Journal of minimally invasive gynecology最新文献

{"title":"Appendectomy in Chronic Pelvic Pain - The True Prevalence of Appendiceal Endometriosis: A Systematic Review and Meta-Analysis","authors":"JR Kohn ,&nbsp;M McHale","doi":"10.1016/j.jmig.2024.09.071","DOIUrl":"10.1016/j.jmig.2024.09.071","url":null,"abstract":"<div><h3>Study Objective</h3><div>Through systematic review and meta-analysis, to determine the prevalence of histologically-proven endometriosis of the appendix in patients undergoing gynecologic surgery for chronic pelvic pain or suspected endometriosis.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Setting</h3><div>N/A.</div></div><div><h3>Patients or Participants</h3><div>Systematic review of MEDLINE, EMBASE, and Scopus from inception to April 2024, including cross-sectional or cohort studies and excluding case reports or case series. Studies must report the proportion of histologically-proven appendiceal endometriosis (AppE) among all appendectomies performed during gynecologic surgery for pelvic pain or suspected endometriosis.</div></div><div><h3>Interventions</h3><div>Comparison of findings between incidental appendectomy (removal of appendix without evidence of appendicitis or appendiceal pathology) vs visible appendectomy (removal of abnormal appearing appendix with suspected pathology). Random-effects meta-analysis was performed to determine the pooled prevalence.</div></div><div><h3>Measurements and Main Results</h3><div>29 studies were identified with 6,111 appendectomies performed during gynecologic surgery for pelvic pain or suspected endometriosis. Results appear in Figure 1. The pooled prevalence of histologically-proven endometriosis in the appendix (AppE) differed significantly between incidental appendectomy and appendectomy for an appendix with suspected pathology. Incidental appendectomy resulted in histologically-proven endometriosis in 8% of patients (95% confidence interval 6-11%). When only the abnormal appearing appendix was removed, the pooled prevalence of appendiceal endometriosis was 66% (95% confidence interval 34-88%).</div></div><div><h3>Conclusion</h3><div>Among those with “visible abnormalities”, the rate of histologically-proven endometriosis of the appendix was quite variable between studies – reinforcing the inconsistency between visual and histologic diagnosis of endometriosis. When appendectomy is performed routinely at the time of surgery for chronic pelvic pain or suspected endometriosis, the pooled prevalence of appendiceal endometriosis is 8%; as such, routine appendectomy should be considered for inclusion as a standard component of endometriosis excision surgery.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page S2"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658435","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":"Video Endoscopic Inguinal Lymphadenectomy Via the Vulva Single Incision (VEIL-V)","authors":"C Liu ,&nbsp;X Bi ,&nbsp;Z Guan ,&nbsp;X Lv ,&nbsp;T Lei ,&nbsp;X Ma","doi":"10.1016/j.jmig.2024.09.048","DOIUrl":"10.1016/j.jmig.2024.09.048","url":null,"abstract":"<div><h3>Study Objective</h3><div>This study evaluates a novel, minimally invasive single-incision technique for vulvar surgery, aimed at improving safety and reducing complications.</div></div><div><h3>Design</h3><div>A 2cm incision on the standard vulvar incision line serves as the entry for single port endoscopic lymphadenectomy.</div></div><div><h3>Setting</h3><div>The procedure involves the patient in lithotomy position with the surgeon operating in between the legs.</div></div><div><h3>Patients or Participants</h3><div>Three patients with vulvar squamous cell carcinoma, FIGO stage Ib or lower, underwent the surgery post ethics approval, with no major contraindications.</div></div><div><h3>Interventions</h3><div>The surgery involves a single-port insertion through a 2cm incision, with subcutaneous separation by ultrasonic knife to create an anterior workspace AWS. Continue to expand AWS to the inguinal ligament, the outer edge to the medial anterior superior iliac spine, the inner edge is located 2cm from the inner side of the pubic symphysis, and down to the vertex of the femoral triangle. Remove the lymph nodes around the great saphenous vein, give top priority to the protection of the branches of the great saphenous vein. Expose the sartorius muscle, to make the femoral triangle clear, and completely remove the superficial inguinal lymph nodes. Incise the saphenous vein hiatus resect the lymph nodes between the femoral artery and vein, as well as deep inguinal lymph nodes.</div></div><div><h3>Measurements and Main Results</h3><div>The surgery duration was 60 minutes with a blood loss of about 10ml. Pathologically, the margins were clear of the tumor, and 13 inguinal lymph nodes were removed without finding metastases.</div></div><div><h3>Conclusion</h3><div>The single-incision method shortens the operative route and incision length. It ensures precise lymph node removal with enhanced endoscopic visibility, lowers lymphatic and vascular injury risks, and maintains skin integrity at the operative site.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page S10"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658140","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":"Introducing the International Deep Endometriosis Analysis Group Ultrasound Evaluation for Pre-Operative Planning","authors":"A Chandler ,&nbsp;P Akametalu ,&nbsp;MV Vargas","doi":"10.1016/j.jmig.2024.09.080","DOIUrl":"10.1016/j.jmig.2024.09.080","url":null,"abstract":"<div><h3>Study Objective</h3><div>To review the steps of the International Deep Endometriosis Analysis (IDEA) ultrasound protocol for integration in preoperative planning, identify findings that may be present on endometriosis ultrasound evaluation, and discuss the benefits of pre-operative mapping of endometriosis on ultrasound.</div></div><div><h3>Design</h3><div>Video presentation.</div></div><div><h3>Setting</h3><div>Endometriosis surgical center.</div></div><div><h3>Patients or Participants</h3><div>Patients with clinical signs and symptoms of endometriosis or adenomyosis.</div></div><div><h3>Interventions</h3><div>IDEA ultrasound evaluation for surgical planning.</div></div><div><h3>Measurements and Main Results</h3><div>N/A.</div></div><div><h3>Conclusion</h3><div>Transvaginal ultrasound can be used to understand the location and severity of endometriosis prior to surgery. This allows the surgeon to anticipate the stage of disease, individualize patient counseling, and assemble the appropriate multi-disciplinary team for a single well-planned surgery with optimal surgical outcomes.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page S17"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658006","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 Management of Cervico Vaginal Agenesis in Rudimentary Horn Uterus With Pelvic Kidney, Two Step Approach","authors":"H Pandit,&nbsp;A Tajane,&nbsp;A Shaikh","doi":"10.1016/j.jmig.2024.09.051","DOIUrl":"10.1016/j.jmig.2024.09.051","url":null,"abstract":"<div><h3>Study Objective</h3><div>Developmental anomalies involving mullerian or paramesonephric ducts represents some of the most fascinating disorders in Obstetrics and Gynaecology.</div><div>Congenital absence of the uterine cervix and vagina in the presence of a functional endometrium is an extremely rare congenital anomaly. Women born with this anomaly present with collection of blood in the uterine cavity or hematometra, disabling pelvic pain and progressively worsening endometriosis</div><div>To present a two-step laparoscopic approach for the management of cervico-vaginal agenesis in rudimentary horn uterus with pelvic kidney in adolescent patients.</div></div><div><h3>Design</h3><div>A case report.</div></div><div><h3>Setting</h3><div>Pandit hospital and Laparoscopy centre, Ahmednagar, India.</div></div><div><h3>Patients or Participants</h3><div>A 15-year-old girl with primary amenorrhea and cyclical abdominal pain.</div></div><div><h3>Interventions</h3><div>MRI finding suggestive of right sided 5 × 3 × 2 cm rudimentary non communicating horn with vaginal agenesis.</div></div><div><h3>Measurements and Main Results</h3><div>Underwent a two-step laparoscopic procedure. The first step involved creating a vagina through meticulous dissection between the bladder and rectum, followed by the insertion of a specialized mold for vaginal dilation. Vaginoscopy was performed post-operatively to assess vaginal length and epithelialization. The second step involved mobilization of the right-sided uterine horn for central vagina anastomosis, utilizing various laparoscopic techniques including ligament dissection, broad ligament opening, ureterolysis, and careful fascial dissection.</div><div>The patient achieved significant vaginal length and proper epithelialization post-operatively. Menstrual regularity was achieved following the procedure, indicating successful functional restoration.</div></div><div><h3>Conclusion</h3><div>The two-step laparoscopic approach presented in this case offers a safe and effective method for managing cervico-vaginal agenesis in rudimentary horn uterus with pelvic kidney in adolescent patients. This approach minimizes morbidity and complications associated with traditional surgical techniques, providing a promising solution for this complex gynecological anomaly.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page S11"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658143","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 Adverse Impact of Endometrial Trauma on Pregnancy Outcomes; A Real-World Evidence Study","authors":"MG Munro ,&nbsp;C Martin ,&nbsp;IB Feldberg ,&nbsp;O Kshirsagar ,&nbsp;D Sobti ,&nbsp;MP Bharadwaz ,&nbsp;J Miller ,&nbsp;R Wang","doi":"10.1016/j.jmig.2024.09.098","DOIUrl":"10.1016/j.jmig.2024.09.098","url":null,"abstract":"<div><h3>Study Objective</h3><div>Evaluate pregnancy outcomes in women following uterine surgery, including hysteroscopic adhesiolysis.</div></div><div><h3>Design</h3><div>Retrospective study.</div></div><div><h3>Setting</h3><div>Database.</div></div><div><h3>Patients or Participants</h3><div>A 6.5-year United States 150-payor database comprising 120 million patients with commercial, Medicaid, or Medicare coverage.</div></div><div><h3>Interventions</h3><div>Pregnancy outcomes in women with hysteroscopic adhesiolysis, uterine surgery without adhesiolysis, or no documented uterine surgery.</div></div><div><h3>Measurements and Main Results</h3><div>The database was searched for individuals with continuous enrollment, identifying three cohorts with trailing data back to April 2017: A history of intrauterine adhesiolysis (HA), a uterine procedure, but no adhesiolysis (UP), and those without any history of uterine surgery (NoUP). All cohorts were followed until May 2023 (41 months) to identify those with a completed pregnancy. Propensity score matching was employed to make the baseline cohort composition similar. Preterm delivery, placenta accreta spectrum, placenta previa, and postpartum hemorrhage were all identified more frequently in those undergoing previous surgery as follows: Preterm Delivery: HA - 14.5%, UP - 10.1%, NoUP - 8.4%, p &lt;0.05. Placenta Accreta Spectrum: HA - 4.6%, UP – 0.9%, NoUP – 0%, p &lt;0.05. Placenta Previa: HA - 13.5%, UP - 10.1%, NoUP – 3.9%, p &lt; 0.05. Postpartum Hemorrhage HA – 17.7%, UP – 25%, NoUP – 7.8% p &lt; 0.05.</div></div><div><h3>Conclusion</h3><div>In this study, women identified with a history of hysteroscopic adhesiolysis experienced increased risks of preterm delivery, placenta accreta spectrum, placenta previa, and postpartum hemorrhage compared to those without a history of uterine surgery in the study interval. While the magnitude of the difference was less, those with uterine surgery absent adhesiolysis were also at increased risk. These data align with findings from other cohort studies and suggest that endometrial trauma is a risk factor for adverse pregnancy outcomes for both the women and the fetus, likely incurring the expenditure of considerable healthcare resources. Research and development of means by which such trauma could be minimized is needed.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page S23"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Societies","authors":"","doi":"10.1016/S1553-4650(24)00780-5","DOIUrl":"10.1016/S1553-4650(24)00780-5","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page A2"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586736","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":"Fowl Play Can Lead to Improved Surgical Skills: A Novel Simulation Model for Bladder Flap Creation, Colpotomy, and Vaginal Cuff Closure","authors":"M Murnane,&nbsp;KW Benabou,&nbsp;MW Griffith","doi":"10.1016/j.jmig.2024.09.111","DOIUrl":"10.1016/j.jmig.2024.09.111","url":null,"abstract":"<div><h3>Study Objective</h3><div>The objective was to create a reproducible simulation model designed for trainees that incorporates 3 important laparoscopic hysterectomy surgical skills: the creation of the bladder flap, the creation of the colpotomy, and vaginal cuff closure.</div></div><div><h3>Design</h3><div>This simulation model utilizes a chicken drumstick with skin to represent the lower segment of the uterus and cervix. The model has 3 parts. The first part simulates the creation of the bladder flap. The drumstick is mounted to a uterine manipulator by inserting the manipulator through the joint of the drumstick and advancing the colpotomy cup over the joint. The skin of the drumstick serves to function as the bladder peritoneum and the goal is to laparoscopically incise the skin and bluntly dissect the skin down towards the joint. From there, after ensuring the skin is circumferentially dissected, the skin is then everted and folded down over the joint of the drumstick and over the colpotomy cup. The skin is secured down with a purse string suture. This is to facilitate the second part of the simulation, the creation of the colpotomy. For the third part, the vaginal cuff closure, the drumstick is removed from the manipulator and the joint of the chicken leg is then positioned towards the endoscope. The circumferential skin incision will mimic the vaginal cuff.</div></div><div><h3>Setting</h3><div>This model should be performed in a simulation lab that is capable of accommodating raw animal products.</div></div><div><h3>Patients or Participants</h3><div>No patients or participants are included.</div></div><div><h3>Interventions</h3><div>No treatment or intervention was employed.</div></div><div><h3>Measurements and Main Results</h3><div>There is no data to share.</div></div><div><h3>Conclusion</h3><div>We successfully created a simulation model that can be utilized by trainees to practice three key skills employed in a laparoscopic hysterectomy. This model successfully allows for the practice of bladder flap creation, colpotomy creation, and vaginal cuff closure. This simulation model is cost-effective and easily reproducible.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Pages S26-S27"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658452","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":"ICG Guided Sentinel Lymph Node Mapping: Which Node to Harvest?","authors":"F Heredia ,&nbsp;JR Escalona ,&nbsp;D Sanabria ,&nbsp;J Landeros ,&nbsp;M Arévalo ,&nbsp;I Arévalo","doi":"10.1016/j.jmig.2024.09.052","DOIUrl":"10.1016/j.jmig.2024.09.052","url":null,"abstract":"<div><h3>Study Objective</h3><div>To show an important issue concerning Sentinel Lymph node mapping strategy.</div></div><div><h3>Design</h3><div>A descriptive video highlighting the technical details to succesfuly harvest the correct sentinel node.</div></div><div><h3>Setting</h3><div>A tertiary private center.</div></div><div><h3>Patients or Participants</h3><div>two cases of endometrial cancer with Sentinel node mapping using NIR-ICG platform.</div></div><div><h3>Interventions</h3><div>Description of a possible pitfall while performing endoscopic surgery for endometrial cancer.</div></div><div><h3>Measurements and Main Results</h3><div>The selection of the correct node to harvest is commented and explaned in the two similar cases but with different decision.</div></div><div><h3>Conclusion</h3><div>Correct SLN mapping requires careful pathway tracking from the paracervix until the appearance of the first lymph node following the usual lymphatic courses.</div><div>Therefore, finding a highlighted lymph node does not result in an SLN.</div><div>Each highlighted pathway must be thoroughly explored to identify deeper and true SLNs.</div><div>The technique of SLN mapping demands careful exploration of ICG spread into lymphatic channels to guarantee a low false negative nodal status.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page S11"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658467","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":"Fertility Preserving Laparoscopic Approach for Scar Ectopic Pregnancy Excision","authors":"V Bhivsane,&nbsp;A Kendre","doi":"10.1016/j.jmig.2024.09.056","DOIUrl":"10.1016/j.jmig.2024.09.056","url":null,"abstract":"<div><h3>Study Objective</h3><div>Surgical management of cesarean section scar ectopic pregnancy with temporary ligation of bilateral uterine artery at origin with shoelace knot technique.</div></div><div><h3>Design</h3><div>A stepwise video demonstration of procedure.</div></div><div><h3>Setting</h3><div>Surgery was done using 2D high-definition laparoscopy by qualified and experienced team.</div></div><div><h3>Patients or Participants</h3><div>A 30-year-old patient presented with 2-months amenorrhoea with vaginal bleeding and pain in lower abdomen. She had undergone two full term cesarean section. Patient was willing to preserve her fertility. Consent was obtained from patient for surgical management.</div></div><div><h3>Interventions</h3><div>Laparoscopic management of cesarean scar ectopic pregnancy with temporary ligation of bilateral uterine arteries at origin.</div></div><div><h3>Measurements and Main Results</h3><div>On USG, live cesarean scar ectopic pregnancy of 8 weeks gestation type IIa was diagnosed. Her B-HCG level was 26,400 IU/L. Surgical treatment was planned for her. In this video, we stepwise described our technique: 1) Adhesiolysis of omentum from anterior abdominal wall. 2) Retroperitoneum was opened. Temporary ligation of bilateral uterine arteries at origin was done with shoelace knot technique. 3) Uterus was densely adherent to anterior abdominal wall, dissected down. 4) Bladder dissection was done to expose scar. 5) Intramyometrial injection of vassopressin was given. 6) Complete evacuation of products of conception was done 7) Uterine scar repair was done with 1-0 vicryl. 8) Bilateral uterine arteries ligature was released. The surgery was uneventful with minimal blood loss.</div></div><div><h3>Conclusion</h3><div>Laparoscopic excision of cesarean scar ectopic pregnancy is a safe, effective, easily adaptable minimal invasive procedure for maintaining haemostasis, simultaneous repair of scar that lead to successful revision with minimal impact to subsequent fertility.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page S8"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658135","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":"AAGL 2024 Cover","authors":"","doi":"10.1016/j.jmig.2024.10.027","DOIUrl":"10.1016/j.jmig.2024.10.027","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page CO1"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658263","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}