Journal of minimally invasive gynecology最新文献

{"title":"Bowel Injuries Reported After NovaSure® Endometrial Ablation: A 10-Year Review of FDA MAUDE Data.","authors":"Jillian G Gomez, Juan Avitia, Magdy P Milad","doi":"10.1016/j.jmig.2026.04.017","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.04.017","url":null,"abstract":"<p><strong>Objective: </strong>To characterize adverse event reports involving bowel injury associated with NovaSure® (Hologic, Marlborough, MA) endometrial ablation devices using the U.S. Food and Drug Administration's (FDA) Manufacturer and User Facility Device Experience (MAUDE) database.</p><p><strong>Design: </strong>Reports were coded and tallied based on primary, secondary, and tertiary procedures, findings & complications, and interventions.</p><p><strong>Setting: </strong>Retrospective study using the nationwide FDA MAUDE database.</p><p><strong>Participants: </strong>Reports from January 2015 through February 2025, yielding 1,912 device reports, 153 of which described bowel injuries.</p><p><strong>Interventions: </strong>Each report was reviewed for type and location of bowel injury, concurrent injuries, subsequent interventions, and outcomes.</p><p><strong>Results: </strong>Among 153 reports, 95 (62.1%) involved at least one thermal bowel injury, 47 (30.7%) described bowel perforation, and 44 (28.8%) documented unspecified bowel injury (including adhesions, erythema, or ileus). Surgical interventions included bowel resection in 74 (48.4%), anastomosis in 24 (15.7%), and other bowel repairs in 26 (17%). When specified, the small bowel was the most frequent site of injury. Additional injuries included 56 (36.6%) uterine thermal injuries, 62 (40.5%) uterine perforations, and 15 (9.8%) reports of unspecified uterine injury. In 57 reports where time to return for complication management was specified, approximately 14% of patients returned after one week of the initial procedure, with the largest proportion of patients returning within 24 hours (28.1%). Over the ten-year period, there was a decline in the absolute number of adverse reports involving any bowel injury per year, with a high of 28 reports in 2015 and a low of 6 reports in 2024.</p><p><strong>Conclusions: </strong>Despite multiple built-in safety mechanisms-including operator training, cavity integrity assessment (CIA), impedance-controlled energy delivery, automated self-tests, and recent updates to integrated safety features, concerns regarding uterine and bowel injuries remain. Over a 10-year period, 153 bowel injuries were reported following NovaSure® use; many requiring major surgical interventions such as bowel resection.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774099","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":"Evidence-Based Guidelines for Instrument and Handle Selection for Ergonomic Optimization in Laparoscopic Surgery.","authors":"Rosanne Kho","doi":"10.1016/j.jmig.2026.04.014","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.04.014","url":null,"abstract":"<p><strong>Objective: </strong>To develop evidence-based practice guidelines for ergonomic optimization in laparoscopic surgery through evaluation of various instrument handle designs.</p><p><strong>Methods: </strong>A systematic review of the literature was conducted in accordance with PRISMA guidelines. Searches of Ovid MEDLINE, Embase, CINAHL, and the Cochrane Library were performed from database inception through February 2025. Studies evaluating laparoscopic instrument handle design-including needle drivers, graspers, and electrosurgical devices-and their impact on surgeon ergonomic outcomes were included. Outcomes were grouped into four domains: operative performance, muscle workload and fatigue, motion efficiency, and surgeon discomfort. Study quality was assessed using the Cochrane Risk of Bias tool (RoB 2) for randomized trials and ROBINS-I for nonrandomized studies. Evidence synthesis was performed narratively due to heterogeneity of study designs and outcomes.</p><p><strong>Recommendations: </strong>Twenty-three studies met inclusion criteria. Most were simulation-based randomized crossover trials with small sample sizes and heterogeneous outcome measures. Evidence comparing laparoscopic needle driver handle designs was limited and insufficient to support superiority of any configuration. For graspers, inline or intermediate handle configurations may promote more neutral wrist posture and reduce forearm muscle activation compared with pistol-grip design, although findings were inconsistent. Studies evaluating electrosurgical devices suggest that ergonomic performance may be influenced by handle geometry, activation button placement, and surgeon-specific factors such as hand size; however, no device demonstrated consistent superiority.</p><p><strong>Conclusion: </strong>Current evidence supporting specific laparoscopic instrument handle designs for ergonomic optimization remains limited and heterogeneous. Conventional instruments remain appropriate for routine use, while alternative designs may be considered in select circumstances. Further prospective clinical studies using standardized ergonomic metrics are needed to guide evidence-based instrument development and reduce musculoskeletal strain for surgeons.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774102","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":"Artificial Intelligence in Minimally Invasive Gynecological Surgery: A Systematic Review of Task- Specific Performance and Clinical Translational Readiness.","authors":"Eman Alnajjar, Fatma Al Hajeri, Latifa Alsaad, Conor Harrity, Kushal Chummun, Hassan Rajab","doi":"10.1016/j.jmig.2026.04.015","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.04.015","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the task-specific performance and clinical translational readiness of artificial intelligence (AI) applications across the preoperative, intraoperative, and postoperative phases of minimally invasive gynecologic surgery (MIGS).</p><p><strong>Data sources: </strong>A comprehensive search of PubMed, Embase, Scopus, Web of Science, Google Scholar, CENTRAL, and the Cochrane Library was conducted for English-language studies published between January 1, 2015, and August 31, 2025.</p><p><strong>Methods of study selection: </strong>This systematic review followed PRISMA guidelines. Studies evaluating artificial intelligence or machine learning models for predictive or diagnostic tasks in MIGS (laparoscopy, hysteroscopy, or robotic surgery) were included. Animal studies, technical feasibility reports without clinical outcomes, and non-English publications were excluded. Risk of bias was assessed using a validated tool for AI prediciton models (PROBAST-AI) framework.</p><p><strong>Tabulation, integration, and results: </strong>Eight studies involving 6,577 patients met the inclusion criteria. AI applications were categorized according to perioperative phase. Preoperative models for endometriosis and adnexal torsion demonstrated high sensitivity (95%-96%) but limited specificity (11%-45%), suggesting utility as screening triage rather than definitive diagnostic systems. One randomized controlled trial demonstrated that AI-assisted surgical planning for hysteroscopic myomectomy significantly reduced operative time and intraoperative blood loss (p<0.05). Postoperative deep learning models predicting fertility outcomes following hysteroscopic adhesiolysis demonstrated the highest discriminative performance (AUC >0.95) and were the only studies incorporating prospective external validation. PROBAST-AI assessment identified high risk of bias in 75% of studies.</p><p><strong>Conclusion: </strong>AI applications in MIGS demonstrate promising task-specific performance; however, evidence is predominantly observational with high risk of bias and limited external validation, constraining clinical translation. Multicenter prospective validation is required before routine adoption.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774127","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":"Oral Gonadotropin-Releasing Hormone Antagonists for the Treatment of Endometriosis-Associated Pain: A Systematic Review and Meta-Analysis.","authors":"R Hsu, E S Han, M Farrow, M Pacis, S Swartz, K Denny","doi":"10.1016/j.jmig.2026.04.004","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.04.004","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study objective: &lt;/strong&gt;To evaluate the efficacy of oral gonadotropin-releasing hormone (GnRH) antagonists versus placebo for treatment of endometriosis-associated pain and to compare individual antagonists indirectly for dysmenorrhea and non-menstrual pelvic pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Systematic review and meta-analysis of phase 3 randomized, double-blind, placebo-controlled trials of oral GnRH antagonists in people with moderate-to-severe endometriosis-associated pain, with dual screening, standardized data extraction, and risk of bias assessment using the Cochrane Risk of Bias 2 tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Multicenter phase 3 clinical trials conducted in outpatient gynecology and reproductive health settings across North America, Europe, and other international sites, identified through electronic databases and trial registries from inception through October 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;A total of 2,060 participants with surgically or imaging-diagnosed endometriosis and moderate-to-severe baseline pain, with mean ages of 31-35 years, enrolled in five phase 3 trials (ELARIS, SPIRIT 1 and 2, and EDELWEISS-3).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interventions: &lt;/strong&gt;The included trials evaluated three oral GnRH antagonist regimens: elagolix 200 mg twice daily without add‑back, relugolix 40 mg once daily combination therapy, and linzagolix 200 mg once daily with add-back. Add-back and combination therapy were defined as co‑administration of estradiol 1 mg and norethindrone acetate 0.5 mg once daily. Each regimen was compared with matching placebo for treatment durations up to 24 weeks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements and main results: &lt;/strong&gt;Primary outcomes were binary responder rates for dysmenorrhea and non-menstrual pelvic pain, defined by prespecified reductions in daily pain scores with stable or reduced analgesic use. Fixed-effects meta-analysis with inverse-variance weighting yielded a pooled risk ratio of 3.06 (95% CI, 2.76-3.39; p &lt; 0.001) and a number needed to treat (NNT) of 2 (95% CI, 2-3) for dysmenorrhea responders, and a pooled risk ratio of 1.53 (95% CI, 1.40-1.67; p &lt; 0.001) and NNT of 5 (95% CI, 4-7) for non-menstrual pelvic pain responders, with no statistical heterogeneity (I² = 0%) for either outcome. Drug-level pooled risk ratios for dysmenorrhea were 3.49 (95% CI, 2.93-4.16) for elagolix 200 mg twice daily, 3.11 (95% CI, 2.32-4.17) for linzagolix 200 mg with add-back, and 2.61 (95% CI, 2.22-3.07) for relugolix combination therapy; corresponding pooled risk ratios for non-menstrual pelvic pain were 1.54 (95% CI, 1.31-1.80), 1.52 (95% CI, 1.15-2.01), and 1.52 (95% CI, 1.32-1.74), respectively. Bucher-adjusted indirect comparisons did not demonstrate robust differences in efficacy between agents for either pain domain, although elagolix was associated with a statistically significant higher dysmenorrhea response than relugolix combination therapy (risk ratio 1.34; 95% CI, 1.05-1.70; p = 0.017).&lt;/p&gt;&lt;p&gt;&lt;stro","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774152","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":"Compartment-Specific Outcomes of Single-Mesh and Double-Mesh Reinforcement in Laparoscopic Sacrocolpopexy: A Retrospective Cohort Study.","authors":"Hirotaka Sato, Shota Otsuka, Kenji Sugita, Hirokazu Abe, Sachiyuki Tsukada","doi":"10.1016/j.jmig.2026.04.011","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.04.011","url":null,"abstract":"<p><strong>Objective: </strong>To compare long-term anatomical, subjective, and surgical outcomes of single-mesh and double-mesh reinforcement for laparoscopic sacrocolpopexy (LSC) by focusing on compartment-specific failure and reoperation.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Single tertiary referral center.</p><p><strong>Participants: </strong>Women (n = 897) who underwent LSC-based apical prolapse surgery between 2015 and 2024.</p><p><strong>Interventions: </strong>Patients were classified according to whether single-mesh (anterior-only or posterior-only mesh; n = 560) or double-mesh (anterior and posterior mesh; n = 337) reinforcement was performed during the index surgery.</p><p><strong>Results: </strong>The primary outcome was time to anatomical failure (AF) in the reinforced compartment (n = 54 patients). Secondary outcomes included AF in nonreinforced compartments, subjective failure (SF), composite failure (CF), reoperation for recurrent prolapse, and mesh-related complications. The AF-free survival rate in the double-mesh group was similar to that in the single-mesh group (92.6% vs. 92.7%; log-rank p = 0.95). The mesh configuration was not associated with AF in the reinforced compartment (adjusted hazard ratio [HR], 0.84; 95% confidence interval [CI], 0.47-1.49). AF in nonreinforced compartments occurred exclusively in the single-mesh group. Firth's penalized Cox regression demonstrated a substantially increased risk of AF in nonreinforced compartments associated with single-mesh reinforcement (adjusted HR, 38.13; 95% CI, 3.70-86,989.61). Reoperation in nonreinforced compartments was limited to the single-mesh group (adjusted HR, 38.23; 95% CI, 3.78-5269.73). CF and SF were more frequent in the single-mesh group. The single-mesh group had a higher risk of SF (adjusted HR, 4.88; 95% CI, 1.19-20.0). Mesh-related complications were infrequent and comparable between groups.</p><p><strong>Conclusion: </strong>Reinforced compartment durability after LSC was similar between groups. Single-mesh reinforcement was associated with higher risks of failure and reoperation, which led to inferior composite and subjective outcomes without increased mesh-related complications.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774122","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":"Abdominal Wall Elevation for Pneumoperitoneum in Laparoscopic Gynecologic Surgery: A Retrospective Comparative Study of Experienced and Trainee Surgeons.","authors":"Francesco Giuseppe Martire, Ilaria Ianes, Eugenia Costantini, Errico Zupi, Lucia Lazzeri","doi":"10.1016/j.jmig.2026.04.012","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.04.012","url":null,"abstract":"<p><strong>Study objective: </strong>To evaluate the success rate and incidence of complications associated with pneumoperitoneum induction using an abdominal wall elevation device when performed by surgeons with different levels of laparoscopic experience.</p><p><strong>Design: </strong>Retrospective comparative study.</p><p><strong>Setting: </strong>Gynecologic minimally invasive surgery setting.</p><p><strong>Patients: </strong>A total of 40 patients undergoing laparoscopic procedures were included. Procedures were performed by 2 cohorts: experienced gynecologists with >5 years of minimally invasive surgical activity and residents with limited experience (<5 prior minimally invasive laparoscopic procedures).</p><p><strong>Interventions: </strong>Pneumoperitoneum induction using the LevaLap 1.0 abdominal wall elevation device.</p><p><strong>Measurements and main results: </strong>Successful peritoneal entry was achieved in all patients without major access-related complications. The success rate was 100% (20/20) in the experienced group and 95% (19/20) in the resident group, with comparable results between groups. The mean time required for pneumoperitoneum induction did not prolong routine laparoscopic entry times. Procedure duration and number of attempts were comparable between groups.</p><p><strong>Conclusion: </strong>The LevaLap 1.0 device was associated with high success rates, absence of major access-related complications, and no need for conversion to laparotomy. Its use provided effective and reproducible pneumoperitoneum induction, including when performed by less experienced surgeons under supervision, supporting a favorable safety profile.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774067","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":"Virtual Reality for Pain Reduction During Transvaginal Ultrasound in Women with Endometriosis: A Randomized Controlled Trial.","authors":"Aviad Cohen, Ishai Levin, Yoni Cohen, Yaron Gil, Noa Feldman, Shikma Bar-On, Nina Krajden, Ran Nagar","doi":"10.1016/j.jmig.2026.04.013","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.04.013","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether virtual reality (VR) glasses reduce pain perception during transvaginal ultrasound (TVUS) in women with endometriosis.</p><p><strong>Design: </strong>Open-label randomized controlled trial.</p><p><strong>Setting: </strong>University-affiliated medical center.</p><p><strong>Participants: </strong>117 premenopausal women with a confirmed diagnosis of endometriosis.</p><p><strong>Interventions: </strong>TVUS performed with or without the use of immersive VR glasses.</p><p><strong>Results: </strong>A total of 117 women were randomized to either the VR group (n = 58) or the control group (n = 59). Although mean pain scores were not significantly different (VR: 3.2 ± 2.6 vs. control: 4.0 ± 3.0; p = 0.08), moderate-to-severe pain was reported less frequently in the VR group (33.9% vs. 55.2%; p = 0.027). In a multivariate logistic regression analysis, VR use (OR = 0.26, 95% CI: 0.10-0.63; p = 0.0027), current pain [odds ratio (OR) = 1.31, 95% CI: 1.02-1.69], and anticipated pain (OR = 1.22, 95% CI: 1.00-1.49) were shown to be independent predictors of moderate-to-severe pain during TVUS. Among women with high anticipated pain [Numeric rating scale (NRS) ≥ 4], the VR group reported significantly lower actual pain scores compared to controls [3.0 (1.0-5.0) vs. 6.0 (4.0-7.5), respectively, p = 0.037].</p><p><strong>Conclusion: </strong>Use of VR during TVUS in women with endometriosis reduced the frequency of moderate-to-severe pain and mitigated the impact of anticipated pain on pain perception. VR may be a beneficial non-pharmacologic adjunct in pelvic imaging for women with endometriosis.</p><p><strong>Trial registration number: </strong>NCT04711408.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774117","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":"Impact of Prior Conization on Oncological Outcomes of Laparoscopic versus Open Radical Hysterectomy in Early-Stage Cervical Cancer: A Propensity Score-Weighted Retrospective Observational Study.","authors":"Guiyue Shi, Yunyun Xiao, Lu Han, Wancheng Zhao","doi":"10.1016/j.jmig.2026.04.010","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.04.010","url":null,"abstract":"<p><strong>Study objective: </strong>To compare long-term oncological outcomes of laparoscopic (LRH) versus open radical hysterectomy (ORH) in patients with early-stage cervical cancer who underwent prior cervical conization.</p><p><strong>Design: </strong>A single-center retrospective observational study using propensity score-based inverse probability of treatment weighting (PS-IPTW) to balance covariates.</p><p><strong>Setting: </strong>Shengjing Hospital of China Medical University, a tertiary academic medical center.</p><p><strong>Participants: </strong>A total of 241 patients with FIGO 2009 stage IA2, IB1, and IIA1 cervical cancer from January 1, 2014, to December 31, 2018, were included. All patients underwent diagnostic conization followed by radical hysterectomy and were restaged according to the FIGO 2018 classification.</p><p><strong>Interventions: </strong>Patients underwent either laparoscopic radical hysterectomy (LRH, n = 42) or open radical hysterectomy (ORH, n = 199).</p><p><strong>Measurements and main results: </strong>Primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS). Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. Median follow-up exceeded 6 years. Remarkably, the LRH group experienced zero deaths or recurrences. The 5-year OS (100% vs. 99.5%, p=0.646) and PFS (100% vs. 98.0%, p=0.385) were comparable between LRH and ORH. Post-IPTW adjustment confirmed no statistically significant differences in survival outcomes.</p><p><strong>Conclusions: </strong>Contrary to findings in the general population, LRH yields excellent oncological outcomes comparable to ORH in patients with prior conization. Prior cervical conization may reduce the risk of tumor dissemination, suggesting a potentially suitable subgroup for minimally invasive surgery.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729204","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":"The Hyperechogenic Levonorgestrel Intrauterine System. An Underrecognized Ultrasound Finding Confirmed by Hysteroscopy.","authors":"Jose Carlos Vilches, Jose Carugno, Luis Alonso Pacheco","doi":"10.1016/j.jmig.2026.04.008","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.04.008","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717040","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":"Rectal transluminal erosion of pedunculated uterine leiomyoma.","authors":"Ana-Maria Iancu, Emma Sparks, Herbert Wong","doi":"10.1016/j.jmig.2026.04.009","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.04.009","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717057","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}