Journal of minimally invasive gynecology最新文献

{"title":"Minimally Invasive Benign Hysterectomy Surgical Technique Using the MIRA Surgical System Under Ide-Study Protocol.","authors":"J. Dubuisson ,&nbsp;N. Gomez ,&nbsp;G. Heidrick ,&nbsp;M. Diana ,&nbsp;T.B. Erickson ,&nbsp;T. Martin ,&nbsp;P. Hinoul ,&nbsp;R. Estape","doi":"10.1016/j.jmig.2025.09.087","DOIUrl":"10.1016/j.jmig.2025.09.087","url":null,"abstract":"<div><h3>Study Objective</h3><div>To assess device performance and safety of the MIRA Surgical System (Virtual Incision, Nebraska, USA) when used to robotically assist in benign hysterectomy surgery.</div></div><div><h3>Design</h3><div>International, prospective, multi-center, multi-operator, non-randomized, consecutively enrolled clinical investigation.</div></div><div><h3>Setting</h3><div>The study will be conducted in four centers in Switzerland and the U.S. (NCT06028542)</div></div><div><h3>Patients or Participants</h3><div>Adult females following informed consent indicated for hysterectomy for benign disease. Uterine size ≤16 weeks. BMI &lt;40 kg/m². Weight ≥45.4kg. Height ≥152cm. ASA grades I-III. Sample size, n=35, was selected to provide at least 80% chance to observe at least one safety event if the event occurs in at least 5.3% of subjects. Post-operative follow-up is 42 days(±7days).</div></div><div><h3>Interventions</h3><div>The video demonstrates the components of the system. Insertion and deployment of the Minibot are illustrated. Subsequently, the video showcases the procedure's essential steps: dissection and exposure is achieved with the bipolar graspers and monopolar scissors. The infundibulopelvic ligament and the uterine artery are dissected, coagulated and transected. Following creation of the bladderflap a colpotomy is performed and uterus and ovaries are removed vaginally. The procedure is completed by closing the vaginal cuff using the needle driver and grasper.</div></div><div><h3>Measurements and Primary Results</h3><div>The primary efficacy endpoint is the successful completion of the procedural steps in &gt;31/35 patients. Safety analyses will be based on the intra- and post-operative adverse events. Secondary outcome measures include: estimated blood loss, length of stay, cuff tissue healing, readmission and reoperation rates, number of ports, ancillary tools used (+reason). In US sites a secondary laparoscopic camera at the level of the upper abdomen will capture a panoramic view to enable an independent observer and the DSMB to document off-screen movement of the RAS device to determine whether a correlation exists between tissue interactions and adverse events.</div></div><div><h3>Conclusion</h3><div>The video exemplifies the effective use of the MIRA Surgical System in a total hysterectomy and bilateral salpingo-oophorectomy.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S9"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334456","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":"Ovarian Tissue Cryopreservation for Premenarchal Eight-Year-Old Prior to Hematopoietic Stem Cell Transplantation","authors":"T Gemesi ,&nbsp;M McCracken ,&nbsp;SM Cizek","doi":"10.1016/j.jmig.2025.09.128","DOIUrl":"10.1016/j.jmig.2025.09.128","url":null,"abstract":"<div><h3>Study Objective</h3><div>To describe optimal surgical technique of unilateral oophorectomy for ovarian tissue cryopreservation in a premenarchal patient.</div></div><div><h3>Design</h3><div>8-year-old premenarchal patient with acute myelogenous leukemia and planned hematopoietic stem cell transplantation referred to Pediatric and Adolescent Gynecology for ovarian tissue cryopreservation. Patient underwent an uncomplicated laparoscopic left oophorectomy.</div></div><div><h3>Setting</h3><div>Academic hospital operating room with supine positioning.</div></div><div><h3>Patients or Participants</h3><div>Single patient undergoing case of interest. Consents signed for intraoperative recording.</div></div><div><h3>Interventions</h3><div>Laparoscopic Left Oophorectomy</div></div><div><h3>Measurements and Primary Results</h3><div>Video presentation of laparoscopic left oophorectomy for ovarian tissue cryopreservation.</div></div><div><h3>Conclusion</h3><div>This video provides a brief overview of ovarian tissue cryopreservation and demonstrates how laparoscopic unilateral oophorectomy for ovarian tissue cryopreservation in premenarchal patients can be optimized and safely performed.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S29"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334631","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":"Step-By-Step Vaginal Anvil Insertion and Specimen Extraction for Rectosigmoidectomy in Endometriosis","authors":"I. Chiminacio,&nbsp;J.F. Petry,&nbsp;C. Obrzut,&nbsp;H. Sabadin","doi":"10.1016/j.jmig.2025.09.082","DOIUrl":"10.1016/j.jmig.2025.09.082","url":null,"abstract":"<div><h3>Study Objective</h3><div>To present a safe step-by-step technique for minimally invasive vaginal insertion and totally intracorporeal placement of the circular stapler anvil used in rectosigmoidectomy procedures for endometriosis treatment.</div></div><div><h3>Design</h3><div>Didactic video demonstrating the step-by-step standardization of the vaginal insertion technique of the anvil and its application to the proximal bowel stump for intestinal anastomosis.</div></div><div><h3>Setting</h3><div>Laparoscopic procedure using a four-port French technique, 4K imaging system, and a 31mm circular stapler.</div></div><div><h3>Patients or Participants</h3><div>A 31-year-old patient with symptomatic bilateral parametrium endometriosis, chronic pelvic pain, tenesmus, and diarrhea. Rectosigmoid involvement was identified by magnetic resonance imaging.</div></div><div><h3>Interventions</h3><div>En bloc excision of endometriosis affecting the parametrium and pelvic somatic nerves was performed using neuropelveology techniques. A rectosigmoidectomy was conducted to resect the diseased bowel segment, which was missed during a prior surgery two years earlier, with persistent symptoms. The anvil of the circular stapler was introduced vaginally without exteriorization of the proximal bowel, achieving fully intracorporeal positioning. The procedure was preceded by bowel preparation using a combination of oral monobasic sodium phosphate dihydrate and dibasic sodium phosphate heptahydrate solution the night before surgery, plus two rectal doses (8 and 2 hours preoperatively). The resected bowel specimen was also removed transvaginally.</div></div><div><h3>Measurements and Primary Results</h3><div>Postoperative outcomes at immediate, 6-month, and 1-year follow-up were completely suitable, with no infection, full resolution of pelvic pain, and release of the parametrium confirmed on physical examination. Bowel function normalized to 1–3 daily evacuations initially, then stabilized at one per day without tenesmus. The technique proved to be feasible and reproducible.</div></div><div><h3>Conclusion</h3><div>Vaginal introduction of the anvil is a safe and reproducible technique when performed step-by-step. Adequate bowel preparation is essential. Vaginal specimen extraction offers a truly minimally invasive approach with uterine preservation and no need for abdominal wall incision.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S8"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334968","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":"Successful Pregnancy after Extensive Robotic Adenomyosis Surgery Using the Double-Flap Technique and Intrauterine Indocyanine Green","authors":"M.A.P. Oliveira ,&nbsp;T.D. Pereira ,&nbsp;J.C. Alves ,&nbsp;B.S. Faria","doi":"10.1016/j.jmig.2025.09.084","DOIUrl":"10.1016/j.jmig.2025.09.084","url":null,"abstract":"<div><h3>Study Objective</h3><div>To evaluate the feasibility and outcomes of extensive robotic adenomyomectomy using the double-flap technique combined with intrauterine indocyanine green (ICG) for fertility preservation in patients with diffuse adenomyosis.</div></div><div><h3>Design</h3><div>Retrospective case report with longitudinal follow-up after extensive diffuse adenomyosis resection by robotics.</div></div><div><h3>Setting</h3><div>Procedures were performed in a high-volume tertiary referral center with the patient in dorsal lithotomy position using the Da Vinci robotic system. Three 8 mm robotic arms and one auxiliary 5 mm trocar were utilized. Ergonomics favored precise dissection and layered suturing.</div></div><div><h3>Patients or Participants</h3><div>A 41-year-old nulligravid patient with severe diffuse adenomyosis and a history of failed IVF cycles. The reproductive endocrinologist (RE) recommended fertility-preserving robotic surgery in an attempt to improve the chances of implantation of the patient’s remaining two frozen embryos</div></div><div><h3>Interventions</h3><div>Robotic adenomyomectomy with uterine vessels tourniquet, intraoperative vasopressin injection, intrauterine ICG to delineate infiltration depth, and the double-flap technique for uterine wall reconstruction.</div></div><div><h3>Measurements and Primary Results</h3><div>ICG fluorescence allowed to identify less infiltrated (green-intense) from more diseased myometrium. Adenomyotic tissue was resected while preserving a 1 cm margin of healthy myometrium internally and externally. The uterine cavity and the myometrium were reconstructed in multiple layers using barbed sutures. MRI and hysteroscopy at 1 year confirmed uterine integrity and normal anatomy. Embryo transfer resulted in a pregnancy, delivered via C-section at 32 weeks. There were no intraoperative or postoperative complications, and the patient remains asymptomatic.</div></div><div><h3>Conclusion</h3><div>Robotic double-flap adenomyomectomy with intrauterine ICG evaluation appears to be a safe and feasible fertility-preserving approach in selected patients with diffuse adenomyosis. Further studies with larger cohorts are needed to validate these findings and assess long-term reproductive outcomes.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S8"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334970","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":"Robotic Assisted and Cystoscopic Partial Cystectomy for Deep Endometriosis: A Bladder Sparing Approach","authors":"F.C.Y.O. Lee Yamada,&nbsp;T.C. Dantas,&nbsp;A. Kopelman,&nbsp;E. Schor","doi":"10.1016/j.jmig.2025.09.080","DOIUrl":"10.1016/j.jmig.2025.09.080","url":null,"abstract":"<div><h3>Study Objective</h3><div>The objective of this vídeo is to demonstrate a surgical case of patient with bladder endometriosis, a bladder sparing approach.</div></div><div><h3>Design</h3><div>We present a 6-minutes video describing the surgical technique of a robotic and cystoscopic approach for partial cystectomy for deep infiltrating endometriosis.</div></div><div><h3>Setting</h3><div>A robotic partical cystectomy was performed as the treatment of choice for this patient.</div></div><div><h3>Patients or Participants</h3><div>Patient consented to the presentation of this vídeo.</div></div><div><h3>Interventions</h3><div>Robotic partical cystectomy was performed as the treatment of bladder endometriosis.</div></div><div><h3>Measurements and Primary Results</h3><div>Patient was discharged on the first postoperative day and had the indwelling catheter removed after 14 days.</div></div><div><h3>Conclusion</h3><div>Bladder endometriosis can be a challeging surgical case. Robotic assisted surgery provides better visualization, dexterity and instruments movement considering anatomical complexity.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Page S7"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335098","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 Approach to Multi-Nerve Involvement of Endometriosis","authors":"AC Fitzgerald,&nbsp;G Namazi,&nbsp;J Einarsson","doi":"10.1016/j.jmig.2025.09.146","DOIUrl":"10.1016/j.jmig.2025.09.146","url":null,"abstract":"<div><h3>Study Objective</h3><div>Our objective is to review the surgical approach to excision of a deep endometriosis lesion involving multiple pelvic nerves.</div></div><div><h3>Design</h3><div>Using annotated intraoperative footage, we will review the lateral and medial approaches to dissection of the sciatic and superior gluteal nerves, lumbosacral trunk and sacral nerve roots.</div></div><div><h3>Setting</h3><div>Academic medical center. Patient in dorsal lithotomy position with camera in umbilical port, with accessory ports in the bilateral lower quadrants and at Jain point.</div></div><div><h3>Patients or Participants</h3><div>35yo G0 with 3-year history of progressive foot drop and sciatica, with MRI demonstrating deep infiltrating endometriosis involving the sciatic and superior gluteal nerves and lumbosacral trunk.</div></div><div><h3>Interventions</h3><div>Medial and lateral approach to dissection, with complete excision of endometriosis at the conclusion of procedure.</div></div><div><h3>Measurements and Primary Results</h3><div>Patient followed clinically and is four months post-op at the time of submission.</div></div><div><h3>Conclusion</h3><div>A thorough understanding of the relevant anatomy is required for safe excision of endometriosis involving the pelvic nerves.</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":"145334452","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":"Robotic Approach to Iatrogenic Intra-Abdominal Pregnancy","authors":"K. Brito,&nbsp;J. Kim,&nbsp;W. Zhang,&nbsp;J. Lager,&nbsp;T. Ito","doi":"10.1016/j.jmig.2025.09.088","DOIUrl":"10.1016/j.jmig.2025.09.088","url":null,"abstract":"<div><h3>Study Objective</h3><div>To present a case of iatrogenic intra-abdominal pregnancy in a morbidly obese patient; discuss surgical considerations in bariatric patients; highlight advantages of robotic surgery in the setting of prior infection; and demonstrate the use of avascular spaces in performing complex hysterectomies.</div></div><div><h3>Design</h3><div>Video documentation of the surgical procedure</div></div><div><h3>Setting</h3><div>University of California, San Francisco Hospital operating room</div></div><div><h3>Patients or Participants</h3><div>36-year-old G5P4004 (BMI 50) diagnosed with intrauterine fetal demise measuring 14 weeks 5 days with a history of four prior cesarean sections. Patient underwent induction of labor complicated by septic abortion, necessitating D&amp;E. Patient ultimately presented to our institution 2 weeks after the D&amp;E with imaging showing fetal parts outside of the uterus.</div></div><div><h3>Interventions</h3><div>We present a case of an abdominal pregnancy in a morbidly obese patient, review the clinical course, case imaging and demonstrate a stepwise robotic hysterectomy in an inflamed surgical field with distorted anatomy.</div><div>Despite the complex pathology, we approach this case systematically We begin by mobilizing the colon and opening the retroperitoneum to identify the ureters. Blunt dissection along the pelvic sidewall, reveals a thick rind encapsulating the placenta, organized blood products, and the abdominal pregnancy.</div><div>After safely mobilizing the omentum and small bowel, we visualize the fetus. The fetus and placenta are separated from the uterus and placed in the upper abdomen. Once the uterus is fully visible and mobile, we proceed with hysterectomy using our standard approach.</div></div><div><h3>Measurements and Primary Results</h3><div>The robotic platform is a valuable tool for morbidly obese patients undergoing complex hysterectomy. The case took 5 hours, and the estimated blood loss was 100mL.</div></div><div><h3>Conclusion</h3><div>With Knowledge of avascular spaces and thoughtful approach to minimally invasive surgery in the morbidly obese patients, laparotomy may be avoided for medically and surgically complex patients.</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":"145334457","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 Sparing Multidisciplinary Management of Deep Infiltrating Endometriosis","authors":"NS Parra ,&nbsp;JM Moyett ,&nbsp;AP Advincula","doi":"10.1016/j.jmig.2025.09.142","DOIUrl":"10.1016/j.jmig.2025.09.142","url":null,"abstract":"<div><h3>Study Objective</h3><div>To demonstrate fertility sparing multidisciplinary excision of deep infiltrating endometriosis</div></div><div><h3>Design</h3><div>Surgical video of a patient undergoing endometriosis resection</div></div><div><h3>Setting</h3><div>Operating room</div></div><div><h3>Patients or Participants</h3><div>Patient with deep infiltrating endometriosis</div></div><div><h3>Interventions</h3><div>Excision of bowel endometriosis, excision of ureteral endometriosis, transection and reimplantation of ureter</div></div><div><h3>Measurements and Primary Results</h3><div>The video will be used for educational purposes to continue to provide ways to surgically treat deep infiltrating endometriosis with a fertility sparing approach</div></div><div><h3>Conclusion</h3><div>Surgical excision of deep infiltrating endometriosis with a fertility sparing approach is achievable with a multidisciplinary team</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":"145334548","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 Complex Case of Severe Cervical Stenosis and Isthmocele","authors":"MC Alzamora Schmatz ,&nbsp;G Mintz ,&nbsp;S Sridhar ,&nbsp;L Bar-El ,&nbsp;M Billow","doi":"10.1016/j.jmig.2025.09.130","DOIUrl":"10.1016/j.jmig.2025.09.130","url":null,"abstract":"<div><h3>Study Objective</h3><div>To review specific considerations for isthmocele repair and abdominal cerclage and illustrate the surgical technique for transuterine cervical dilation, isthmocele repair and abdominal cerclage.</div></div><div><h3>Design</h3><div>Case Report</div></div><div><h3>Setting</h3><div>Academic tertiary referral center</div></div><div><h3>Patients or Participants</h3><div>33yo G1P1001 who presented with a retained IUD, cervical stenosis and shortening, and an isthmocele diagnosed on imaging.</div></div><div><h3>Interventions</h3><div>Laparoscopic transuterine IUD removal, isthmocele repair, cervical dilation with possible catheter insertion, and transabdominal cerclage.</div></div><div><h3>Measurements and Primary Results</h3><div>Patient underwent uncomplicated surgical procedure as described, intrauterine foley catheter was left in place to maintain cervical patency. At her 2-week postoperative visit, the catheter was removed and office hysteroscopy was performed without complication and with no need for cervical dilation.</div></div><div><h3>Conclusion</h3><div>This video emphasizes the importance of patient-centered care and shared decision-making in managing complex reproductive surgical cases, particularly when aligning with fertility preservation goals. It also highlights the value of multidisciplinary collaboration in guiding evidence-informed yet individualized care. Finally, the surgical approach demonstrates how minimally invasive techniques can be adapted to address multiple pathologies simultaneously, minimizing risk and optimizing future reproductive potential.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"32 11","pages":"Pages S29-S30"},"PeriodicalIF":3.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334633","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 Crisis Simulation: Creation of a Cost-Effective, Low-Fidelity Laparoscopic Vascular Injury Model","authors":"C.A. Saad ,&nbsp;A. Afewerki ,&nbsp;N. Kerner ,&nbsp;M. Larzelere ,&nbsp;K. Stampler ,&nbsp;L. Berkowitz ,&nbsp;D. Zoorob","doi":"10.1016/j.jmig.2025.09.069","DOIUrl":"10.1016/j.jmig.2025.09.069","url":null,"abstract":"<div><h3>Study Objective</h3><div>To enhance resident preparedness in the management of laparoscopic major vascular injuries by creating a cost-effective, low-fidelity laparoscopic vascular injury simulation model.</div></div><div><h3>Design</h3><div>We used materials that were cheap and easily accessible to create this low-fidelity model. Cost to build the model ranged from $20 to $25 per model. The model can easily fit into an FLS task trainer, making it accessible to programs without access to laparoscopic towers for simulation. This model also allows for conversion from laparoscopy to laparotomy to fully simulate the steps and decision-making involved in managing a major laparoscopic injury.</div></div><div><h3>Setting</h3><div>This model was designed, built, and successfully used at 5 ACGME-accredited Obstetrics and Gynecology residencies.</div></div><div><h3>Patients or Participants</h3><div>N/A</div></div><div><h3>Interventions</h3><div>N/A</div></div><div><h3>Measurements and Primary Results</h3><div>N/A</div></div><div><h3>Conclusion</h3><div>This low-fidelity simulation model can be economically reproduced and fits into a standard FLS task trainer, making it accessible to gynecology residencies as well as other surgical specialties. Simulation is integral in increasing exposure to improve confidence and knowledge when managing this rare but potentially life-threatening complication.</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":"145334842","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}