Journal of minimally invasive gynecology最新文献

{"title":"Predictors of Bilateral Sentinel Lymph Node Mapping Failure in Endometrial Cancer: A Systematic Review and Meta-Analysis","authors":"Zhaojuan Qin MM,&nbsp;Yi Du MD,&nbsp;Qi Wan MD,&nbsp;Ai Zheng MD","doi":"10.1016/j.jmig.2026.05.013","DOIUrl":"10.1016/j.jmig.2026.05.013","url":null,"abstract":"<div><h3>Objective</h3><div>To identify clinicopathological and procedural predictors of bilateral sentinel lymph node (SLN) mapping failure in patients with apparent early-stage endometrial cancer predominantly undergoing minimally invasive surgery with indocyanine green (ICG) fluorescence imaging.</div></div><div><h3>Data Sources</h3><div>A systematic literature search was performed in PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials from database inception to March 2026. Reference lists of relevant studies were also manually screened.</div></div><div><h3>Methods of Study Selection</h3><div>Observational studies were included, as randomized trials in this field typically do not report sufficient data on predictors of SLN mapping failure. Eligible studies predominantly involved patients with apparent early-stage disease undergoing minimally invasive surgery with cervical ICG-based SLN mapping and reporting extractable effect estimates or sufficient data for analysis. Studies were excluded if they had overlapping cohorts, used exclusively noncervical injection techniques, or included fewer than 50 patients. Two reviewers independently screened studies and extracted data.</div></div><div><h3>Tabulation, Integration, and Results</h3><div>Sixteen studies comprising 6977 patients were included. Random-effects meta-analysis demonstrated that obesity (BMI ≥30 kg/m²), high tumor grade (G3), nonendometrioid histology, and lymph node involvement were significantly associated with an increased risk of bilateral SLN mapping failure. In contrast, age, prior pelvic surgery, tumor size, cervical involvement, FIGO stage, lymphovascular space invasion, and surgical approach were not significantly associated with mapping outcomes. Heterogeneity was assessed using the I² statistic, and sensitivity analyses confirmed the robustness of the findings.</div></div><div><h3>Conclusion</h3><div>Bilateral SLN mapping failure in endometrial cancer is primarily driven by patient- and tumor-related factors, whereas surgical approach was not significantly associated with mapping outcomes. Identification of high-risk patients may facilitate individualized surgical planning and intraoperative decision-making.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1263-1272"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987947","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":"Total vNOTES Approach for the Removal of a Giant Adnexal Cyst","authors":"Hajar Alawadi MD,&nbsp;Aslam Mansoor MD,&nbsp;Luka Velemir MD","doi":"10.1016/j.jmig.2026.01.003","DOIUrl":"10.1016/j.jmig.2026.01.003","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the successful minimally invasive management of a giant paratubal cyst using total vaginal Natural Orifice Transluminal Endoscopic Surgery (tvNOTES), an emerging alternative to conventional laparoscopy for large adnexal masses [<span><span>1</span></span>].</div></div><div><h3>Design</h3><div>Stepwise demonstration of a surgical technique with narrated video, illustrating the tvNOTES approach for a giant adnexal mass.</div></div><div><h3>Setting</h3><div>Tertiary referral center specializing in minimally invasive gynecologic surgery.</div></div><div><h3>Interventions</h3><div>A 34-year-old multiparous woman presented with abdominal discomfort and a visible lower abdominal bulge, a typical mode of revelation for giant paratubal cysts [<span><span>2</span></span>]. Magnetic resonance imaging revealed a giant unilocular cyst (28 × 25 × 12 cm) with pure fluid content occupying the entire abdominopelvic cavity. Hypertrophy of the right utero-ovarian ligament suggested a right adnexal origin, and tumor markers were within normal limits, arguing against borderline paraovarian pathology [<span><span>4</span></span>]. A tvNOTES approach was selected given its established safety and efficacy in benign adnexal disease [<span><span>3</span></span>], combining endoscopic precision with no visible scar, clear visualisation, and improved surgeon ergonomics. Building on the original tvNOTES technique [<span><span>5</span></span>], and contrary to conventional vNOTES, in which the inner ring of the Alexis O Retractor (Applied Medical, Rancho Santa Margarita, CA) is positioned within the peritoneal cavity, a 7-cm Alexis O Retractor was placed circumferentially within the vagina around the cervix. The GelSEAL Cap (Applied Medical) with four trocars was then secured to the anterior perineum. Pneumovagina was maintained at 12 mmHg using a thoracic drainage bottle, with active smoke evacuation. A 3 cm posterior colpotomy was performed under endoscopic guidance, revealing a giant right paratubal cyst. The cyst was incised at its most dependent point and drained of 5 liters of clear fluid. A right salpingectomy was performed due to fallopian tube elongation, preserving the ovarian blood supply. The procedure lasted 40 minutes without complications. The patient was discharged 6 hours postoperatively with minimal pain.</div></div><div><h3>Conclusion</h3><div>TvNOTES allows all surgical steps under endoscopic visualization, with the potential for rapid recovery, minimal postoperative pain, and ovarian preservation, even in cases involving very large paratubal masses. TvNOTES may represent a feasible approach for the minimally invasive management of giant adnexal cysts.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Page 1241"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944612","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":"Adenomyotic Cyst Masquerading as a Subserosal Fibroid: Always a Laparoscopic Surprise?","authors":"Elad Preuss MD,&nbsp;Zoey Berdan BSc,&nbsp;Moran Bitton MD,&nbsp;Oshri Barel MD","doi":"10.1016/j.jmig.2026.02.011","DOIUrl":"10.1016/j.jmig.2026.02.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To describe the clinical evaluation, diagnostic challenges, and laparoscopic management of a symptomatic uterine mass initially suspected to be a fibroid and ultimately confirmed as an adenomyotic cyst.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;To describe the clinical evaluation, diagnostic challenges, and laparoscopic management of a symptomatic uterine mass initially suspected to be a fibroid and ultimately confirmed as an adenomyotic cyst.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;University-affiliated tertiary care hospital.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;University-affiliated tertiary care hospital.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patient(s)&lt;/h3&gt;&lt;div&gt;A 41-year-old G4P2 woman with a 2-year history of chronic pelvic pain and severe dysmenorrhea refractory to NSAIDs, associated with heavy menstrual bleeding. She previously underwent hysteroscopic myomectomy. Examination revealed an enlarged, tender uterus, and transvaginal ultrasound demonstrated interstitial fibroids with cystic features, raising suspicion for a Müllerian anomaly or adenomyotic cyst.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;A 41-year-old G4P2 woman with a 2-year history of chronic pelvic pain and severe dysmenorrhea refractory to NSAIDs, associated with heavy menstrual bleeding. She previously underwent hysteroscopic myomectomy. Examination revealed an enlarged, tender uterus, and transvaginal ultrasound demonstrated interstitial fibroids with cystic features, raising suspicion for a Müllerian anomaly or adenomyotic cyst.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Intervention(s)&lt;/h3&gt;&lt;div&gt;Laparoscopic excision of the lesion was performed and recorded as a surgical video. Incision of the lesion released characteristic “chocolate-like” content (&lt;span&gt;&lt;span&gt;Fig. 1&lt;/span&gt;&lt;/span&gt;). Indocyanine green injection demonstrated atypical fluorescence compared with fibroid tissue (&lt;span&gt;&lt;span&gt;Fig. 2&lt;/span&gt;&lt;/span&gt;), and comparison with typical fibroid uptake supported the diagnosis (&lt;span&gt;&lt;span&gt;Fig. 3&lt;/span&gt;&lt;/span&gt;). Complete excision and multilayer uterine reconstruction were achieved without entry into the uterine cavity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Laparoscopic excision of the lesion was performed and recorded as a surgical video. Incision of the lesion released characteristic “chocolate-like” content (&lt;span&gt;&lt;span&gt;Fig. 1&lt;/span&gt;&lt;/span&gt;). Indocyanine green injection demonstrated atypical fluorescence compared with fibroid tissue (&lt;span&gt;&lt;span&gt;Fig. 2&lt;/span&gt;&lt;/span&gt;), and comparison with typical fibroid uptake supported the diagnosis (&lt;span&gt;&lt;span&gt;Fig. 3&lt;/span&gt;&lt;/span&gt;). Complete excision and multilayer uterine reconstruction were achieved without entry into the uterine cavity.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome and Results&lt;/h3&gt;&lt;div&gt;Histopathology confirmed adenomyosis without fibroid tissue. The patient experienced complete postoperative pain resolution.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Histopathology confirmed adenomyosis without fibroid tissue. The patient experienced complete postoperative pain resolution.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Adenomyotic cysts may mimic fibroids on imaging. Intraoperative assessment with in","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1235-1236"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201916","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":"Laparoscopic Removal of Migrated Intrauterine Device in the Presacral Space","authors":"Nadin Alghanaim MBBS, FRCSC,&nbsp;Mark Magdy MBBS, FRACS,&nbsp;Dean Conrad MD, FRANZCOG","doi":"10.1016/j.jmig.2025.12.038","DOIUrl":"10.1016/j.jmig.2025.12.038","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1226-1228"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046783","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":"Sustainable Practices in Minimally Invasive Gynecologic Surgery: Opportunities for Resource Stewardship","authors":"Rita Sangtani","doi":"10.1016/j.jmig.2026.03.025","DOIUrl":"10.1016/j.jmig.2026.03.025","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1372-1373"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503802","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":"Understanding the Value of the Uterus: A Nationwide Cross-sectional Survey on Women's Preferences With Benign Gynecological Conditions","authors":"Ashley Huynh BS,&nbsp;Whitney Horner MD,&nbsp;Danielle Antosh MD,&nbsp;Isuzu Meyer MD,&nbsp;William D. Winkelman MD,&nbsp;Gabriela E. Halder MD,&nbsp;Jessica Ton MD,&nbsp;Kate V. Meriwether MD,&nbsp;Patricia L. Hudson MD,&nbsp;Nancy Ringel MD,&nbsp;Emily R.W. Davidson MD,&nbsp;Olivia H. Chang MD, MPH","doi":"10.1016/j.jmig.2026.03.009","DOIUrl":"10.1016/j.jmig.2026.03.009","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To identify clinical and demographic predictors associated with placing high value on the uterus among women with gynecological conditions in the United States.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;To identify clinical and demographic predictors associated with placing high value on the uterus among women with gynecological conditions in the United States.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Multicenter cross-sectional survey study utilizing the validated Value of the Uterus (VALUS) instrument and visual analog scale (VAS) to assess uterine value perceptions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Multicenter cross-sectional survey study utilizing the validated Value of the Uterus (VALUS) instrument and visual analog scale (VAS) to assess uterine value perceptions.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Eleven medical centers across four U.S. regions (South, Southwest, West, and Northeast) from December 2023 to June 2024.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Eleven medical centers across four U.S. regions (South, Southwest, West, and Northeast) from December 2023 to June 2024.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patients&lt;/h3&gt;&lt;div&gt;Participants included adult patients with a uterus, assigned female sex at birth, and not considering future pregnancies. Of 906 surveys distributed, 714 completed surveys (79% response rate) were analyzed. Most participants identified as White (74.9%), were 45 to 60 years old (36%), and postmenopausal (55.3%). Regional distribution included South (35.6%), West (34.7%), Northeast (22%), and Southwest (4.3%).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Participants included adult patients with a uterus, assigned female sex at birth, and not considering future pregnancies. Of 906 surveys distributed, 714 completed surveys (79% response rate) were analyzed. Most participants identified as White (74.9%), were 45 to 60 years old (36%), and postmenopausal (55.3%). Regional distribution included South (35.6%), West (34.7%), Northeast (22%), and Southwest (4.3%).&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;Participants completed surveys assessing demographics, clinical history, the VALUS instrument (range 6–30), and a VAS question rating importance of uterine preservation (0–100 scale). Participants were stratified using median VALUS score of 16 as the cut-off: 336 (47%) had low uterine value (VALUS &lt;16) and 378 (53%) had high uterine value (VALUS ≥16).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Participants completed surveys assessing demographics, clinical history, the VALUS instrument (range 6–30), and a VAS question rating importance of uterine preservation (0–100 scale). Participants were stratified using median VALUS score of 16 as the cut-off: 336 (47%) had low uterine value (VALUS &lt;16) and 378 (53%) had high uterine value (VALUS ≥16).&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Measurements and Main Results&lt;/h3&gt;&lt;div&gt;The mean VAS score was 40.8 (SD: 32.4). Multivariable logistic regression, controlling for income, age, and urinary incontinence (UI), revealed significant predictors of high uterine value. Asian American/Pacific Islander (AAPI) individuals had higher odds compared","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1315-1321"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458168","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 Randomized Double Blind Placebo Controlled Study to Assess the Efficacy of Fundal Block Analgesia During Radiofrequency Endometrial Ablation","authors":"Dinusha T. Hamilton MD, MSc, BSc,&nbsp;Sarah Smith MD,&nbsp;Huse Kamencic MD,&nbsp;John Thiel MD, MSc, FRCSC,&nbsp;Kirat Shukla PhD,&nbsp;Darrien Rattray MD","doi":"10.1016/j.jmig.2026.01.023","DOIUrl":"10.1016/j.jmig.2026.01.023","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Study Objective&lt;/h3&gt;&lt;div&gt;To assess the efficacy of the addition of a hysteroscopic fundal block on patient’s perception of intra-operative pain during NovaSure endometrial ablation in an ambulatory setting.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;To assess the efficacy of the addition of a hysteroscopic fundal block on patient’s perception of intra-operative pain during NovaSure endometrial ablation in an ambulatory setting.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Single centre, randomized, double-blind, placebo-controlled trial with a parallel design and a 1:1 treatment allocation ratio.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Single centre, randomized, double-blind, placebo-controlled trial with a parallel design and a 1:1 treatment allocation ratio.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Canadian gynecologic ambulatory-care clinic.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Canadian gynecologic ambulatory-care clinic.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;A total of 100 premenopausal female patients with abnormal uterine bleeding undergoing an ambulatory NovaSure endometrial ablation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;A total of 100 premenopausal female patients with abnormal uterine bleeding undergoing an ambulatory NovaSure endometrial ablation.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Intervention&lt;/h3&gt;&lt;div&gt;Hysteroscopic fundal injections with 10 mL 1% lidocaine (treatment group) or hysteroscopic fundal injections with normal saline (placebo group).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Hysteroscopic fundal injections with 10 mL 1% lidocaine (treatment group) or hysteroscopic fundal injections with normal saline (placebo group).&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;There was no difference in Numeric Rating Scale (NRS) for pain scores at 30 seconds, 60 seconds, and 1-hour postprocedure in the placebo and fundal block groups (p = .08; p = .28; p = .09). Secondary subgroup analysis revealed significantly higher NRS scores in those with a self-reported history of dysmenorrhea (NRS score &gt;5) who received placebo compared to the lidocaine fundal block at 30 and 60 seconds (p = .02; p = .03). The procedure was found to be acceptable to the majority of participants and 95.6% would recommend the procedure to someone else with no difference between groups. There was no difference in use of intraoperative analgesics and sedatives, postoperative pain, or adverse events between the groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;There was no difference in Numeric Rating Scale (NRS) for pain scores at 30 seconds, 60 seconds, and 1-hour postprocedure in the placebo and fundal block groups (p = .08; p = .28; p = .09). Secondary subgroup analysis revealed significantly higher NRS scores in those with a self-reported history of dysmenorrhea (NRS score &gt;5) who received placebo compared to the lidocaine fundal block at 30 and 60 seconds (p = .02; p = .03). The procedure was found to be acceptable to the majority of participants and 95.6% would recommend the procedure to someone else with no difference between groups. There was no difference in use of intraoperative analgesics and sedatives, postoperative pain, or adverse events betwee","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1364-1370"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984985","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":"C-Shaped Double Uterine Artery: An Uncommon Vascular Variant With Major Surgical Impact","authors":"Stefano Ferla MD,&nbsp;Agnese Virgilio MD,&nbsp;Renato Seracchioli MD,&nbsp;Diego Raimondo MD","doi":"10.1016/j.jmig.2026.01.056","DOIUrl":"10.1016/j.jmig.2026.01.056","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1224-1225"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100249","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":"“Twist of Fate”: Parasitized Leiomyoma Causing Recurrent Small Bowel Obstructions","authors":"Meyha N. Swaroop MD, MS,&nbsp;Natalie Domeisen MD,&nbsp;David D. Childs MD,&nbsp;Janelle K. Moulder MD MSCR","doi":"10.1016/j.jmig.2026.01.025","DOIUrl":"10.1016/j.jmig.2026.01.025","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1222-1223"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984988","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":"Intraoperative Proctosigmoidoscopy Following Bowel Endometriosis Surgery: A Retrospective Evaluation","authors":"Anshumala S. Kulkarni MD,&nbsp;Roshni Khanna DGO, DNB,&nbsp;Kiran R. Konda MS, DNB, FMIS,&nbsp;Manoj Mulchandani MS","doi":"10.1016/j.jmig.2026.03.006","DOIUrl":"10.1016/j.jmig.2026.03.006","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Study Objective&lt;/h3&gt;&lt;div&gt;To evaluate the effectiveness of intraoperative proctosigmoidoscopy in patients undergoing bowel endometriosis surgery&lt;/div&gt;&lt;/div&gt;&lt;div&gt;To evaluate the effectiveness of intraoperative proctosigmoidoscopy in patients undergoing bowel endometriosis surgery&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Retrospective, single-centre observational study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Retrospective, single-centre observational study.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Department of Gynecology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Department of Gynecology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patients&lt;/h3&gt;&lt;div&gt;Patients undergoing bowel endometriosis surgery and intraoperative proctosigmoidoscopy at the end of the intervention, from April 2022 to March 2025.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Patients undergoing bowel endometriosis surgery and intraoperative proctosigmoidoscopy at the end of the intervention, from April 2022 to March 2025.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;Description of findings at intraoperative proctosigmoidoscopy after bowel endometriosis resection.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Description of findings at intraoperative proctosigmoidoscopy after bowel endometriosis resection.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Measurements and Main Results&lt;/h3&gt;&lt;div&gt;Among 300 endometriosis surgeries, 126 involved bowel lesions: 100 partial thickness discoid excisions/shaving, 18 full-thickness discoid excision, and 8 segmental bowel resections. This study reports on the latter 2 groups (26 patients in total) who also underwent intraoperative proctosigmoidoscopy. In these 26 patients, findings included 1 case each of bleeding and leak at the anastomosis site (bleed identified only on proctosigmoidoscopy). Postoperatively, 4 patients reported persistent constipation, and another 2 had chronic pelvic pain. No rectovaginal fistulas or luminal narrowing or dyschezia/dyspareunia were observed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Among 300 endometriosis surgeries, 126 involved bowel lesions: 100 partial thickness discoid excisions/shaving, 18 full-thickness discoid excision, and 8 segmental bowel resections. This study reports on the latter 2 groups (26 patients in total) who also underwent intraoperative proctosigmoidoscopy. In these 26 patients, findings included 1 case each of bleeding and leak at the anastomosis site (bleed identified only on proctosigmoidoscopy). Postoperatively, 4 patients reported persistent constipation, and another 2 had chronic pelvic pain. No rectovaginal fistulas or luminal narrowing or dyschezia/dyspareunia were observed.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Intraoperative proctosigmoidoscopy is a feasible and valuable adjunct to endometriosis surgery involving the bowel. It may refine intraoperative decision-making and has the potential reduce both short- and long-term complications.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Intraoperative proctosigmoidoscopy is a feasible and valuable adjunct to endometriosis surgery involving the bowel. It may refine intraoperative dec","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1300-1305"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463424","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}