Journal of minimally invasive gynecology最新文献

{"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":"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 center.</p><p><strong>Patient: </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: </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: </strong>A video presenting transvaginal EST in preparation for IVF and laparoscopic EST during endometriosis surgery.</p><p><strong>Conclusion: </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":"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":"10.1016/j.jmig.2025.02.017","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":"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":"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":"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 \"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}

{"title":"Surgical management of near complete labia majora fusion without hymenal disruption.","authors":"Houyu Yang, Yuanjunzi Shi, Gang Ji","doi":"10.1016/j.jmig.2025.03.009","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.03.009","url":null,"abstract":"<p><p>The manuscript showcases images of a near-total fusion of a patient's labia majora. A 2-week therapy of estrogen was applied to resolve the adhesion, but it failed. Because the patient had a special requirement to keep her hymen intact, we performed surgical separation of the labia majora adhesion under hysteroscopic guidance. Subsequent 18-year follow-up confirmed the success of the surgery in achieving the expected normalization of the external genitalia. To the best of our knowledge, it is the first hysteroscopic application in major labial adhesion searching PubMed, and this technique's capacity to resolve extensive fibrous fusion without manipulating virginityrelated structures suggests endoscopic methods may address both anatomical and sociocultural needs in selected patients.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743106","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":"Quadratus Lumborum Block for Total Laparoscopic Hysterectomy: A Systematic Review and Meta-analysis.","authors":"Jin Wu, Yuanfang Ou, Yi Gu, Xiaofeng Zhou, Huiyu She, Yifan Qin","doi":"10.1016/j.jmig.2025.03.012","DOIUrl":"10.1016/j.jmig.2025.03.012","url":null,"abstract":"<p><strong>Objective: </strong>No regional blockade techniques are considered standard of care for total laparoscopic hysterectomy (TLH). Quadratus lumborum block (QLB), a novel fascial plane block, has emerged as a potential option; however, its analgesic efficacy in TLH remains unclear.</p><p><strong>Data sources: </strong>We conducted a comprehensive search across multiple databases, including Medline PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science. No filters or language restrictions were imposed.</p><p><strong>Methods of study selection: </strong>The Population, Intervention, Comparison, and Outcomes framework in this review was as follows: (1) adult patients undergoing TLH; (2) QLB as the intervention; (3) comparison with no block or placebo; (4) primary outcome: 24-hour postoperative intravenous morphine-equivalent consumption; secondary outcomes: postoperative pain at 2, 4, 6, 12, and 24 hours, and the incidence of postoperative nausea and vomiting (PONV); (5) randomized controlled trials. Meta-analyses, including subgroup and sensitivity analyses, were conducted using a random-effects model.</p><p><strong>Tabulation, integration, and results: </strong>This analysis included 8 trials with 540 patients. QLB significantly reduced postoperative 24-hour intravenous morphine-equivalent consumption following TLH (mean difference: -4.61 mg; 95% confidence interval: -7.13 to -2.09; p <.001; I² = 57%), though the reduction was below the minimal clinically important difference (MCID) of 10 mg. The static pain scores at 2, 6, and 12 hours, as well as dynamic pain scores at 2, 6, and 24 hours postoperatively, were significantly lower in the QLB group than in the control group. However, only the 2-hour postoperative dynamic pain score (mean difference = 1.19) exceeded the MCID of 1. No statistically significant differences were observed in the incidence of PONV.</p><p><strong>Conclusion: </strong>QLB statistically reduced postoperative opioid consumption and pain scores at certain time points after TLH, but only the 2-hour dynamic pain score exceeded the MCID with no improvement in PONV, suggesting limited clinical benefit of QLB in TLH.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743098","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":"Enhanced Myometrial Vascularity. A potentially serious complication after pregnancy loss. When to wait... when to intervene?","authors":"Patryk Piekos, Suset Rodriguez, Pasquale Patrizio, Jose Carugno","doi":"10.1016/j.jmig.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.03.011","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730451","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}