Gynecology and Minimally Invasive Therapy-GMIT最新文献

{"title":"Size Does Matter: Long-term Efficacy and Safety of Minimesh in Transvaginal Pelvic Organ Prolapse Repair.","authors":"Ronen Samuel Gold, Jonatan Neuman, Menahem Neuman, Asnat Groutz","doi":"10.4103/gmit.GMIT-D-24-00016","DOIUrl":"10.4103/gmit.GMIT-D-24-00016","url":null,"abstract":"<p><strong>Objectives: </strong>The Food and Drug Administration banned the use of transvaginal mesh for pelvic organ prolapse (POP) repair due to safety and efficacy concerns. The present study aimed to evaluate the safety and efficacy of a novel lightweight minimesh (SERATOM^® MN) for transvaginal repair of significant primary or recurrent POP.</p><p><strong>Materials and methods: </strong>A cohort study of 134 consecutive patients (mean age: 61.7 ± 9.4 years, range: 46-88) who underwent transvaginal minimesh repair (SERATOM^® MN) for Stage III or IV POP was retrospectively analyzed. At 10 years postoperatively, a telephone survey was conducted to assess long-term outcomes. The mean postoperative follow-up was 9.8 ± 0.45 years (range: 9.4-10.9 years). A comparison was made between 99 (73.9%) patients who underwent primary mesh-assisted POP repair versus 35 (26.1%) patients who underwent mesh-assisted surgery for recurrent POP. Primary outcomes comprised postoperative complications, POP recurrence rate, and subjective long-term satisfaction.</p><p><strong>Results: </strong>The mean duration of surgery and blood loss was 30.8 min and 32.4 ml, respectively. Most patients (98.5%) were discharged on the day of surgery or the day after. There were no significant intra- or early postoperative complications, except for one case of postoperative perineal hematoma that was managed conservatively. Of the initial 134 patients, 110 (82%) were available for long-term follow-up. There were no mesh erosions. <i>De novo</i> dyspareunia occurred in 6.4%. Rates of recurrent POP repair were similar among patients who had mesh-assisted repair after previous pelvic surgery (23.3%) and those who had primary mesh-assisted repair (15%).</p><p><strong>Conclusion: </strong>Transvaginal SERATOM^® MN minimesh is a safe, effective, and durable surgical option for significant POP repair.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"15 1","pages":"30-35"},"PeriodicalIF":2.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Indocyanine Green in the Detection of Sentinel Lymph Nodes in Laparoscopic Staging Surgery for Endometrial Cancer: A Retrospective Cohort Study.","authors":"Chin-Tzu Tien, Dah-Ching Ding","doi":"10.4103/gmit.GMIT-D-24-00020","DOIUrl":"10.4103/gmit.GMIT-D-24-00020","url":null,"abstract":"<p><strong>Objectives: </strong>Indocyanine green (ICG) sentinel lymph node (SLN) mapping has been used in endometrial cancer. We aimed to report our experience in the lymph node detection rate, negative predictive value (NPV), distribution, and risk factors of laparoscopic ICG SLN mapping in patients with endometrial cancer.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed patients with endometrial cancer who underwent laparoscopic staging surgery with ICG SLN mapping between January 2019 and July 2023. Thirty-one patients were included. ICG was injected into the cervix at 2-4 points. The outcomes were detecting and mapping failure rates and subsequent adjuvant therapy. Kruskal-Wallis and Chi-square tests were used for continuous and categorical variables. Statistical significance was set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>The overall detection rate of SLN was 80.6% (25/31). Both NPV and sensitivity were 100%. Bilateral SLN was detected in 52% (13/25) of cases. The right and left sides were visualized in 84% (21/25) and 68% (17/25) cases, respectively. Complete pelvic lymph node dissection was done when SLN mapping failed. The most common SLN locations were the right and left external iliac regions. SLN detection in the para-aortic area was observed in 20% (5/25) cases. Twenty-five patients had positive SLN mapping. Two patients (8%) had positive lymph node metastasis: one underwent bilateral pelvic sentinel lymphadenectomy plus para-aortic sentinel lymphadenectomy with the final histologic type of Grade 2 endometrioid carcinoma (Stage IIIC1), and the other underwent bilateral pelvic lymphadenectomy with the final histologic type of serous carcinoma (Stage IIIC1). Sixteen patients had high-grade stage IA or above; five received postoperative adjuvant chemotherapy, five received postoperative radiotherapy, four received chemotherapy with radiotherapy, and two were followed up.</p><p><strong>Conclusion: </strong>The NPV and sensitivity of ICG application in our study were high. The metastatic status of the lymph nodes is important for future therapeutic planning for advanced endometrial cancer.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"15 1","pages":"22-29"},"PeriodicalIF":2.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Strategies to Improve Healthcare Provider - Focus on Nurses.","authors":"Rui-Bin Huang, Ming-Hsuan Su, Hui-Ying Chiang, Ming-Ping Wu","doi":"10.4103/gmit.gmit_146_23","DOIUrl":"10.4103/gmit.gmit_146_23","url":null,"abstract":"<p><p>Nursing requires significant physical and emotional effort, leading to high workplace stress. Most nurses are young, female, and of childbearing age, facing job-related stress and personal health challenges. This review explores three common health issues among female nurses: menstrual disorders, early pregnancy loss, and mental illness, which contribute to absenteeism and reduced job performance. Nurses experience higher rates of menstrual irregularity, dysmenorrhea, and pregnancy loss than nonmedical workers, along with increased anxiety and depression but lower healthcare-seeking due to stigma. Risk factors include night shifts, long hours, and insomnia. Nurses also prefer minimally invasive treatments for benign uterine conditions due to greater medical knowledge. To enhance nurses' well-being, we suggest strategies promoting diversity, equity, and inclusion to improve their work environment and overall health.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"15 2","pages":"108-113"},"PeriodicalIF":2.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13299107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dienogest Therapy Against the Combined Oral Contraceptive Pill in Deep Infiltrating Endometriosis Cases: A Systematic Review and Meta-Analysis.","authors":"Indra Adi Susianto, Neni Susilaningsih, Syarief Taufik Hidayat, Banundari Rachmawati","doi":"10.4103/gmit.GMIT-D-24-00021","DOIUrl":"10.4103/gmit.GMIT-D-24-00021","url":null,"abstract":"<p><strong>Objectives: </strong>Deep endometriosis (DE) is a common disease in 15%-45% of childbearing-age women. Combined oral contraceptive pill (COCP) and dienogest have been used for decades to treat many forms of endometriosis after laparoscopy surgery. This study aims to assess the latest evidence on the effect of dienogest compared with the COCP on the pain scores of dysmenorrhea, dyspareunia, and dyschezia in DE patients.</p><p><strong>Materials and methods: </strong>Data from 1363 samples of 9 research literature were taken. The postlaparoscopy surgical patients are divided into the dienogest group and the COCP group. The main symptoms were assessed using a visual analog scale for dysmenorrhea, dyspareunia, and dyschezia in addition to the demographic data from patients of the 2 study groups being compared.</p><p><strong>Results: </strong>Seven studies show significant differences in dysmenorrhea scores between the dienogest group and the COCP group. Dyspareunia scores in cases of postoperative endometriosis implants showed 6 studies with lower dyspareunia scores in the dienogest group than the COCP group, while 3 other articles showed higher dyspareunia scores in the dienogest group than in the COCP group. Assessment of the risk of bias in the meta-analysis of the therapeutic effectiveness of the Egger regression test shows nonsignificant results which proves no tendency for publication bias (<i>t</i> = 1.111; df = 7.00; <i>P</i> = 0.303).</p><p><strong>Conclusion: </strong>Dienogest is an effective pain treatment and it is effective for a subgroup of patients with endometriosis and pelvic pain. It is well tolerated as a pain treatment in adenomyosis patients without complications of severe uterine enlargement or severe anemia.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"15 2","pages":"145-152"},"PeriodicalIF":2.1,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13299015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Different Laparoscopic Suturing Techniques in a Case of Recurrent Cornual Ectopic Pregnancy 1 Year Apart.","authors":"Neset Gumusburun","doi":"10.4103/gmit.GMIT-D-24-00007","DOIUrl":"10.4103/gmit.GMIT-D-24-00007","url":null,"abstract":"<p><p>Although cornual ectopic pregnancy is a rare condition in obstetric practice, it poses a great risk for pregnant women due to bleeding and hysterectomy. In this article, we aimed to minimise bleeding with two different suturing techniques after laparoscopic cornuostomy in a patient with recurrent cornual pregnancy (CP) 1 year apart. In the first operation, the cornuostomy was performed laparoscopically and the bleeding site was sutured one by one in a single layer with 2-0 monofilament absorbable suture. The same patient became spontaneously pregnant 1 year later and was hospitalised again with the diagnosis of CP. Laparoscopically, 3-0 barbed absorbable suture was applied around the gestational sac in the form of purse-string and bleeding was minimised by creating a tourniquet. In conclusion, barbed sutures can be easily applied laparoscopically as a purse-string in cornual pregnancies and surgical success can be increased by minimising the amount of bleeding.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"15 2","pages":"170-173"},"PeriodicalIF":2.1,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13299010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine-sparing Robot-assisted Sacrocolpopexy for Pelvic Organ Prolapse in Women Aiming for Pregnancy.","authors":"Wakiko Shimomai, Hiroe Ito, Jiro Suzuki, Satoshi Yanagida, Aikou Okamoto, Keiichi Isaka","doi":"10.4103/gmit.GMIT-D-24-00042","DOIUrl":"10.4103/gmit.GMIT-D-24-00042","url":null,"abstract":"<p><p>Pelvic organ prolapse (POP) is frequently encountered in elderly women. However, it can also affect relatively young women of reproductive age. Here, we present three cases of uterine-sparing robot-assisted sacrocolpopexy (RSC) in women aiming for pregnancy. All cases were diagnosed with POP-Q stage III. Utilizing the da Vinci X or Xi robotic surgical system, they underwent uterine-sparing RSC with dual mesh anterior and posterior walls. The anterior wall mesh was not a Y-shaped mesh encircling the cervix; The anterior wall mesh was not a Y-shaped mesh encircling the cervix; rather, it was placed only through the window of the right broad ligament to minimize uterine artery compression caused by the mesh. No perioperative complications or short-term recurrences were noted. Uterine-sparing robotic-assisted sacrocolpopexy represents a valuable surgical option for patients with POP who wish to become pregnant.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"15 1","pages":"75-79"},"PeriodicalIF":2.1,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Reconstructive Repair of Uterine and Rectal Prolapse with Posterior Perineal Hernia after Wide Resection of Soft-tissue Sarcoma of the Buttocks: A Case Report.","authors":"Divina Yumul Soliza, Masayoshi Nomura, Antonette Ramos Pesebre, Tokumasa Hayashi, Shino Tokiwa, Mika Nagae, Kojiro Nishio, Tomoka Obuchi, Moeko Kuriyama, Purim Ruanphoo","doi":"10.4103/gmit.gmit_69_24","DOIUrl":"10.4103/gmit.gmit_69_24","url":null,"abstract":"<p><p>Pelvic organ prolapse (POP) with concomitant perineal hernia is an infrequent complication following the resection of soft-tissue sarcoma of the buttocks (BSTS). If present, these cases may be secondary to abdominoperineal resection for rectal carcinoma. Here, we report a rare case of uterine and rectal prolapse with posterior perineal hernia following extensive resection and flap placement for BSTS. We performed laparoscopic subtotal hysterectomy, sacrocolpopexy, and ventral rectopexy for POP reconstruction. In addition, mesh was placed on the pelvic surface of the sacrum to further reinforce the pelvic floor. Long-term benefits and efficiency are achieved through a multidisciplinary surgical approach that addresses both POP and perineal hernia, strengthens the pelvic floor, and may prevent recurrence while also improving patient quality of life.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"15 1","pages":"80-83"},"PeriodicalIF":2.1,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Strategy for Uterine Parametrium Tissue Dissection Using Robotically Enhanced Surgical Anatomy for Robot-assisted Hysterectomy.","authors":"Yasuhito Tanase","doi":"10.4103/gmit.GMIT-D-25-00006","DOIUrl":"10.4103/gmit.GMIT-D-25-00006","url":null,"abstract":"<p><p>The concept of robotically enhanced surgical anatomy (RESA) has recently been proposed. We concur with the concept of RESA and have been pursuing surgical techniques that benefit from the attribute of robot-assisted surgery. We evaluated RESA and its significance for organ dissection and cavity development in total robot-assisted hysterectomy. Pelvic cavity development and organ dissection can be achieved naturally by applying the appropriate counter traction and carefully dissecting the areolar connective tissue identified by RESA. For uterine parametrial tissue, which is based on the bunching technique, the uterine vessels, including the deep uterine vein, can be readily isolated and ligated through RESA. In some cases, the vaginal vessels can also be isolated and bunching technique can be minimized. Currently, we are striving to perform robotic surgeries that maximize the use of RESA. The following video shows some of the robotic-assisted surgeries that we perform in our department.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"14 4","pages":"348-350"},"PeriodicalIF":1.7,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12626172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foley Catheter Tourniquet in Laparoscopic Myomectomy.","authors":"Zahar Azuar Zakaria, Fadzlin Mohd Adzlan, Nur Amirah Zulwardi, Nadhirah Mohd Norman","doi":"10.4103/gmit.GMIT-D-24-00060","DOIUrl":"10.4103/gmit.GMIT-D-24-00060","url":null,"abstract":"","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"14 4","pages":"359-360"},"PeriodicalIF":1.7,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12626171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometrial Fibroid Fistula Formation after Uterine Fibroid Embolization: A Case Report.","authors":"Mehak Gadh, Chloe Issa, Ansh Bhatia, Zachary Stauber, Arnav Bhatia, Shivank Bhatia","doi":"10.4103/gmit.GMIT-D-24-00061","DOIUrl":"10.4103/gmit.GMIT-D-24-00061","url":null,"abstract":"<p><p>Uterine fibroids are benign tumors that originate from the smooth muscle of the uterus. They are often associated with menorrhagia, pelvic pain, infertility, and a sensation of pressure. The symptoms depend on the location of the fibroids, with submucosal fibroids more commonly causing menorrhagia due to their proximity to the endometrium. Meanwhile, intramural and subserosal fibroids typically do not cause excessive bleeding unless they disrupt the endometrial lining. Uterine Fibroid embolization (UFE) is a minimally invasive treatment for fibroids that works by occluding the arteries supplying the fibroids, leading to ischemic necrosis and fibroid shrinkage. This case report describes a 40-year-old female who presented with heavy menstrual bleeding, pelvic pain, and increased urinary frequency due to an endometrial uterine fibroid - for which she underwent a UFE. Follow-up at 3.5 months post-UFE revealed reduced uterine size and menstrual symptom improvement. At one year post-procedure, the patient developed increased pelvic pressure and heavier bleeding compared to her post-UFE baseline. MRI obtained 9 months later displayed a reduction in the size of the fundal fibroid. A new finding of a fistula between this fundal fibroid and the endometrial canal was also observed and confirmed with an in-office hysteroscopy. Conservative management, including iron supplementation, pain control, and serial ultrasound monitoring, resulted in symptom resolution within two weeks.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"14 4","pages":"351-354"},"PeriodicalIF":1.7,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12626149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}