{"title":"Noninvasive Blood-Based Detection of Endometriosis Prior to Surgical Laparoscopy Among Symptomatic Women: Is There a Benefit?","authors":"FZ Bischoff, WH Wong, A Yu","doi":"10.1016/j.jmig.2025.09.031","DOIUrl":"10.1016/j.jmig.2025.09.031","url":null,"abstract":"<div><h3>Study Objective</h3><div>To demonstrate efficacy in performing noninvasive blood-based testing to confirm the presence or absence of endometriosis among women considering laparoscopy with symptoms of pelvic pain and/or abnormal menstrual bleeding.</div></div><div><h3>Design</h3><div>This is a case-control, observational, prospective study designed to demonstrate the concordance between a noninvasive blood-based diagnostic approach for detecting endometriosis as compared to gold standard laparoscopy with histology.</div></div><div><h3>Setting</h3><div>Under IRB consent, 10ml peripheral blood was drawn from symptomatic women prior to scheduled laparoscopy. Blood samples were processed to separate serum for RNA isolation, cDNA preparation followed by analysis by qPCR and a bioinformatic AI model that was developed using machine learning to predict presence or absence of endometriosis. Concordance between histology and the miRNA blood test was determined.</div></div><div><h3>Patients or Participants</h3><div>215 women with symptoms of pelvic pain and/or abnormal menstrual bleeding and undergo laparoscopy were enrolled. Subjects had no previous history of endometriosis.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Measurements and Primary Results</h3><div>An overall 91% concordance between the invasive gold standard procedure and the noninvasive blood-based miRNA test was observed with 95% specificity. Results were is independent of disease stage, type of endometriosis and the presence of other gynecologic conditions, such as uterine fibroids and leiomyomas. Among cases found to be discordant between visual laparoscopy and histology, miRNA results were more consistent with histology outcome.</div></div><div><h3>Conclusion</h3><div>Using circulating serum miRNAs as a diagnostic to confirm the presence or absence of endometriosis offers several advantages over conventional diagnostic. Currently, the gold standard for endometriosis diagnosis relies on laparoscopy for direct visualization, an invasive surgical procedure that poses risk to the subject. A noninvasive blood-based miRNA test can inform and aid the surgical team in preparing for potentially difficult cases where the need to search for lesions may justified. This may be particularly valuable for early detection and for patients who may not have immediate access to specialized surgical evaluation.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S25"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334978","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":"Optimizing Percutaneous Sacrospinous Fixation with Suture Passing Device","authors":"GR Seeland , R Greer , D Shalom","doi":"10.1016/j.jmig.2025.09.106","DOIUrl":"10.1016/j.jmig.2025.09.106","url":null,"abstract":"<div><h3>Study Objective</h3><div>We demonstrate a novel surgical step to further refine the minimally invasive, percutaneous, anchor-based approach to the sacrospinous ligament suspension (SSLS).</div></div><div><h3>Design</h3><div>This is a video recorded case report of a novel surgical technique. The patient was discharged on postoperative day 0 with outpatient follow up planned for 2 and 6 weeks postoperatively.</div></div><div><h3>Setting</h3><div>This same-day surgery was performed with the patient in dorsal lithotomy positioning.</div></div><div><h3>Patients or Participants</h3><div>Patient consent was obtained for the recording and educational presentation of a deidentified video. The consent form is preserved within the confidential patient electronic medical record.</div></div><div><h3>Interventions</h3><div>The standard surgical steps for the percutaneous, anchor-based device placement were followed, with one key modification. Instead of using a free needle, we employed the suture passer device to pass the sacrospinous sutures under the vaginal epithelium for placement through the cervical stroma.</div></div><div><h3>Measurements and Primary Results</h3><div>Final apical suspension was measured at -7cm. At her two-week postoperative visit, the patient was feeling well, meeting all milestones, and her surgical sites were well-healing. The vaginal apex remained suspended.</div></div><div><h3>Conclusion</h3><div>In this video, we present a modification to the percutaneous, anchor-based approach to SSLS using the suture passing device. This technique allows for more accurate suture passage under the vaginal epithelium and ultimately through the cervical stroma as compared to the free needle. Such enhanced precision decreases tissue trauma and minimizes the risk of inadvertent intraoperative organ injury. By utilizing the suture-passing device during the percutaneous SSLS procedure, we further optimize operative efficiency while improving patient safety and surgical outcomes.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Pages S20-S21"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334985","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":"Fistula after Fibroids: Minimally Invasive Solution for a Uterocutaneous Tract","authors":"M Hotz , I Ostrowski , SL Kass , A Grant","doi":"10.1016/j.jmig.2025.09.113","DOIUrl":"10.1016/j.jmig.2025.09.113","url":null,"abstract":"<div><h3>Study Objective</h3><div>To demonstrate a surgical case of a uterocutaneous fistula after open myomectomy treated with total laparoscopic hysterectomy.</div></div><div><h3>Design</h3><div>A case report with surgical video.</div></div><div><h3>Setting</h3><div>A tertiary care center.</div></div><div><h3>Patients or Participants</h3><div>A 33-year-old G1P1 with abnormal uterine bleeding secondary to fibroids with history of one prior myomectomy.</div></div><div><h3>Interventions</h3><div>The patient previously underwent an abdominal myomectomy via Pfannenstiel incision during which 60 fibroids were removed. She developed a subcutaneous abscess 6-weeks post-operatively that was treated with antibiotics and an incision and drainage. The wound was then followed outpatient with packing and daily dressing changes. Despite the wound healing well, 14-weeks post-operatively the patient experienced bloody discharge from her incision coinciding with her menstrual cycle. She presented to the emergency room and imaging showed a uterocutaneous fistula.</div></div><div><h3>Measurements and Primary Results</h3><div>The patient opted for definitive surgical management. A total laparoscopic hysterectomy was performed without complication and colorectal surgery performed an excision of the lower midline fistula tract to the level of the fascia. The patient recovered well without complication and the incisional defect was closed one month post-operatively.</div></div><div><h3>Conclusion</h3><div>Uterocutaneous fistulas are extremely rare with few cases reported in the literature. They occur most commonly after open myomectomy or cesarean section and oftentimes after a subsequent infection. This pathology can be treated medically or surgically and surgical treatment can be conservative with repair of the uterus or definitive with hysterectomy. The existing case reports of hysterectomy for treatment have been performed with an open approach and, to our knowledge, this is the first report of laparoscopic hysterectomy for treatment of a uterocutaneous fistula.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Pages S22-S23"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334991","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}
L. Bar-El , G. Mintz , M. McCracken , J. Danneberger , C.R. King
{"title":"Essential Techniques for Assisting in Laparoscopic Hysterectomy","authors":"L. Bar-El , G. Mintz , M. McCracken , J. Danneberger , C.R. King","doi":"10.1016/j.jmig.2025.09.070","DOIUrl":"10.1016/j.jmig.2025.09.070","url":null,"abstract":"<div><h3>Study Objective</h3><div>Laparoscopic hysterectomy (LH) is one of the most common surgeries in the United States, requiring a skilled two- to three-person team. Junior surgical assistants often lack the nuanced skills necessary for effective assistance. While technical videos typically focus on the surgeon’s role, this video aims to fill the gap by emphasizing the critical role of the assistant and equipping them with the necessary skills and techniques for successful LH assistance.</div></div><div><h3>Design</h3><div>Educational video guide illustrating essential assistant moves during LH, with a focus on foundational laparoscopic techniques.</div></div><div><h3>Setting</h3><div>N/A</div></div><div><h3>Patients or Participants</h3><div>N/A</div></div><div><h3>Interventions</h3><div>This step-by-step educational video guides surgical assistants using real-life analogies, visual aids, and unique descriptions to clarify essential moves. It covers laparoscopic principles like optimal visualization, traction-countertraction, and presenting vessels at 90 degrees for effective sealing. Key techniques, such as the uterine “T-pose,” “overhead side stretch pose,” and “rope pulling,” are demonstrated as core moves for assisting in LH.</div></div><div><h3>Measurements and Primary Results</h3><div>The video provides a comprehensive guide from the assistant’s perspective, emphasizing technical and ergonomic aspects of laparoscopic support. It underscores efficiency, safety, and synchronized teamwork as key factors for optimizing surgical outcomes.</div></div><div><h3>Conclusion</h3><div>This video offers a structured, visually engaging method for training LH assistants, introducing a shared vocabulary and simplifying complex tasks through analogies. By mastering these foundational skills, assistants can provide effective intraoperative support and prepare for future roles as lead surgeons.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S4"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335089","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":"Novel Model Employing the Placenta for Pelvic Dissection","authors":"S. Ali , A. Trivedi , E. Williams , R. Deger","doi":"10.1016/j.jmig.2025.09.071","DOIUrl":"10.1016/j.jmig.2025.09.071","url":null,"abstract":"<div><h3>Study Objective</h3><div>Make low cost, easy to obtain new teaching module and to demonstrate feasibility. Previous models developed for this purpose have been established in high-resource centers such as those with 3D printing capabilities, however not all institutions have these resources. We will be using placentas for pelvic dissection in the open, laparoscopic, and robotic approach. Retroperitoneal dissection is a difficult technique to practice and teach due to lack of appropriate models that mimic the tissue. The goal of this surgical dissection is to expose various anatomical structures while ensuring structural and physiologic integrity of the tissue. Specific skills are necessary to perform a safe and efficient retroperitoneal surgical dissection in the female pelvis.</div></div><div><h3>Design</h3><div>Our model is the placenta as the amnion mimics the peritoneal tissue. The underlying or interposed vessels overlaying the chorion represent retroperitoneal structures including blood vessels and ureters. Placentas are easy to use because no preparation is needed, easy to gather, and easy to dispose of. Our placentas were stored in normal saline or on ice and were stored anywhere from 15 minutes to 8 hours before usage.</div></div><div><h3>Setting</h3><div>In institutions practicing obstetrics, placentas are readily available.</div></div><div><h3>Patients or Participants</h3><div>Despite the disposition of the placentas as waste, consent for educational purposes use was obtained from patients.</div></div><div><h3>Interventions</h3><div>This video shows open and laparoscopic approach of retroperitoneal dissection practice on placenta.</div></div><div><h3>Measurements and Primary Results</h3><div>The video shows techniques to practice pelvic dissection.</div></div><div><h3>Conclusion</h3><div>We hope this shows a feasible easy model to practice pelvic dissection.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S5"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335090","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}
M. Briggs , K. Stewart , D. Encalada Soto , A. Cope , I. Green , Z. Khan , T. Burnett
{"title":"Seven-Step Approach to Deconstructing the Obliterated Posterior Cul-De-Sac","authors":"M. Briggs , K. Stewart , D. Encalada Soto , A. Cope , I. Green , Z. Khan , T. Burnett","doi":"10.1016/j.jmig.2025.09.081","DOIUrl":"10.1016/j.jmig.2025.09.081","url":null,"abstract":"<div><h3>Study Objective</h3><div>This video demonstrates a systematic approach to safely and efficiently normalize the obliterated posterior cul-de-sac for complete endometriosis excision. The seven-step technique provides a framework for learners to approach this complex endometriosis surgery. Learning theory supports breaking down a complex task into smaller parts which reduces learner cognitive load and provides a focus for feedback.</div></div><div><h3>Design</h3><div>Educational Tutorial</div></div><div><h3>Setting</h3><div>Academic Hospitals</div></div><div><h3>Patients or Participants</h3><div>Three patients with deep endometriosis with obliteration of the posterior cul-de-sac.</div></div><div><h3>Interventions</h3><div>Excision of endometriosis was completed using a specific technique involving seven steps. Steps included 1) prepare the pelvis, 2) identify the uterosacral ligaments, 3) perform ureterolysis if required, 4) separate the uterosacral ligaments from the rectum, 5) develop the distal rectovaginal space, 6) separate the rectum from the main adhesion point, and 7) excise the remaining endometriosis.</div></div><div><h3>Measurements and Primary Results</h3><div>Robotic-assisted laparoscopic excision of endometriosis was completed without unintended injury to surrounding structures.</div></div><div><h3>Conclusion</h3><div>This video demonstrates a reproducible surgical technique that can be reliably utilized by learners to obtain efficiency and confidence in completely excising endometriosis in the setting of an obliterated posterior cul-de-sac.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Pages S7-S8"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335099","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":"Hatching from the Myometrium: Unusual Excision of an Endometrioma","authors":"MC Ochoa, O Fajardo","doi":"10.1016/j.jmig.2025.09.143","DOIUrl":"10.1016/j.jmig.2025.09.143","url":null,"abstract":"<div><h3>Study Objective</h3><div>To showcase a rare presentation of intra-myometrial endometrioma and demonstrate laparoscopic excision technique when faced with an unusual presentation.</div></div><div><h3>Design</h3><div>Video presentation</div></div><div><h3>Setting</h3><div>Tertiary care center</div></div><div><h3>Patients or Participants</h3><div>This is a case of a 21 year old female who presented with one week of right lower quadrant pelvic pain and abnormal uterine bleeding. Medical history notable for levonorgestrel intrauterine device and dysmenorrhea. Physical exam notable for right adnexal tenderness. Complete blood count was normal and pregnancy test negative. Transvaginal ultrasound and magnetic resonance imaging (MRI) pelvis findings noted a 3.2 × 2.1 cm hemorrhagic lesion within the right uterine horn at the insertion of the fallopian tube suspicious for endometriosis.</div></div><div><h3>Interventions</h3><div>Laparoscopy revealed a 2 × 3cm cyst in the right anterior uterine body, proximal to the right round ligament. The cyst was superficial with approximately one millimeter of overlying serosa and extended less than 50% into the myometrium. The cyst was injected circumferentially with 20 mL of vasopressin. Cyst remained intact during careful dissection using sharp and blunt technique. The cavity was closed in three layers. Hemorrhagic brown fluid was noted when drained after the case. Final pathology report consistent with endometriotic cyst.</div></div><div><h3>Measurements and Primary Results</h3><div>Endometriotic cyst was successfully excised without spillage or full-thickness injury to uterine wall. Patient recovered well and reported improvement in pain at postoperative visit.</div></div><div><h3>Conclusion</h3><div>This case highlights a rare presentation of endometriosis and demonstrates the use of multiple surgical techniques when faced with a novel finding. Intra-myometrial endometriotic cysts are rare with unknown prevalence and have been described in very few case reports, most commonly in patients with prior uterine incisions. This is a rare presentation of an intra-myometrial endometrioma in a young patient without prior surgery. Surgical techniques for cystectomy and myomectomy were applied to this unusual case. Surgical excision provided symptomatic relief without full-thickness injury to myometrium.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S33"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334549","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}
P Coombs , F Elli , Y Erben , H Farres , AR Carrubba
{"title":"Robotic Assisted Left Gonadal Vein Transposition: A Treatment for Pelvic Congestion Syndrome","authors":"P Coombs , F Elli , Y Erben , H Farres , AR Carrubba","doi":"10.1016/j.jmig.2025.09.136","DOIUrl":"10.1016/j.jmig.2025.09.136","url":null,"abstract":"<div><h3>Study Objective</h3><div>To describe the clinical presentation and surgical management of a patient with secondary pelvic congestion syndrome caused by posterior nutcracker syndrome.</div></div><div><h3>Design</h3><div>Video-based case presentation of a robotic-assisted left gonadal vein transposition.</div></div><div><h3>Setting</h3><div>Operating room at a tertiary academic medical center.</div></div><div><h3>Patients or Participants</h3><div>A 44-year-old G3P2012 with a five-year history of abnormal uterine bleeding, chronic pelvic pain, and fibromyalgia. Symptoms began following a 40-pound weight loss. She declined medical therapy and found minimal relief with pelvic floor physical therapy. CT imaging revealed a retroaortic left renal vein compressed by the aorta, with associated dilated left gonadal vein and periuterine varices up to 1 cm—findings consistent with posterior nutcracker syndrome and secondary pelvic congestion syndrome.</div></div><div><h3>Interventions</h3><div>Robotic-assisted left gonadal vein transposition was performed, given that this vein served as the primary drainage pathway of the left kidney. Due to persistent heavy menstrual bleeding and pelvic pain, a hysterectomy, bilateral salpingectomy, and left oophorectomy were also completed.</div></div><div><h3>Measurements and Primary Results</h3><div>Retroaortic left renal vein is a rare anatomical variant (≈4%) where the vein courses posterior to the aorta before draining into the inferior vena cava. In posterior nutcracker syndrome, this vein is compressed between the aorta and lumbar spine, leading to venous hypertension and pelvic congestion. Treatment options range from conservative management to surgical intervention, depending on anatomy and symptom severity. In this case, the patient recovered well postoperatively with resolution of pelvic pain, nausea, diarrhea, and GI upset. A 4-week follow-up CT venogram confirmed a patent transposed left gonadal vein draining into the patent left iliac vein.</div></div><div><h3>Conclusion</h3><div>Robotic-assisted gonadal vein transposition is a feasible treatment for pelvic congestion secondary to posterior nutcracker syndrome, with symptom resolution and restored venous drainage observed postoperatively.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S31"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334582","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}
S. Alani , D. Bach Nguyen , F.W. Mansour , J. Papillon-Smith , S. Krishnamurthy , A. Zakhari
{"title":"Laparoscopic Excision of Obturator Nerve Endometriosis: A Stepwise Approach","authors":"S. Alani , D. Bach Nguyen , F.W. Mansour , J. Papillon-Smith , S. Krishnamurthy , A. Zakhari","doi":"10.1016/j.jmig.2025.09.092","DOIUrl":"10.1016/j.jmig.2025.09.092","url":null,"abstract":"<div><h3>Study Objective</h3><div>To demonstrate a reproducible approach to the laparoscopic excision of endometriosis involving the obturator nerve.</div></div><div><h3>Design</h3><div>Narrated surgical video.</div></div><div><h3>Setting</h3><div>Academic tertiary care hospital.</div></div><div><h3>Patients or Participants</h3><div>Case of a 30-year-old woman found on MRI to have a 1.6 cm endometriosis nodule involving the left obturator nerve, along with adenomyosis, rectovaginal and ureteric endometriosis. Due to symptoms refractory to medical management, a laparoscopy is performed to excise the obturator nerve lesion, in addition to a disc rectal excision and ureteral reimplantation.</div></div><div><h3>Interventions</h3><div>Laparoscopic excision of obturator nerve endometriosis.</div></div><div><h3>Measurements and Primary Results</h3><div>The surgical steps can be summarized in six steps: (1) abdominal survey; (2) sigmoid mobilization; (3) iliolumbar space (lateral) dissection; (4) pararectal space (medial) dissection; (5) obturator space (caudal) dissection; (6) nodule release and excision.</div></div><div><h3>Conclusion</h3><div>Excision of obturator nerve endometriosis by laparoscopy can be safely performed with a thorough knowledge of anatomy and a systematic dissection of pelvic spaces. MRI is essential for preoperative planning in these rare forms of deep infiltrating endometriosis.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S16"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334634","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}