertainment, and follow-up materially limit cross-study interpretation. The observed LNG-IUS association is nonrandomized and does not establish causality.</p><p><strong>Summation: </strong>Comparative evidence is insufficient to determine whether hysteroscopic instrument choice independently affects endometrial polyp recurrence; postoperative LNG-IUS is associated with lower observed recurrence, but the evidence is nonrandomized and very low certainty.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887786","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":"Primary Retroperitoneal Ovary Presenting as Acute Pelvic Pain: A Diagnostic Pitfall.","authors":"Yuanjunzi Shi, Gang Ji, Houyu Yang","doi":"10.1016/j.jmig.2026.08.031","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.08.031","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887851","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 \"Complementary Roles of Rectal Magnetic Resonance Imaging and Endoscopic Ultrasound in the Preoperative Assessment of Rectal Deep Endometriosis: A Retrospective Cohort\".","authors":"Yinwen Hong","doi":"10.1016/j.jmig.2026.08.030","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.08.030","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880805","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 “Artificial Intelligence in Academic Publishing: A Comparative Analysis of Author and Reviewer Guidelines Across Major Obstetrics and Gynecology Journals”","authors":"Shigeki Matsubara MD, PhD","doi":"10.1016/j.jmig.2026.02.040","DOIUrl":"10.1016/j.jmig.2026.02.040","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1375-1376"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321694","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":"Duplicated Ureter: Double the Vigilance","authors":"Ahmad Hasan MD,&nbsp;Dilkash Kajal MD,&nbsp;Nigel Pereira MD","doi":"10.1016/j.jmig.2025.12.031","DOIUrl":"10.1016/j.jmig.2025.12.031","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1215-1216"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Pressure Versus Standard-Pressure Pneumoperitoneum in Gynecologic Laparoscopic Surgery: A Systematic Review and Meta-Analysis","authors":"Maria Julia Lemos MD,&nbsp;Berenice Curi-Pesantes MD,&nbsp;Davi Barbosa Pereira da Silva MS,&nbsp;Laura Fonseca Queiroz MD,&nbsp;Jose Carugno MD","doi":"10.1016/j.jmig.2026.05.017","DOIUrl":"10.1016/j.jmig.2026.05.017","url":null,"abstract":"<div><h3>Objective</h3><div>To compare low-pressure pneumoperitoneum (8–10 mm Hg) with standard-pressure pneumoperitoneum (12–15 mm Hg) in women undergoing gynecologic laparoscopic surgery, focusing on postoperative pain, operative time, estimated blood loss, and length of hospital stay.</div></div><div><h3>Data Sources</h3><div>PubMed, Embase, and Cochrane Central Register were systematically searched up to February 2026 using the terms \"gynecologic laparoscopy,\" \"pneumoperitoneum,\" \"intraperitoneal pressure,\" and \"insufflation pressure.\" Reference lists of included studies and prior systematic reviews were also manually searched.</div></div><div><h3>Methods of Study Selection</h3><div>Randomized controlled trials (RCTs) enrolling adult women undergoing gynecologic laparoscopic procedures that compared low- versus standard-pressure pneumoperitoneum and reported at least one outcome of interest were included.</div></div><div><h3>Tabulation Integration and Results</h3><div>Eleven RCTs comprising 1156 patients were included. A Bayesian random-effects meta-analysis was performed. Low-pressure pneumoperitoneum was not associated with significant differences in postoperative pain at 24 hours (SMD -0.17; 95% CrI: -0.67, 0.34), postoperative pain at 3-6 hours (SMD -0.45; 95% CrI: -1.34, 0.45), shoulder-tip pain at 24 hours (MD −0.37; 95% CrI: -1.20, 0.43), operative time (MD -0.18 min; 95% CrI: -10.81, 11.14), length of hospital stay (MD -0.03 days; 95% CrI: -0.48, 0.42), or estimated blood loss (MD 31.90 mL; 95% CrI: -4.71, 67.66). Subgroup analysis revealed that low pressure was associated with reduced pain at 3–6 hours compared with 15 mm Hg specifically (MD -0.95; 95% CrI: -1.83, -0.05), and 12 mm Hg was associated with lower pain at 24 hours than 15 mm Hg (MD -0.84; 95% CrI: -1.54, -0.15). The overall certainty of evidence was rated as very low to moderate per GRADE assessment.</div></div><div><h3>Conclusion</h3><div>Low-pressure pneumoperitoneum was not associated with consistent improvements in perioperative outcomes compared with standard-pressure pneumoperitoneum in gynecologic laparoscopic surgery. However, clinical heterogeneity, a very low to moderate certainty of evidence, and limited reporting of intraoperative complications, operative conditions, and surgeon satisfaction limit the interpretation and clinical applicability of these findings. Further well-designed RCTs with standardized outcome reporting are needed to determine whether specific surgical settings or patient subgroups may benefit from lower insufflation pressures.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1273-1282"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015968","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(26)00419-X","DOIUrl":"10.1016/S1553-4650(26)00419-X","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Page A2"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861749","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":"Initial Results in the Automatic Visual Recognition of Endometriosis Lesions by Artificial Intelligence During Laparoscopy: A Proof-of-Concept Study","authors":"Sida Chen MM,&nbsp;Jang Song BS,&nbsp;Yanmei Sun MM,&nbsp;Jing Xiao MD","doi":"10.1016/j.jmig.2025.12.047","DOIUrl":"10.1016/j.jmig.2025.12.047","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1373-1374"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113507","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}