Journal of minimally invasive gynecology最新文献

{"title":"Lateral-to-Medial Approach for Lateral Parametrial Endometriosis with Ureteral Entrapment: A Step-By-Step Technique","authors":"LM Chagas ,&nbsp;P Costa Campos de Santana ,&nbsp;SP Gurgel","doi":"10.1016/j.jmig.2025.09.145","DOIUrl":"10.1016/j.jmig.2025.09.145","url":null,"abstract":"<div><h3>Study Objective</h3><div>To demonstrate a step-by-step lateral-to-medial approach for the surgical treatment of lateral parametrial endometriosis with ureteral entrapment, emphasizing key anatomical landmarks and technical strategies for safe ureteral release and en bloc excision.</div></div><div><h3>Design</h3><div>Surgical video presentation of a case of deep infiltrating endometriosis involving the lateral parametrium, with detailed anatomical dissection and ureteral management.</div></div><div><h3>Setting</h3><div>Tertiary referral center for endometriosis surgery. The patient was positioned in dorsal lithotomy with Trendelenburg tilt. A laparoscopic approach was performed with the surgeon on the patient’s left. High-definition imaging and ergonomic instrumentation enabled meticulous dissection.</div></div><div><h3>Patients or Participants</h3><div>A 45-year-old female with chronic pelvic pain, severe right renal colic, recurrent urinary tract infections, and sciatica. Preoperative assessment revealed a non-functioning left kidney and suspected ureteral entrapment. Informed consent was obtained for the procedure and video use.</div></div><div><h3>Interventions</h3><div>Peritoneal opening was initiated over the psoas muscle to access the pelvic sidewall. Dissection followed the umbilical artery to develop medial and lateral paravesical spaces and expose branches of the internal iliac artery. Obturator vessels and nerve were isolated, and the lumbosacral trunk identified. After uterine artery ligation, the ureter was released from the fibrotic parametrium. Due to absent renal function, distal ureteral ligation and nephrectomy were performed.</div></div><div><h3>Measurements and Primary Results</h3><div>Key anatomical structures were clearly visualized, including the superior gluteal artery, middle rectal artery, lumbosacral trunk, and hypogastric fascia. The lateral-to-medial approach enabled complete and safe ureteral liberation. No intraoperative complications occurred, and the patient was discharged on postoperative day four.</div></div><div><h3>Conclusion</h3><div>The lateral-to-medial approach is a feasible and effective technique for treating lateral parametrial endometriosis with ureteral entrapment. It offers enhanced visualization of critical anatomical structures, potentially reducing risks of ureteral injury or bleeding. Further studies are needed to assess its broader applicability.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S34"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334451","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 Robotic Assisted Management of OHVIRA Syndrome (Obstructed Hemi-Vagina)","authors":"R.J. Jalloul ,&nbsp;M. Cusick ,&nbsp;V. Tammisetti","doi":"10.1016/j.jmig.2025.09.089","DOIUrl":"10.1016/j.jmig.2025.09.089","url":null,"abstract":"<div><h3>Study Objective</h3><div>To describe robotic-assisted surgical management in a patient with OHVIRA syndrome (obstructed hemi-vagina).</div></div><div><h3>Design</h3><div>This is a video submission describing the surgical steps. The patient was followed for 3 months.</div></div><div><h3>Setting</h3><div>The patient underwent robotic-assisted surgery under general anesthesia in the dorsal lithotomy position.</div></div><div><h3>Patients or Participants</h3><div>29 YO G0 was referred for infertility, pelvic pain, and irregular menstrual cycles.</div></div><div><h3>Interventions</h3><div>Preoperative MRI imaging revealed a didelphys uterus, an obstructed left hemi-vagina, and left renal agenesis. The patient had a surgical history significant for rectal surgery as a newborn and a history of laparoscopy indicating adhesions and endometriosis. A decision was made to proceed with robotic-assisted hemivaginal septum excision due to the surgical complexity.</div></div><div><h3>Measurements and Primary Results</h3><div>A robotic-assisted approach allowed for complete drainage of the hematocolpos via a posterior colpotomy, as well as excision of a 4 cm disc of the vaginal septum.</div></div><div><h3>Conclusion</h3><div>This surgical video outlines the steps required to excise a vaginal septum for an obstructed hemi-vagina using robotic assistance under direct visualization.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S10"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334455","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":"A Case of Uterine Didelphys with Atypical Peritoneal Anatomy","authors":"K Woodward ,&nbsp;C Swain ,&nbsp;I Dhanuka ,&nbsp;CH Gould ,&nbsp;L Palacios-Helgeson","doi":"10.1016/j.jmig.2025.09.134","DOIUrl":"10.1016/j.jmig.2025.09.134","url":null,"abstract":"<div><h3>Study Objective</h3><div>This video reviews intra-operative considerations for patients with Mullerian anomalies by demonstrating a robotic-assisted laparoscopic hysterectomy for uterine didelphys in a patient with atypical peritoneal anatomy.</div></div><div><h3>Design</h3><div>Video case presentation.</div></div><div><h3>Setting</h3><div>Tertiary care center that is a referral center for Minimally Invasive Gynecologic Surgery.</div></div><div><h3>Patients or Participants</h3><div>This patient is a 20 yo patient with gender dysphoria undergoing laparoscopic hysterectomy for gender affirmation. Pre-operative evaluation is notable for a complete vaginal septum and pelvic MRI shows uterine didelphys.</div></div><div><h3>Interventions</h3><div>This video outlines a pre-operative approach and checklist for patients with Mullerian anomalies. It then demonstrates robotic-assisted hysterectomy, right salpingo-oophorectomy and left salpingectomy and robotic-assisted vaginal septum take-down. Cystoscopy and bilateral ureteral stent placement was also performed at the beginning of the case. Due to the atypical peritoneal anatomy of the patient, in addition to uterine didelphys, this case is used to review pre-operative planning and intra-operative considerations for patients with Mullerian anomalies undergoing surgery.</div></div><div><h3>Measurements and Primary Results</h3><div>Not applicable.</div></div><div><h3>Conclusion</h3><div>In addition to uterine and renal anomalies, patients with Mullerian anomalies may have additional unexpected unique anatomy. Defining patient goals, anticipating distorted anatomy, and planning uterine manipulation and a strategy for tissue extraction are vital for a successful and safe surgery.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Pages S30-S31"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334580","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-Assisted Hysteroscopic Metroplasty for a Hybrid Septate/Bicornuate Uterus","authors":"O Ezike ,&nbsp;R Schneyer","doi":"10.1016/j.jmig.2025.09.119","DOIUrl":"10.1016/j.jmig.2025.09.119","url":null,"abstract":"<div><h3>Study Objective</h3><div>Demonstrate how laparoscopy can be an instrumental tool in the diagnosis and surgical management of a complete uterine septum.</div></div><div><h3>Design</h3><div>Surgical video.</div></div><div><h3>Setting</h3><div>OR in large, tertiary care academic hospital.</div></div><div><h3>Patients or Participants</h3><div>Surgical footage was obtained from one patient with a hybrid septate bicornuate uterus with a complete longitudinal uterine and vaginal septum who underwent diagnostic laparoscopy and hysteroscopic metroplasty and vaginal septoplasty.</div></div><div><h3>Interventions</h3><div>Laparoscopic-guided hysteroscopic metroplasty, vaginal septum excision.</div></div><div><h3>Measurements and Primary Results</h3><div>Demonstrating how laparoscopy can aid in accurate diagnosis of uterine anomalies, especially in the setting of inconclusive imaging, while also illustrating safe and effective techniques for complete hysteroscopic resection of a uterine septum.</div></div><div><h3>Conclusion</h3><div>Uterine anomalies are congenital abnormalities in uterine architecture that can have significant ramifications on patients’ gynecologic and reproductive health. They can often be difficult to diagnose and surgically manage. Laparoscopy is an effective tool to aid in the accurate diagnosis of uterine anomalies as well as guide the safe and precise removal of a uterine septum.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S27"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334644","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":"Deep Infiltrating Rectovaginal Endometriosis: Partial Vaginectomy and Anterior Discoid Resection","authors":"K. Kwon ,&nbsp;T.T. Lee","doi":"10.1016/j.jmig.2025.09.077","DOIUrl":"10.1016/j.jmig.2025.09.077","url":null,"abstract":"<div><h3>Study Objective</h3><div>To demonstrate varying presentations of deep infiltrating rectovaginal endometriosis</div></div><div><h3>Design</h3><div>N/a- video submission</div></div><div><h3>Setting</h3><div>Conventional laparoscopic case with patient in dorsal lithotomy position</div></div><div><h3>Patients or Participants</h3><div>Two cases of deep infiltrating rectovaginal endometriosis, presenting with dysmenorrhea, dyspareunia and dyschezia, both requiring partial vaginectomy and anterior discoid resection, however of varying degrees.</div></div><div><h3>Interventions</h3><div>Complete resection of disease with partial vaginectomy and anterior discoid resection. Case 1 presents as classic stage 4 endometriosis with bilateral endometriomas. It demonstrates a larger partial vaginectomy, requiring resection of a portion of the vaginal mucosa in addition to a superficial longitudinal resection of a rectal nodule. Case 2 seemingly presents without overt evidence of stage 4 disease, however the rectal nodule involves full thickness of the bowel wall, requiring a transverse repair while the partial vaginectomy is smaller and able to spare the mucosa.</div></div><div><h3>Measurements and Primary Results</h3><div>Demonstrate surgical techniques to achieve complete resection of rectovaginal endometriosis including use of breisky retractors rather than the uterine manipulator, squeeze technique, tagging the nodule and developing the median pararectal space.</div></div><div><h3>Conclusion</h3><div>We demonstrate two cases of deep infiltrating rectovaginal endometriosis requiring varying degrees of surgical resection based on location and extent of disease. Case 1 requires more significant partial vaginectomy, while case 2 requires more significant anterior discoid resection. Both cases utilize the same surgical techniques, but are able to tailor to the individual's extent of disease.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S6"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335095","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":"Hysteroscopic Management of Interstitial Ectopic Pregnancy","authors":"J Desilets ,&nbsp;R Lakabi ,&nbsp;L Brennan ,&nbsp;M Mcgrattan ,&nbsp;K Kumar ,&nbsp;A Murji","doi":"10.1016/j.jmig.2025.09.120","DOIUrl":"10.1016/j.jmig.2025.09.120","url":null,"abstract":"<div><h3>Study Objective</h3><div>To help identify a proximal interstitial ectopic pregnancy on ultrasound and at laparoscopy, and to demonstrate an hysteroscopic surgical approach</div></div><div><h3>Design</h3><div>Surgical Video</div></div><div><h3>Setting</h3><div>operating room</div></div><div><h3>Patients or Participants</h3><div>N/A</div></div><div><h3>Interventions</h3><div>Hysteroscopic ressection of an interstitial ectopic pregnancy, with laparoscopic guidance.</div></div><div><h3>Measurements and Primary Results</h3><div>N/A</div></div><div><h3>Conclusion</h3><div>Accurate and precise diagnosis of a proximal interstitial ectopic pregnancy is essential. Once identified, these can be treated with hysteroscopy, avoiding a more invasive surgical approach.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S27"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335100","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":"TOC","authors":"","doi":"10.1016/S1553-4650(25)00892-1","DOIUrl":"10.1016/S1553-4650(25)00892-1","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page A1"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335187","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":"Histologic Comparison of Ablative Techniques for Endometriosis: A Randomized Trial","authors":"D Namaky ,&nbsp;M Carrel-Lammert ,&nbsp;J Hoehn ,&nbsp;J Yeung","doi":"10.1016/j.jmig.2025.09.012","DOIUrl":"10.1016/j.jmig.2025.09.012","url":null,"abstract":"<div><h3>Study Objective</h3><div>To compare ablative energy technologies and evaluate their ability to destroy native endometriosis tissue in humans.</div></div><div><h3>Design</h3><div>Prospective, randomized, triple-arm, single-blind, clinical trial.</div></div><div><h3>Setting</h3><div>Good Samaritan Hospital, Cincinnati, Ohio.</div></div><div><h3>Patients or Participants</h3><div>Women undergoing excision of lesions for pelvic pain symptoms or endometriosis by a high-volume minimally invasive gynecologic surgeon.</div></div><div><h3>Interventions</h3><div>During the already planned excision of lesions, just prior to excision, identified lesions were uniquely numbered and randomized to ablative treatment with either 1) electrical diathermy, 2) Argon beam coagulation, or 3) CO₂ laser. The lesions were ablated with the assigned technologies. Excision of the ablated lesions was then performed for pathologic evaluation.</div></div><div><h3>Measurements and Primary Results</h3><div>The primary outcome was the frequency of positive histology for endometriosis within the ablated surgical specimens. Sample size was calculated in advance to be 140 samples, which would provide power of 0.8 and significance of 0.0167. A total of 153 samples of ablated lesions were excised and collected from a total of 34 patients, with 51 samples in each of the three surgical technology arms. Overall, 20 (13%) of the ablated lesions still contained endometriosis identified on pathology after subsequent excision. Stratified by treatment arm, the numbers of specimens that remained endometriosis-positive after ablative treatment were 10 (20%) for electrical diathermy, 4 (8%) for Argon beam coagulation, and 6 (12%) for CO₂ Laser (p=0.20).</div></div><div><h3>Conclusion</h3><div>Endometriosis lesions are incompletely treated at similar rates with electrical diathermy, Argon beam coagulation, or CO₂ laser. Excision of these areas post-ablation removes more disease. Histologic effectiveness of these treatments stratified by stage or depth of lesions remains to be elucidated.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S11"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335189","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":"AMH Levels before and after Non-Ovarian Endometriosis Excisional Procedures","authors":"O Onwumere ,&nbsp;M Holden ,&nbsp;A Kosturakis ,&nbsp;M Pisarska ,&nbsp;KM Hamilton ,&nbsp;R Meyer","doi":"10.1016/j.jmig.2025.09.017","DOIUrl":"10.1016/j.jmig.2025.09.017","url":null,"abstract":"<div><h3>Study Objective</h3><div>To study the effects of non-ovarian endometriosis excision on levels of Anti-Müllerian Hormone (AMH) after surgery.</div></div><div><h3>Design</h3><div>A retrospective cohort study.</div></div><div><h3>Setting</h3><div>Academic medical center.</div></div><div><h3>Patients or Participants</h3><div>Patients who underwent minimally invasive surgery between 12/2013 - 5/2024 and had an AMH level collected before and after surgery.</div></div><div><h3>Interventions</h3><div>Excisional procedure of non-ovarian endometriosis, endometrioma excision, hysteroscopy, myomectomy, or salpingectomy.</div></div><div><h3>Measurements and Primary Results</h3><div>Patients were divided into three groups: endometriosis excision only with confirmed pathology (n = 21), ovarian endometrioma excision with confirmed pathology (n = 12), and control (n = 40; no endometriosis on pathology or excisional procedures). The pathology report was used to confirm if endometriosis was present. AMH levels were obtained from the EMR before and after surgical intervention. Multivariable linear regression analysis was used to adjust for time from surgery to post-AMH levels.</div><div>No statistically significant difference was observed in AMH level decline when comparing all endometriosis patients (median -0.52 ng/mL [-1.46, -0.07]) to controls (median -0.26 ng/mL [-1.01, 0.02]; p = .626). The endometrioma excision group showed a greater decline (median -0.86 ng/mL [-2.32, -0.57]) compared to controls (p = .006). The endometriosis excision only group had a similar change (median -0.37 ng/mL [-0.57, -0.03]) to controls (p = .340). Comparing endometriosis excision to endometrioma excision, the latter showed a significantly greater decline in AMH levels (p = .022).</div></div><div><h3>Conclusion</h3><div>There was no difference in the decline of AMH levels when comparing endometriosis excision to controls, suggesting that non-ovarian endometriosis excision does not affect ovarian reserve. In contrast, endometrioma excision was associated with a significant decline compared to endometriosis excision only and to control, suggesting an impact on ovarian reserve.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S13"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335200","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":"Non-Invasive Electroviscerography for the Diagnosis of Endometriosis: A Prospective Pilot Study","authors":"MP Andres ,&nbsp;ACP Servidoni ,&nbsp;ALB Luduwig ,&nbsp;LL Passos ,&nbsp;MM Brunoro ,&nbsp;MS Abrao","doi":"10.1016/j.jmig.2025.09.020","DOIUrl":"10.1016/j.jmig.2025.09.020","url":null,"abstract":"<div><h3>Study Objective</h3><div>To evaluate the sensitivity and specificity of non-invasive electroviscerography (EVG) in predicting the presence of endometriosis, compared to findings from transvaginal ultrasound with bowel preparation (TVUS) and laparoscopic surgery.</div></div><div><h3>Design</h3><div>Prospective validation study.</div></div><div><h3>Setting</h3><div>Two tertiary hospitals in Brazil</div></div><div><h3>Patients or Participants</h3><div>A total of 43 women aged 18 to 45 years were enrolled. Thirteen patients underwent laparoscopic surgery (12 with endometriosis and 1 without). Thirty patients underwent TVUS only (11 with endometriosis and 19 without). All participants underwent EVG testing prior to surgery or imaging.</div></div><div><h3>Interventions</h3><div>Participants underwent EVG, a non-invasive technique that records abdominal myoelectric activity using surface electrodes. TVUS was performed by experienced radiologists using bowel preparation. Laparoscopy with histological confirmation served as the gold standard in surgical patients.</div></div><div><h3>Measurements and Primary Results</h3><div>Compared to laparoscopy (n=13), EVG showed a sensitivity of 100.0% (95% CI: 73.54% to 100.0%) and specificity of 0.0% (95% CI: 0.0% to 97.50%). The positive predictive value was 92.31%, and accuracy was 92.31% (95% CI: 63.97% to 99.81%). Compared to TVUS (n=30), EVG showed a sensitivity of 81.82% (95% CI: 48.22% to 97.72%) and specificity of 26.32% (95% CI: 9.15% to 51.20%). The positive predictive value was 39.13%, negative predictive value was 71.43%, and accuracy was 46.67% (95% CI: 28.34% to 65.67%).</div></div><div><h3>Conclusion</h3><div>EVG demonstrated high sensitivity but low specificity when compared to both laparoscopy and ultrasound. Its best performance was observed in high-prevalence settings. While EVG is a promising non-invasive diagnostic tool, further validation in larger and more balanced populations is needed to confirm its clinical utility.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S14"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335202","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}