Journal of minimally invasive gynecology最新文献

{"title":"Hidden in Plain Sight: Recognizing Post-Surgical Anterior Abdominal Wall Neuralgias","authors":"HM Lewis,&nbsp;M Castellanos,&nbsp;G Lamvu,&nbsp;C Ouyang,&nbsp;J Feranec,&nbsp;JF Carrillo","doi":"10.1016/j.jmig.2024.09.089","DOIUrl":"10.1016/j.jmig.2024.09.089","url":null,"abstract":"<div><h3>Study Objective</h3><div>Educate gynecologic surgeons on how to suspect and diagnose post-operative iliohypogastric and ilioinguinal neuralgias.</div></div><div><h3>Design</h3><div>An educational video was created to discuss the prevalence of post-surgical neuralgias, review the different types of pain, and describe pertinent anterior abdominal wall nerve anatomy. We will explain through a clinical scenario how to obtain a thorough history and perform a focused physical examination. We will demonstrate the steps of conducting directed nerve blocks for diagnostic and therapeutic purposes.</div></div><div><h3>Setting</h3><div>Outpatient clinic and operating room.</div></div><div><h3>Patients or Participants</h3><div>Post-surgical patients with anterior abdominal wall neuralgias.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Measurements and Main Results</h3><div>Not applicable.</div></div><div><h3>Conclusion</h3><div>Post-surgical abdominopelvic neuralgias are a prevalent, yet underdiagnosed condition that can lead to persistent abdominopelvic pain. Treatment options are often multimodal and may involve nonpharmacologic options, pharmacotherapy and/or interventional procedures. We demonstrate in this video step-by-step instructions for diagnostic and therapeutic blocks that can either be performed in the office or operating room. Surgeons should familiarize themselves with the assessment, diagnosis, and treatment of these commonly missed neuralgias.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page S20"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658437","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":"Three Types of Minimally Invasive Paraaortic Lymphadenectomy","authors":"M Andou ,&nbsp;S Yanai ,&nbsp;K Kanno ,&nbsp;M Sawada ,&nbsp;T Hoshiba ,&nbsp;Y Kurose","doi":"10.1016/j.jmig.2024.09.087","DOIUrl":"10.1016/j.jmig.2024.09.087","url":null,"abstract":"<div><h3>Study Objective</h3><div>Originally open para-aortic dissection is very invasive. To reduce patient morbidity, we introduced minimally invasive extraperitoneal techniques.</div></div><div><h3>Design</h3><div>Techniques for minimally invasive para-aortic lymphadenectomy will be shown.</div></div><div><h3>Setting</h3><div>All operations were conducted in a general hospital in Japan.</div><div>Patients were all placed in the lithotomy position. Patient positioning was the same irrespective of whether procedures were single port or multi-port.</div></div><div><h3>Patients or Participants</h3><div>We began laparoscopic para-aortic dissection in 1998 and da Vinci XP surgery in 2018. The SP system was introduced in 2023. In totally, we have performed more then 900 para-aortic lymphadenectomy surgeries.</div></div><div><h3>Interventions</h3><div>Techniques for minimally invasive para-aortic lymphadenectomy using various approaches will be shown. The progression of techniques using surgical robots top maximize minimally invasiveness will be described, specifically focusing on how-to's in real surgical circumstances.</div></div><div><h3>Measurements and Main Results</h3><div>No patients underwent blood transfusion, and the post-operative courses of all patients were uneventful. Patients could ambulate and take a regular diet the day after surgery.</div></div><div><h3>Conclusion</h3><div>Robotic surgery for para-aortic lymphadenectomy is feasible and makes this once invasive surgery patient-friendly. Both laparoscopy and robotics offer safe dissection and a good cosmetic result for patients.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page S19"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658003","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":"Accessory Obturator Nerve During vNOTES Pelvic Lymphadenectomy","authors":"","doi":"10.1016/j.jmig.2024.06.001","DOIUrl":"10.1016/j.jmig.2024.06.001","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Pages 897-898"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293466","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":"“RAIL BIOPSY” A Novel and Useful Technique for Hysteroscopic Endometrial Target Biopsy","authors":"","doi":"10.1016/j.jmig.2024.06.013","DOIUrl":"10.1016/j.jmig.2024.06.013","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Study Objective&lt;/h3&gt;&lt;div&gt;&lt;span&gt;Endometrial biopsy&lt;span&gt; (EB) is one of the most common gynecologic procedures. Office-based EB has replaced procedures involving general/loco-regional anesthesia and cervical dilatation performed in the operating room [&lt;/span&gt;&lt;/span&gt;&lt;span&gt;&lt;span&gt;1&lt;/span&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;2&lt;/span&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;3&lt;/span&gt;&lt;/span&gt;&lt;span&gt;]. The Grasp Biopsy seems to be the most appropriate EB technique for reproductive-aged women [&lt;/span&gt;&lt;span&gt;&lt;span&gt;1&lt;/span&gt;&lt;/span&gt;,&lt;span&gt;&lt;span&gt;2&lt;/span&gt;&lt;/span&gt;,&lt;span&gt;&lt;span&gt;4&lt;/span&gt;&lt;/span&gt;]. Recently, the Visual D&amp;C performed with hysteroscopic tissue removal devices has shown to be a valid alternative [&lt;span&gt;&lt;span&gt;5&lt;/span&gt;&lt;/span&gt;&lt;span&gt;]. However, it is often difficult to obtain an adequate specimens in peri/post-menopausal women with hypo/atrophic endometrium [&lt;/span&gt;&lt;span&gt;&lt;span&gt;2&lt;/span&gt;&lt;/span&gt;]. Our aim is to show a novel hysteroscopic EB technique called “Rail Biopsy” which requires widespread and cheap instruments.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A step-by-step explanation of surgical techinque with narrated video footage. Setting: Tertiary Level Academic Hospital “IRCCS Azienda Ospedaliero-Universitaria di Bologna” Bologna, Italy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;&lt;span&gt;We performed the “Rail Biopsy” technique with a 5.0 mm Continuous Flow Operative Hysteroscope with a 30° Lens and a 5Fr operative channel. We identify the endometrial target area (ETA), and we create a first track cutting through the endometrium in a caudo-cranial direction using cold scissors. We repeat the procedure, creating a second parallel track, thus completing our “rail” and isolating a wide ETA. Then, in the caudo-cranial direction, we cut through the stromal layer beneath the ETA. With a 5Fr cold grasping forceps, we clench the cranial edge of the ETA, and we remove it from the uterine cavity. A high-quality specimen, even in the case of hypo/atrophic endometrium or focal sessile lesions, can be obtained with this technique. The crucial aspect of the “Rail Biopsy” indeed is cutting through the stromal tissue while the endometrium is minimally touched, avoiding thermal damage deriving from electrosurgery. The instruments required are widespread and cheap. Moreover, this technique can be performed on any wall of the uterus, under vision, and, in the majority of patients, in an office-setting without cervical dilatation or general/loco-regional anesthesia, making it an attractive alternative to &lt;/span&gt;hysteroscopy performed in the operating room setting. Further studies comparing “Rail Biopsy” to other EB techniques are needed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;We showed a novel approach for hysteroscopic EB that may be particularly useful in patients with hypo/atrophic endometrium, easy to learn and with low costs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Video Abstract&lt;/h3&gt;&lt;div&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;span&gt;&lt;video&gt;&lt;source&gt;&lt;/source&gt;&lt;/video&gt;&lt;/span&gt;&lt;span&gt;&lt;span&gt;Download: &lt;span&gt;Download video (34MB)&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Pages 909-910"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468656","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":"Outcomes of Myomectomies Performed by Fellowship-Trained Minimally Invasive Surgeons Compared to General Gynecologists","authors":"R Meyer,&nbsp;ML Barker,&nbsp;RJ Schneyer,&nbsp;K Hamilton,&nbsp;MD Truong,&nbsp;KN Wright,&nbsp;MT Siedhoff","doi":"10.1016/j.jmig.2024.09.043","DOIUrl":"10.1016/j.jmig.2024.09.043","url":null,"abstract":"<div><h3>Study Objective</h3><div>To compare surgical outcomes among patients undergoing laparoscopic/robotic or abdominal myomectomy with minimally invasive gynecologic surgery (MIGS) subspecialists versus general obstetrician/gynecologists (OB/GYN).</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Quaternary care academic hospital.</div></div><div><h3>Patients or Participants</h3><div>Patients undergoing myomectomy from 3/2015 to 3/2020 were included. Exclusion criterion was non-elective surgery.</div></div><div><h3>Interventions</h3><div>Myomectomy.</div></div><div><h3>Measurements and Main Results</h3><div>The primary outcome was the rate of intraoperative and/or postoperative complications (composite). Multivariable regression analysis included factors that reached statistically significant difference in the univariate analysis and are clinically relevant.</div><div>Of 610 myomectomies, 460 (75.4%) were laparoscopic/robotic, of which 401 (87.2%) were performed by MIGS surgeons. 150 (24.6%) were abdominal, of which 37 (24.7%) were performed by MIGS surgeons.</div><div>Composite complication rates were significantly lower for MIGS surgeons (11.0%) than for general OB/GYNs (26.2%, adjusted odds ratio [aOR] 2.57, 95% confidence interval [CI] 1.39-4.72). Rates of conversion to laparotomy were lower among MIGS surgeons (0.2%) compared to general OB/GYNs (10.2%, p&lt;0.001). Excessive blood loss and/or need for blood transfusion (4.1% vs. 17.4%, aOR 3.61 95% CI 1.45-8.96) and surgery time &gt;90th percentile (aOR 1.86, 95% CI 1.01-3.42) were less common among MIGS surgeons.</div><div>In a sub-analysis of laparoscopic/robotic myomectomies only, composite complication rates (9.5% vs. 25.4%, p=0.001), excessive blood loss and/or need for blood transfusion (2.7% vs. 10.2%, aOR 5.75 95% CI 1.85-17.89) and surgery time &gt;90th percentile (aOR 4.66, 95% CI 2.22-9.78) were lower for MIGS surgeons compared with general OB/GYNs.</div><div>In a sub-analysis of abdominal myomectomies only, composite complication rates were comparable between MIGS and general OB/GYNs surgeons, despite a significantly higher number of fibroids excised per case in the MIGS group (median 21.0 vs. 6.0, p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>Fellowship trained MIGS subspecialists had better surgical outcomes for myomectomy compared with general OB/GYNs, with lower rates of intraoperative and/or postoperative complications, fewer conversions to laparotomy, and less blood loss.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Pages S12-S13"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658059","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":"Expanded Use of the EMIGS Laparobowl® for the Psychomotor Skill Development of Gynecologic Surgeons – “EMIGS Plus”","authors":"DT Nassar ,&nbsp;KE Goldrath ,&nbsp;MG Munro","doi":"10.1016/j.jmig.2024.09.113","DOIUrl":"10.1016/j.jmig.2024.09.113","url":null,"abstract":"<div><h3>Study Objective</h3><div>Develop a set of advanced psychomotor skills using the EMIGS LaparoBowl®-based system, intended for those beyond residency training.</div></div><div><h3>Design</h3><div>Conceptual development stage.</div></div><div><h3>Setting</h3><div>Surgical simulation laboratory/center.</div></div><div><h3>Patients or Participants</h3><div>MIGS fellows and obstetrics &amp; gynecology residency graduates at a single US training center.</div></div><div><h3>Interventions</h3><div>N/A.</div></div><div><h3>Measurements and Main Results</h3><div>Participants would complete a set of laparoscopic exercises using the LaparoBowl® and accessory supplies that requires a set of skills advanced beyond those required in the standard EMIGS Skills exam. Scoring of performance on these advanced tasks may be calculated in identical fashion to standard EMIGS Skills exam.</div></div><div><h3>Conclusion</h3><div>The EMIGS LaparoBowl® and associated elements can be used to facilitate skill development beyond that required of residents. Such skills could form a component of a to-be-developed training and testing program for MIGS Fellows.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page S27"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658450","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":"AAGL Table of Contents","authors":"","doi":"10.1016/j.jmig.2024.10.028","DOIUrl":"10.1016/j.jmig.2024.10.028","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page A1"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658264","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":"Varied Intrauterine Pressure- How to Ensure Complete Hysteroscopic Resection of Large Intramural Fibroids","authors":"L Bar-El,&nbsp;J Danneberger,&nbsp;J Clay,&nbsp;LD Bradley","doi":"10.1016/j.jmig.2024.09.031","DOIUrl":"10.1016/j.jmig.2024.09.031","url":null,"abstract":"<div><h3>Study Objective</h3><div>This video showcases the utilization of varied intrauterine pressure techniques to facilitate complete hysteroscopic resection of large intramural fibroids in a single procedure.</div></div><div><h3>Design</h3><div>This descriptive study presents the surgical technique with a visual demonstration of the procedure's execution.</div></div><div><h3>Setting</h3><div>The video features surgical cases where hysteroscopic myomectomy is performed for the resection of intramural fibroids using the varied intrauterine pressure technique.</div></div><div><h3>Patients or Participants</h3><div>Surgical cases demonstrating the implementation of varied intrauterine pressure techniques for hysteroscopic myomectomy are featured in the video.</div></div><div><h3>Interventions</h3><div>The video elucidates the dynamic nature of operative hysteroscopy, emphasizing the need for constant adjustment of intrauterine pressure throughout the procedure. Key concepts include strategic manipulation of pressure to optimize visualization on the one hand and minimize fluid extravasation on the other, facilitating the successful removal of large fibroids. By dynamically adjusting pressure, fibroids are enucleated from the myometrium into the cavity, enabling comprehensive resection. The technique underscores the importance of recognizing the border between the fibroid and the myometrial fascicles to prevent over-resection. Through immersive visual narration, viewers gain insight into the intricate execution of the procedure, elucidating the principles and intricacies of the varied intrauterine pressure technique.</div></div><div><h3>Measurements and Main Results</h3><div>The video provides a comprehensive visual guide, demonstrating step-by-step execution of the procedure from a first-person perspective. Key concepts and intricacies of the technique are elucidated through narration and animation offering viewers an immersive learning experience.</div></div><div><h3>Conclusion</h3><div>Varied intrauterine pressure techniques offer a promising approach for enhancing the efficacy of hysteroscopic myomectomy in the resection of large intramural fibroids. The video serves to illustrate this technique and its potential clinical applications. Achieving complete resection of large intramural fibroids through this technique has the potential to spare many patients from repeated surgeries and potential complications.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Pages S14-S15"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657997","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":"To See or Not to See? A Visually Directed Approach to the Hysteroscopic Removal of RPOC from an Angular Pregnancy in an Arcuate Uterus","authors":"CAZ Mabini ,&nbsp;T Tam ,&nbsp;S Siddique","doi":"10.1016/j.jmig.2024.09.030","DOIUrl":"10.1016/j.jmig.2024.09.030","url":null,"abstract":"<div><h3>Study Objective</h3><div>This video aims to review the diagnosis and management of retained products of conception (RPOC) and underscores the diagnostic utility of 3D transvaginal ultrasound (TVUS) in differentiating between interstitial ectopic pregnancy (IEP) and angular pregnancy (AP). We demonstrate a visually-directed approach to the hysteroscopic removal of retained products of conception (RPOC) of an angular pregnancy in an arcuate uterus.</div></div><div><h3>Design</h3><div>Case review.</div></div><div><h3>Setting</h3><div>Procedure was performed by a MIGS fellowship-trained surgeon at a community-based hospital.</div></div><div><h3>Patients or Participants</h3><div>A 45-year-old G6P0 with a known septate uterus and prior history of infertility referred by REI for surgical consultation of a suspected IEP versus AP measuring approximately 6 wga on initial TVUS.</div></div><div><h3>Interventions</h3><div>Visually-directed hysteroscopic removal of RPOC.</div></div><div><h3>Measurements and Main Results</h3><div>Complete removal of RPOC confirmed on final pathology. Patient experienced an uncomplicated postoperative course with complete resolution of symptoms.</div></div><div><h3>Conclusion</h3><div>This case highlights the diagnostic capabilities of 3D sonography in distinguishing between an IEP and AP and its implications in management strategies. It also demonstrates the advantages of utilizing a visually-directed hysteroscopic removal of RPOC over traditional dilation and curettage (D&amp;C), in regards to diagnostic and therapeutic efficacy, patient safety, and favorable outcomes.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page S14"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658057","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 Integration of Indocyanine Green (ICG) to Optimize Benign Gynecological Surgery","authors":"Y Youssef ,&nbsp;GN Moawad","doi":"10.1016/j.jmig.2024.09.108","DOIUrl":"10.1016/j.jmig.2024.09.108","url":null,"abstract":"<div><h3>Study Objective</h3><div>To demonstrate a surgical tutorial that highlights the integration of Indocyanine Green (ICG) in complex gynecological surgeries.</div></div><div><h3>Design</h3><div>A video footage illustrating the use of ICG in various surgical settings.</div></div><div><h3>Setting</h3><div>An endometriosis and adenomyosis referral center.</div></div><div><h3>Patients or Participants</h3><div>Patients undergoing robotic-assisted laparoscopic surgery for deep endometriosis, nerve-sparing hysterectomies, and uterus-sparing adenomyosis surgeries.</div></div><div><h3>Interventions</h3><div>Intravenous ICG (IV ICG) is used alongside conventional white light to enhance the detection of superficial endometriosis and assess bowel vascularization before and after anastomosis. Additionally, IV ICG aids in identifying hypogastric nerves, vessels, and ureters during deep endometriosis surgeries. Diluted intraluminal ICG is another beneficial modality that can be injected directly into the ureters during cystoscopy to identify the ureters, administered in the uterine cavity to detect breaches, and optimize adenomyosis excision. Intraluminal ICG can also be injected into the bladder or rectum, allowing for precise mucosal-sparing shaving excision of bladder and bowel endometriosis.</div></div><div><h3>Measurements and Main Results</h3><div>N/A.</div></div><div><h3>Conclusion</h3><div>ICG has various applications in benign gynecological surgery, guiding intraoperative decision-making. It could be considered a potential candidate to further enhance patient safety, decrease morbidity, and improve surgical outcomes.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"31 11","pages":"Page S26"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658454","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}