Journal of minimally invasive gynecology最新文献

{"title":"Hysteroscopy-Assisted Laparoscopic Tubo-Tubal Reanastomosis Using a Modified Sequential Distal-Knot Suturing Technique in Women after Sterilization.","authors":"Minjiao Zhu, Shunna Ge, Siqin Yang, Yan Liang","doi":"10.1016/j.jmig.2026.09.002","DOIUrl":"10.1016/j.jmig.2026.09.002","url":null,"abstract":"<p><strong>Study objective: </strong>To describe a modified sequential distal-knot suturing technique in hysteroscopy-assisted laparoscopic tubo-tubal reanastomosis.</p><p><strong>Design: </strong>Surgical video article. Stepwise narrated video demonstration of the modified technique.</p><p><strong>Participants: </strong>A total of 25 women after sterilization were included in our study.</p><p><strong>Setting: </strong>With China's fertility policy adjustment, more women seek fertility restoration after tubal ligation via tubal reanastomosis or in vitro fertilization [1]. Although laparoscopic reanastomosis may offer advantages such as less invasiveness, faster recovery, the possibility of natural conception and more than one subsequent pregnancy, and potentially lower costs than in vitro fertilization, the choice between the two approaches should be individualized according to age, ovarian reserve, remaining tubal length and condition, and male factor infertility [2,3]. Nevertheless, the laparoscopic procedure itself is technically demanding due to the small tubal lumen and the need for precise multiple sutures that tend to tangle and prolong operative time [4]. Here, we describe a hysteroscopy-assisted laparoscopic tubo-tubal reanastomosis with a modified technique that organizes sutures, lowers difficulty, and improves feasibility.</p><p><strong>Interventions: </strong>Hysteroscopy-assisted laparoscopic surgery was performed. After opening the mesosalpinx and confirming anastomosis ends, the sterilized segment was resected. The muscular layer and mucosa were sutured with 5-0 absorbable sutures at 6, 12, 9, and 3 o'clock. A modified suturing and knotting technique was employed here: After each stitch is placed, a temporary distal knot is tied, and the suture ends are cut before the next stitch is placed. Once all four stitches have been secured in this manner, the temporary distal knots are sequentially cut, and the corresponding suture ends are tied proximally. Hysteroscopy was performed to assess tubal patency and confirm proper repair.</p><p><strong>Conclusion: </strong>Our technique, described and demonstrated in this video article, is a feasible and technically reproducible approach for restoring fertility in women after sterilization. The modified sequential distal-knot suturing technique prevents suture disorganization and limit traction on the tubal ends, thereby reducing tubal injury and operative time caused by repeated manipulation-a feature conducive to wider adoption. VIDEO ABSTRACT.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919867","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":"Robot-assisted buccal mucosa graft ureteroplasty for deep infiltrating endometriosis.","authors":"Laurie Peli, Maria Selloua, Thibaut Brierre, Elodie Chantalat","doi":"10.1016/j.jmig.2026.08.025","DOIUrl":"https://doi.org/10.1016/j.jmig.2026.08.025","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905738","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":"Clinical Outcomes of Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) in Gynecology: A Comprehensive Systematic Review and Meta-analysis.","authors":"Giorgia Dinoi, Sara Mastrovito, Vincenzo Tarantino, Camilla Riccetti, Davide Arrigo, Giancarlo Paradisi, Antonella Carcagni, Diana Giannarelli, Anna Fagotti, Francesco Fanfani, Giovanni Panico","doi":"10.1016/j.jmig.2026.08.019","DOIUrl":"10.1016/j.jmig.2026.08.019","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical outcomes of vaginal natural orifice transluminal endoscopic surgery (vNOTES) compared with conventional minimally invasive surgery (MIS), including multiport laparoscopy and laparoendoscopic single-site surgery (LESS), in benign gynecologic procedures.</p><p><strong>Data sources: </strong>A systematic search of PubMed, Web of Science, and Scopus was conducted from database inception through January 2025. Search terms included \"vNOTES\" and \"laparoscopy.\" The review was prospectively registered in PROSPERO (CRD42025639454). Only English-language studies were included.</p><p><strong>Methods of study selection: </strong>Randomized controlled trials, prospective, and retrospective comparative studies evaluating vNOTES versus MIS in adult women undergoing hysterectomy, adnexal surgery, or myomectomy for benign indications were included. Studies were required to report at least one perioperative outcome. A total of 33 studies involving more than 4000 patients met inclusion criteria.</p><p><strong>Tabulation, integration, and results: </strong>Two reviewers independently performed study selection, data extraction, and quality assessment using the Cochrane Risk of Bias 2 tool and Newcastle-Ottawa Scale. Random-effects models were applied. Compared with conventional MIS, vNOTES was associated with significantly shorter operative time (mean difference -25.8 minutes, 95% CI -33.6 to -18.0), lower postoperative pain (mean difference -0.59, 95% CI -1.02 to -0.15), fewer postoperative complications (risk ratio 0.60, 95% CI 0.41-0.87), and shorter hospital stay (mean difference -0.59 days, 95% CI -1.03 to -0.15). No significant differences were observed in intraoperative complications, conversion rates, or estimated blood loss. Prespecified subgroup analyses and meta-regression found no evidence that surgical procedure type modified these associations.</p><p><strong>Conclusion: </strong>vNOTES appears to be an effective alternative to conventional MIS for benign gynecologic surgery, offering improved operative efficiency and reduced postoperative morbidity with no statistically significant differences in intraoperative safety. These findings support its integration into minimally invasive gynecologic practice, while further prospective studies are needed to refine indications and patient selection.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900767","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":"Intraoperative Ultrasound for Localization of Deep Rectosigmoid Endometriosis Nodule.","authors":"Francesca Galasso, Mariana Porsani Hoffman, Clarissa P Diniz, Scott Young, Johnny Yi","doi":"10.1016/j.jmig.2026.09.001","DOIUrl":"10.1016/j.jmig.2026.09.001","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900730","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":"Uterus-preserving Cold-knife Adenomyomectomy Within a Three-stage Treatment Strategy for Severe Diffuse Adenomyosis and Its Effect on IVF/ICSI and Perinatal Outcomes.","authors":"Zhi Zeng, Rui Xiang, Yingying Liu, Jintao Peng, Manchao Li, Panyu Chen, Jingjie Li, Weie Zhao, Xiaolan Li, Yujie Li, Qian Li, Haitao Zeng, Xiaoyan Liang","doi":"10.1016/j.jmig.2026.08.024","DOIUrl":"10.1016/j.jmig.2026.08.024","url":null,"abstract":"<p><strong>Study objective: </strong>To evaluate the effects of a 3-stage treatment strategy featured by cold-knife adenomyomectomy, enhanced endometrial protection and postoperative uterine monitoring for severe diffuse adenomyosis on IVF/ICSI and perinatal outcomes.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Tertiary reproductive center.</p><p><strong>Patients: </strong>This study included 221 infertile women with diffuse adenomyosis treated from January 2021 to October 2025, comprising 125 patients with medically refractory disease or recurrent implantation failure who underwent 3-stage treatment (surgery group) and 96 patients without these indications who received GnRHa-only therapy (control group). In the surgery group, 32 patients haven't completed uterine monitor, and 12 patients haven't made embryo transfer decision.</p><p><strong>Interventions: </strong>A 3-stage protocol: (1) extensive energy-free cold-knife debulking; (2) multilayer tension-balanced uterine reconstruction preserving a 5-mm myometrial-endometrial buffer zone; and (3) postoperative sequential MRI, diagnostic hysteroscopy and/or 3D transvaginal ultrasound screening before embryo transfer.</p><p><strong>Measurements and main results: </strong>Uterine dimensions were significantly reduced after surgery in 93 patients with postoperative MRI assessments. Among 78 patients who proceeded with embryo transfer and definitive outcome (explicitly excluding 2 spontaneous conceptions and one ongoing pregnancy), the cumulative clinical pregnancy rate was 62.82% (49/78) and the cumulative live birth rate was 41.03% (32/78). Doubly robust AIPW estimation across 142 first embryo transfer cycles (46 from surgery and 96 from control group) revealed that the 3-stage strategy was associated with a markedly reduced miscarriage risk (RR = 0.18; 95% Confidence Interval, 0.05-0.67; p = .011), whereas clinical pregnancy and live-birth rates did not differ significantly between groups. Three third-trimester uterine ruptures occurred, corresponding to 8.8% (3/34) of women who delivered. All 3 patients required emergency cesarean delivery, including 1 woman underwent peripartum hysterectomy. All live-born neonates were discharged in good health.</p><p><strong>Conclusion: </strong>This fertility-sparing, nonthermal 3-stage cold-knife technique reduces uterine size and appears to optimize reproductive outcomes in severe adenomyosis by reducing miscarriage. Doubly robust analysis reinforces the reliability of these findings, pending confirmation in larger cohorts. Strict single-embryo transfer, serial monitoring of the reconstructed myometrium and amniotic fluid, and planned cesarean delivery are mandatory to minimize uterine rupture risk.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891913","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":"Paulina Garcia de Alba Graue, Eva Suarthana, Togas Tulandi","doi":"10.1016/j.jmig.2026.08.027","DOIUrl":"10.1016/j.jmig.2026.08.027","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891931","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":"Endometrial Polyp Recurrence after Hysteroscopic Polypectomy: A Systematic Review and Meta-analysis by Surgical Instrument.","authors":"Giuseppe Caruso, Nataša Kenda Šuster, Marco Palumbo","doi":"10.1016/j.jmig.2026.08.028","DOIUrl":"10.1016/j.jmig.2026.08.028","url":null,"abstract":"<p><strong>Objective: </strong>To characterize endometrial polyp recurrence after hysteroscopic removal according to the surgical instrument used and to assess direct comparative evidence without treating instrument-specific single-arm proportions as comparative effects.</p><p><strong>Data sources: </strong>PubMed, Scopus, Web of Science Core Collection, and Cochrane CENTRAL were searched through July 18, 2026. Trial registries and citations were assessed. The review was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD420261335015).</p><p><strong>Methods of study selection: </strong>Randomized and nonrandomized studies with at least 10 patients, a histologically confirmed index polyp, hysteroscopic removal, and recurrence assessment at 6 months or later were eligible. Two reviewers independently screened records and assessed full texts; data extraction, report linkage, instrument classification, and risk-of-bias judgments were independently verified and finalized by consensus. Cointerventions were analyzed separately or in sensitivity analyses.</p><p><strong>Tabulation, integration, and results: </strong>Of 1221 records, 777 were screened and 69 reports were assessed; 38 reports representing 34 studies were included. Strict 12-month single-arm pools were estimable for tissue removal systems (6.3%; 95% confidence interval [CI]: 3.3%-11.7%) and electrosurgery (13.5%; 95% CI: 11.6%-15.7%). A strict mechanical/cold pool was not retained after full-text re-verification identified selective sharp curettage in a contributing cold-knife arm. These proportions are descriptive, not comparative effects. Direct comparisons remained sparse and of very low certainty. In 2 nonrandomized cohorts, postoperative levonorgestrel-releasing intrauterine systems were associated with lower recurrence (pooled risk ratio: 0.36; 95% CI: 0.23-0.57); the certainty was very low.</p><p><strong>Conclusion: </strong>Comparative evidence is insufficient to determine whether hysteroscopic instrument choice independently affects recurrence. Case mix, recurrence ascertainment, and follow-up materially limit cross-study interpretation. The observed levonorgestrel-releasing intrauterine systems association is nonrandomized and does not establish causality.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887786","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":"Primary Retroperitoneal Ovary Presenting as Acute Pelvic Pain: A Diagnostic Pitfall.","authors":"Yuanjunzi Shi, Gang Ji, Houyu Yang","doi":"10.1016/j.jmig.2026.08.031","DOIUrl":"10.1016/j.jmig.2026.08.031","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887851","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 \"Complementary Roles of Rectal Magnetic Resonance Imaging and Endoscopic Ultrasound in the Preoperative Assessment of Rectal Deep Endometriosis: A Retrospective Cohort\".","authors":"Yinwen Hong","doi":"10.1016/j.jmig.2026.08.030","DOIUrl":"10.1016/j.jmig.2026.08.030","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880805","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 “Artificial Intelligence in Academic Publishing: A Comparative Analysis of Author and Reviewer Guidelines Across Major Obstetrics and Gynecology Journals”","authors":"Shigeki Matsubara MD, PhD","doi":"10.1016/j.jmig.2026.02.040","DOIUrl":"10.1016/j.jmig.2026.02.040","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 9","pages":"Pages 1375-1376"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321694","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}