Journal of minimally invasive gynecology最新文献

{"title":"Laparoscopic Enucleation Resection of Ovarian Pregnancy","authors":"Ya-chun Yang , Mei-Chi Lin , Yeou-Lih Wang , Shih-Shien Weng","doi":"10.1016/j.jmig.2024.09.005","DOIUrl":"10.1016/j.jmig.2024.09.005","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 4","pages":"Pages 312-313"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257655","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":"Is Vaginal Repair a Good Option for Severe Cesarean Scar Defect? Comparison of Women With or Without Residual Myometrium","authors":"Lena Bardet MD ,&nbsp;Quentin Berl MD ,&nbsp;Elodie Debras MD ,&nbsp;Anne-Gaelle Pourcelot MD ,&nbsp;Hervé Fernandez MD, PhD ,&nbsp;Perrine Capmas MD, PhD","doi":"10.1016/j.jmig.2024.10.023","DOIUrl":"10.1016/j.jmig.2024.10.023","url":null,"abstract":"<div><h3>Study Objective</h3><div>To compare outcomes of vaginal surgery in women with moderate or severe symptomatic cesarean scar defect (with or without residual myometrium).</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Gynecology department of a teaching hospital.</div></div><div><h3>Patients</h3><div>Fifty-three women, between January 2014 and December 2019, underwent vaginal surgery for symptomatic cesarean scar defect: 20 women with moderate defect (with residual myometrium) and 33 with severe defect (without residual myometrium).</div></div><div><h3>Interventions</h3><div>Vaginal surgical approach to repair cesarean scar defect.</div></div><div><h3>Measurements and Main Results</h3><div>surgery by comparing the myometrial residual thickness before and after surgery. The secondary objectives were evaluation of vaginal surgery efficacy on symptoms resolution, per and postoperative courses, and subsequent fertility. Failure rate was evaluated as the need for a second surgery.</div><div>After vaginal surgery, the residual myometrium significantly increased from 2.4 mm ± 0.9 mm to 6.6 mm ± 2.4 mm (p &lt;.01) in the moderate group and from 0 mm to 4.4 mm ± 2.2 mm (p &lt;.01) in the severe group. The prevalence of abnormal uterine bleeding was significantly reduced after surgery in both groups (p &lt;.01). Pelvic pain was significantly reduced only in the moderate group (p &lt;.01). The rate of complications (5% vs 9.1%) and second surgery (15% vs 24.2%) were not significantly different between moderate and severe groups, respectively. The median time to conceive (7 months vs 12 months); pregnancy rates (84.6% vs 68.2%); and live birth rates (76.9% vs 50%) were not statistically significant in the moderate and severe groups respectively, with 90% of pregnancies occurring naturally. Women delivered by cesarean section at 38 weeks of gestation in both groups, and no uterine rupture was reported.</div></div><div><h3>Conclusion</h3><div>Despite the absence of residual myometrium, vaginal repair of severe cesarean scar defect was effective in increasing myometrial thickness, in relieving bleeding symptoms, and in allowing to achieve pregnancy.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 4","pages":"Pages 352-357"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693083","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 purse-string suture technique for total intracorporeal rectosigmoid end-to-end anastomosis after segmental bowel resection.","authors":"Renato Seracchioli, Stefano Ferla, Agnese Virgilio, Diego Raimondo","doi":"10.1016/j.jmig.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.03.018","url":null,"abstract":"<p><strong>Objective: </strong>Bowel endometriosis affects 8-12% of women with infiltrating endometriosis, mostly involving the rectum and sigmoid¹. Surgery is preferred when medical therapy fails or is contraindicated. Although segmental resection has shown good outcomes, it carries significant risks of perioperative complications^1-3, partially due to the mini-laparotomy required for specimen retrieval and bowel anastomosis (post-operative pain, wound-related issues, blood loss, hernias). Total intracorporeal laparoscopic anastomosis may reduce them^4,5. While promising, experience with this technique is limited, and there is no consensus on its use. This video showcases our technique for total intracorporeal end-to-end anastomosis using a purse-string suture after bowel resection for endometriosis.</p><p><strong>Design: </strong>Case report and video-description of the surgical technique SETTING: Tertiary level academic hospital INTERVENTION: A 32-year-old woman with severe, symptomatic endometriosis unresponsive to hormone therapy was referred to our hospital. Preoperative evaluation identified a 5cm nodule involving the anterior rectal wall, recto-sigmoid junction, and right utero-sacral ligament, located 10cm from the anal verge. After obtaining informed consent, surgery was scheduled. The recto-sigmoid colon was mobilized using a nerve-sparing approach^1-3,5, followed by resection of the affected segment. The specimen was exteriorized from the right ancillary trocar site, and a total intracorporeal end-to-end colorectal anastomosis was performed without the need for a suprapubic mini-laparotomy, using a circular stapler and a monofilament purse-string suture to secure the anvil. Bowel integrity and residual vascular assessment with near-infrared indocyanine green were performed, and the patient experienced an uneventful recovery, with significant clinical improvement at follow-up.</p><p><strong>Conclusion: </strong>In our experience total intracorporeal anastomosis technique improves minimally invasive surgery for deep endometriosis, avoiding the drawbacks of mini-laparotomy and requires less sigmoid mobilization. The most threatening complication after full-thickness bowel resection is anastomotic leakage, often due to poorly supplied residual horns. Our technique using a purse-string suture during intracorporeal anastomosis, preventing formation of residual horns, can provide greater anvil stability for a secure anastomosis seal.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772540","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":"Visualization of Adenomyosis in Gynecologic Surgery: A Multi-Modal Approach.","authors":"Patricia GiglioAyers, Alexis Newmark","doi":"10.1016/j.jmig.2025.03.022","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.03.022","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772544","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":"Transvaginal Ultrasound Guided vs Laparoscopic Ethanol Sclerotherapy; Techniques, Tips & Tricks.","authors":"Yavuz Emre Şükür, Batuhan Aslan, Necati Berk Kaplan","doi":"10.1016/j.jmig.2025.03.015","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.03.015","url":null,"abstract":"<p><strong>Study objective: </strong>To present and compare transvaginal ultrasound guided versus laparoscopic ethanol sclerotherapy (EST) techniques.</p><p><strong>Design: </strong>Step-by-step video demonstration of both sclerotherapy techniques.</p><p><strong>Setting: </strong>A university hospital's reproductive health and research centre.</p><p><strong>Patient(s): </strong>1. Patient with bilateral large endometriomas and infertility. 2. Patient with symptomatic endometriosis and a large endometrioma wishing to conceive naturally.</p><p><strong>Intervention(s): </strong>Transvaginal ultrasound guided EST can be performed with local anesthesia/sedation or general anesthesia (1). Following vaginal iodine cleansing and antibiotic prophylaxis, endometrioma is punctured once with a single lumen 15-16-gauge needle and aspirated. The needle is held steadily until the end of the procedure to prevent leakage of contents or alcohol. Then the cyst cavity is flushed until the irrigation fluid becomes completely clear. Ethanol, equal to 60% of the aspirated cyst volume, is injected, and totally aspirated 10 minutes later (2-4). In case of laparoscopic EST, the endometrioma is punctured directly with ipsilateral 5 mm trocar and the cyst contents are aspirated. The cyst cavity is flushed and a 14F Foley catheter is placed to suspend the cyst and prevent alcohol leakage. Then, the cyst cavity is filled with ethanol which is totally aspirated after 10 minutes (2-5). Following catheter removal, excise the cyst portion not exposed to ethanol and assess inner surface of the cyst. After the steps, the operation is continued with other surgeries.</p><p><strong>Main result(s): </strong>A video presenting transvaginal EST in preparation for IVF and laparoscopic EST during endometriosis surgery.</p><p><strong>Conclusion(s): </strong>Both transvaginal and laparoscopic ethanol sclerotherapy are effective, minimally invasive, and cost-efficient techniques. In any fertility situation where preventing damage to the tubal mucosa is important (due to the possibility of leaked alcohol damaging the tubes and causing peritoneal adhesions), where a biopsy of the cyst is needed, there is difficult access to the pouch/ovaries, or other pathology needs to be treated, we prefer a laparoscopic approach.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753131","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":"Author's Reply.","authors":"Petya Tanovska, Nicolas Samartzis, Maria Themeli Zografou, Laurin Burla, Markus Eberhard, Dimitrios Rafail Kalaitzopoulos, Brigitte Leeners","doi":"10.1016/j.jmig.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.03.014","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753028","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":"Hysteroscopy-Guided Endometrial Sampling Diagnostic Performance in Endometrial Intraepithelial Neoplasia Patients.","authors":"Tarek Khalife, Selim Afsar, Amy L Brien, Aakriti R Carrubba, Megan P Griffith, Katie Casper, Kristina A Butler, Sarah L Cohen Rassier","doi":"10.1016/j.jmig.2025.03.021","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.03.021","url":null,"abstract":"<p><strong>Objective: </strong>To compare the diagnostic performance of hysteroscopy-guided versus blind sampling in detecting concurrent endometrial carcinoma in patients with endometrial intraepithelial neoplasia and to identify factors associated with missing cancer diagnosis.</p><p><strong>Design: </strong>This is a retrospective cohort study.</p><p><strong>Setting: </strong>Integrated academic and community healthcare system in Minnesota and Wisconsin, USA, January 1, 2018, and January 1, 2023 PARTICIPANTS: This included 151 patients diagnosed with endometrial intraepithelial neoplasia during endometrial sampling who underwent a hysterectomy within three months. Patients with concurrent cancer diagnoses were excluded.</p><p><strong>Interventions: </strong>Patients diagnosed with endometrial intraepithelial neoplasia using hysteroscopy-directed biopsy were compared to those diagnosed with blind-sampling methods using the pathology results of the subsequent hysterectomy specimen as the gold standard comparator to analyze rates of missed endometrial cancer diagnosis.</p><p><strong>Measurements and main results: </strong>The primary outcome was a reduced risk of unanticipated concurrent endometrial cancer on the final hysterectomy pathology result for patients diagnosed with endometrial intraepithelial hyperplasia via a hysteroscopy-directed biopsy (OR=0.44, 95% CI=0.20-0.95, p = 0.033). In multivariate analysis, body mass index ≥30 and patient age >60 were associated with an elevated risk of endometrial cancer on final pathology (OR=4.17, 95% CI=1.51-11.51, p = 0.004; OR=5.56, 95% CI=1.22-35.21, p<0.001), respectively, and diabetes mellitus was the only independent variable associated with a higher risk of endometrial intraepithelial neoplasia on final hysterectomy pathology (OR=7.01, 95% CI=1.40-35.04, p = 0.018). Age, BMI, and endometrial thickness on pre-biopsy ultrasound were not associated with an increased risk of overlooking concurrent endometrial carcinoma on final hysterectomy pathology on univariate and multivariate analyses.</p><p><strong>Conclusion: </strong>Hysteroscopy-directed biopsy may reduce the risk of missing a concurrent endometrial malignancy during endometrial sampling in women with endometrial Intraepithelial neoplasia. The results affirm the superior diagnostic accuracy of hysteroscopy-directed endometrial evaluation.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753099","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 \"Association between endometriosis and congenital uterine malformations: A single-center retrospective study.\"","authors":"Linder Diaz, Fernando Heredia, Belkys Zambrano, Harald Krentel","doi":"10.1016/j.jmig.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.02.017","url":null,"abstract":"<p><p>N/A.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753119","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 \"A Comparative Study on the Efficacy of Subendometrial Versus Intrauterine Platelet-Rich Plasma Injections for Treating Intrauterine Adhesions: A Retrospective Cohort Study\".","authors":"Xuehong Zhu, Zhong Lin","doi":"10.1016/j.jmig.2025.03.020","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.03.020","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753115","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 AAGL's Role In Advancing Outpatient Surgery Worldwide had a Phoenix Connection. - The surgical instrument that helped shaped worldwide the delivery of surgical care.","authors":"Franklin D Loffer","doi":"10.1016/j.jmig.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.03.013","url":null,"abstract":"<p><p>The AAGL took the new concept of outpatient surgery which was occurring in the United States and introduced it to the world's surgical community.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753125","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}