Facts Views and Vision in ObGyn最新文献

{"title":"Uptake of virtual reality in outpatient hysteroscopy: a prospective observational study.","authors":"Bibi Zeyah Fatemah Sairally, Lucy Davies, Paul P Smith, Siobhan O'Connor, Charlotte Yates, T Justin Clark","doi":"10.52054/FVVO.2025.95","DOIUrl":"https://doi.org/10.52054/FVVO.2025.95","url":null,"abstract":"<p><p>This prospective cohort study evaluated virtual reality (VR) use during outpatient hysteroscopy in a UK tertiary hospital (Nov 2022-Apr 2023). Of 105 eligible women, 38 (36.2%) used VR; most who declined preferred to remain undistracted. Mean pain score was 5.5, slightly lower than the expected 5.7. Mild side effects included dizziness and claustrophobia. Nearly all users (94.7%) would recommend VR, and all rated it \"acceptable\" or \"very acceptable.\" While VR may improve patient experience, limited uptake highlights the importance of tailoring pain management to individual preferences.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving efficacy and safety of surgery in benign gynaecology: the case for indocyanine green.","authors":"Rebecca Mallick, Bomee Kim, Ian Nouvel","doi":"10.52054/FVVO.2025.94","DOIUrl":"https://doi.org/10.52054/FVVO.2025.94","url":null,"abstract":"<p><p>Indocyanine green (ICG) with near-infrared imaging is a valuable adjunct in minimally invasive gynaecological surgery, enhancing anatomical visualisation and surgical precision. This narrative review synthesises current evidence on ICG's clinical applications, safety, and practical implementation in benign gynaecology. ICG supports bladder and ureteric identification, cavity integrity checks, and assessment of bowel and ovarian perfusion. It also aids detection of endometriosis lesions, though diagnostic accuracy remains variable. ICG is safe and feasible, with growing evidence supporting its role across a range of procedures. Further research is needed to standardise protocols, assess cost-effectiveness, and support broader adoption in clinical practice.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising ergonomics in minimally invasive gynaecological surgery: a comprehensive review and practice recommendations.","authors":"Dimitrios Balafoutas, Ralf Joukhadar, Nikos Vlahos","doi":"10.52054/FVVO.2025.12","DOIUrl":"https://doi.org/10.52054/FVVO.2025.12","url":null,"abstract":"<p><strong>Background: </strong>Modern minimally invasive gynaecological surgery greatly contributes to women's health; however, it can be physically demanding for surgeons. A plethora of available data shows that the optimisation of ergonomics in the operating room (OR) is crucial for the health and efficiency of surgeons.</p><p><strong>Objectives: </strong>To provide an overview of the importance of ergonomics and clinically useful, concise recommendations.</p><p><strong>Methods: </strong>A literature review with critical analysis of available data.</p><p><strong>Main outcome measures: </strong>Impact of ergonomics on the prevalence of musculoskeletal disorders (MSDs), fatigue levels, efficiency and subjective comfort among surgeons.</p><p><strong>Results: </strong>Evidence suggests that MSDs are highly prevalent among minimally invasive gynaecological surgeons and that several ergonomic interventions can greatly reduce muscle strain and improve clinical practice, with the most important being the planning of brief intraoperative breaks, the selection of proper laparoscopic instruments and the positioning of the operating table and monitor at the correct height. The adoption of robotic surgery can also improve surgical ergonomics. Clinical practice recommendations for ergonomic improvement in gynaecological laparoscopy based on the existing evidence are provided.</p><p><strong>Conclusions: </strong>Surgeons must be aware of the optimal ergonomic settings in the OR and impose measures to reduce risks and achieve a comfortable environment.</p><p><strong>What is new?: </strong>A comprehensive, praxis-oriented review with exact ergonomic advice for minimally invasive gynaecological surgeons.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of virtual reality technology in the era of See & Treat hysteroscopy: a randomised controlled trial.","authors":"Brunella Zizolfi, Virginia Foreste, Maria Giuseppina Trinchillo, Danilo Borrelli, Alessandra Gallo, Maria Chiara De Angelis, Fabiola Nardelli, Attilio Di Spiezio Sardo","doi":"10.52054/FVVO.2025.48","DOIUrl":"10.52054/FVVO.2025.48","url":null,"abstract":"<p><strong>Background: </strong>In the context of outpatient hysteroscopy (OPH), performing a single procedure integrating the operative and diagnostic part is known as \"See & Treat hysteroscopy\". The virtual reality (VR) technology provides an immersive virtual environment that can provide a non-invasive analgesic. To date, there is limited evidence regarding its use in the OPH setting.</p><p><strong>Objectives: </strong>To evaluate the feasibility and effectiveness of VR technology for pain and anxiety management in OPH.</p><p><strong>Methods: </strong>Unblinded, prospective, randomised controlled trial, conducted at the Hysteroscopy Unit of the University of Naples \"Federico II\" between May and July 2024. Women aged 18-70 years, indicated for OPH, were randomised into a control group (standard OPH care) and an intervention group (OPH care with the addition of a VR headset).</p><p><strong>Main outcome measures: </strong>Pain and anxiety were assessed through subjective measures: numerical rating scale (NRS) scores before and after the procedure, and objective measures: heart and respiratory rate pre- and during the procedure. Satisfaction, time, and success rates were also evaluated.</p><p><strong>Results: </strong>Overall, 116 women were enrolled. The VR group compared to the control group reported significantly lower mean standard deviation NRS scores for pain [3.9 (2.7) vs. 5.4 (3.0); mean difference 1.5, 95% confidence interval (CI) 0.4 to 2.5] and anxiety [3.2 (2.1) vs. 4.8 (2.8); mean difference 1.6, 95% CI 0.7 to 2.5] respectively. Regarding satisfaction, 96.5% of the VR group would use the headset again, whereas 3.5% requested its removal. All women in the control group desired a distraction. No serious adverse events were reported.</p><p><strong>Conclusions: </strong>VR technology proved feasible and effective for pain and anxiety management in OPH, particularly during operative procedures.</p><p><strong>What is new?: </strong>Its use can support the implementation of the See & Treat philosophy.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual reality for pain relief in gynaecological care.","authors":"Josep Estadella-Tarriel","doi":"10.52054/FVVO.2025.178","DOIUrl":"https://doi.org/10.52054/FVVO.2025.178","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"10-step approach for laparoscopic pectopexy combined with supracervical hysterectomy.","authors":"Angelos Daniilidis, Anna Pitsillidi, Georgios Grigoriadis","doi":"10.52054/FVVO.2025.99","DOIUrl":"https://doi.org/10.52054/FVVO.2025.99","url":null,"abstract":"<p><strong>Background: </strong>Apical prolapse, characterised by the descent of the vaginal apex, uterus, or cervix, is commonly treated by laparoscopic sacrocolpopexy, the current gold standard. Laparoscopic pectopexy (LP) has emerged as an effective alternative, particularly advantageous for obese patients due to its technical approach.</p><p><strong>Objectives: </strong>To demonstrate a standardised 10-step surgical technique for performing laparoscopic pectopexy combined with supracervical hysterectomy, aiming to provide a safe and reproducible method for the treatment of apical prolapse.</p><p><strong>Participant: </strong>A 68-year-old female patient presenting with symptomatic, advanced apical pelvic organ prolapse (POP-Q stage IV) consented to the procedure.</p><p><strong>Intervention: </strong>The patient underwent LP following a 10-step surgical protocol: (1) division of the round ligaments and dissection towards the pelvic sidewall, (2) identification of the iliopectineal ligament, (3) division of the uterovesical peritoneum and development of the vesicovaginal space, (4) supracervical hysterectomy, (5) opening of the rectovaginal space, (6) closure of the cervical canal, (7) mesh insertion and fixation to cervix, anterior and posterior vagina, (8) bilateral anchoring of the mesh lateral arms to the iliopectineal ligaments, (9) closure of the overlying peritoneum, and (10) morcellation of the uterine corpus. The surgery was completed with minimal blood loss and no intraoperative complications.</p><p><strong>Conclusions: </strong>LP combined with supracervical hysterectomy is a safe, effective, and reproducible surgical option for apical prolapse repair, demonstrating favourable perioperative outcomes and early discharge.</p><p><strong>What is new?: </strong>This video-based demonstration introduces a standardised 10-step approach to LP combined with supracervical hysterectomy, facilitating adoption of this technique by surgeons with advanced minimally invasive skills, and highlighting its potential benefits, especially in obese patients.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Euro-Chinese consensus on accessory cavitated uterine malformation^*,†.","authors":"Lan Zhu, Zichen Zhao, Attilio Di Spiezio Sardo, Maribel Acién, Joel Naftalin, Thierry Van den Bosch, Charleen Sze-Yan Cheung, Dabao Xu, Xiaowu Huang, Grigoris Grimbizis","doi":"10.52054/FVVO.2025.62","DOIUrl":"https://doi.org/10.52054/FVVO.2025.62","url":null,"abstract":"<p><strong>Background: </strong>Accessory cavitated uterine malformations (ACUMs) are a rare obstructive uterine anomaly that remains poorly understood, posing challenges for clinical management. The aetiopathogenesis is hypothesised to involve the duplication and persistence of ductal Müllerian tissue usually near the round ligament attachment, potentially related to gubernaculum dysfunction. ACUM is specifically classified by Acién's system, though rare variants necessitate continued international research to refine classification frameworks.</p><p><strong>Objectives: </strong>This consensus aims to develop good clinical practice recommendations for the pathophysiology, terminology, clinical presentation, diagnosis, and treatment of ACUM.</p><p><strong>Methods: </strong>A working group consisted of Chinese and European experts, after approval from the European Society for Gynaecological Endoscopy, developed recommendations based on the best available evidence and experts' opinion.</p><p><strong>Results: </strong>Patients with ACUM present with typical symptoms such as dysmenorrhea and dyspareunia, and atypical symptoms, including gastrointestinal and generalised pelvic pain. Diagnostic criteria include isolated cavitated lesions in the anterolateral myometrium near the round ligament, lined by endometrial tissue and filled with haemorrhagic fluid, surrounded by a myometrial mantle with concentric orientation of myometrial fibres, and typically associated with a normal uterine cavity. Diagnosis is most accurately made through ultrasound and magnetic resonance imaging. Surgical excision of the ACUM is considered the definitive treatment offering near-complete symptom resolution, and minimally invasive approach should be preferred when possible. The timing of surgery and the interval before attempting pregnancy remain unclear. The mode of delivery post-surgery is individualised based on the degree of myometrial involvement.</p><p><strong>Conclusions: </strong>The current consensus summarises the existing evidence on ACUM providing good clinical practice recommendations for their management. Existing gaps in the understanding and management of ACUMs, highlight the need for further research to guide clinical decision-making.</p><p><strong>What is new?: </strong>Good clinical practice recommendations for ACUM aiming to understand and optimise their management.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian remnant syndrome: an unsuspected diagnosis.","authors":"Irene Colombi, Gabriele Centini, Francesco Giuseppe Martire, Alessandro Ginetti, Alberto Cannoni, Lucia Lazzeri, Filiberto Maria Severi, Errico Zupi","doi":"10.52054/FVVO.2025.49","DOIUrl":"https://doi.org/10.52054/FVVO.2025.49","url":null,"abstract":"<p><strong>Background: </strong>Ovarian remnant syndrome (ORS) is a rare condition defined by the presence of residual tissue of ovarian origin, histologically confirmed in a woman with a previous salpingo-oophorectomy, usually as a result of difficult surgery in the presence of adhesions.</p><p><strong>Objectives: </strong>To evaluate the existing literature on ORS.</p><p><strong>Methods: </strong>A narrative review was performed. A search for relevant articles was carried out in PubMed for the period from January 2014 to July 2024. Three original cases of ORS are also reported.</p><p><strong>Main outcome measures: </strong>All available literature on the subject was analysed and articles relevant to the topic of the review were included. Additional articles were reviewed to provide an overview of the issue.</p><p><strong>Results: </strong>A total of 10 different cases of ORS found in the literature were analysed, together with 3 original cases.</p><p><strong>Conclusions: </strong>The presence of distorted anatomy and extensive adhesions may lead to an increased risk of residual ovarian tissue. Residual ovarian tissue may sometimes evolve into a malignant lesion. When difficult oophorectomy is suspected, the surgeon must proceed with caution to complete oophorectomy. Strict follow-up is essential to detect ORS.</p><p><strong>What is new?: </strong>This is the first narrative review including cases described in the literature and three new original cases. Our work provides a comprehensive and global view of this condition and may help in clinical practice to reduce the risk of ORS through appropriate surgical planning and possibly early diagnosis of the syndrome.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic management of presacral retroperitoneal haematoma after sacrocolpopexy.","authors":"Giovanni Panico, Sara Mastrovito, Davide Arrigo, Camilla Riccetti, Giuseppe Campagna, Giovanni Scambia, Alfredo Ercoli","doi":"10.52054/FVVO.2025.33","DOIUrl":"https://doi.org/10.52054/FVVO.2025.33","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive sacrocolpopexy (SCP) has emerged as the gold standard procedure for pelvic organ prolapse. However, it entails a deep surgical dissection, essential for proper mesh positioning, and is not devoid of intraoperative and postoperative complications, including sporadic cases of potentially life-threatening intraoperative bleeding or postoperative haematomashaematomas. The appropriate management of bleeding complications in this area varies depending on the individual case and presence of hemodynamic instability, from emergency open surgery to a conservative wait-and-see approach.</p><p><strong>Objectives: </strong>To illustrate an effective method for the management of bleeding complications of SCP and raise awareness about this unusual complication.</p><p><strong>Participant: </strong>A 69-year-old woman underwent laparoscopic revision surgery due to evidence of a voluminous presacral haematoma on the second postoperative day after SCP.</p><p><strong>Intervention: </strong>The effectiveness of minimally invasive revision surgery for the management of voluminous presacral haematoma following laparoscopic SCP was assessed. Laparoscopic revision surgery allowed for the complete drainage of the haematoma without complications, resulting in discharge on postoperativeday seven.</p><p><strong>Conclusions: </strong>The video reviews the steps of the laparoscopic approach for performing a successful and safe revision surgery to manage presacral haematomas after SCP, and illustrates the procedure's adaptability, also providing specific tips and tricks to successfully perform this procedure without the need for mesh removal, thereby preserving the best outcome for the patient.</p><p><strong>What is new?: </strong>This is the first description of the surgical management of a retroperitoneal hematoma following colposacropexy. The study's conclusions provide a valuable resource for gynecologists facing patients presenting with a retroperitoneal presacral hematoma after prosthetic surgery for prolapse.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of single step hysteroscopic myomectomy: fibroid size is the most significant factor based on data from a single centre and surgeon.","authors":"Ursula Catena, Eleonora La Fera, Diana Giannarelli, Andrea Scalera, Emma Bonetti, Federica Bernardini, Federica Campolo, Francesco Fanfani, Giovanni Scambia","doi":"10.52054/FVVO.2025.10","DOIUrl":"https://doi.org/10.52054/FVVO.2025.10","url":null,"abstract":"<p><strong>Background: </strong>Uterine fibroids are the most common benign solid neoplasms of the uterus. Hysteroscopy represents the gold standard treatment for submucosal fibroids.</p><p><strong>Objectives: </strong>The aim of this study was to retrospectively analyse all consecutive symptomatic patients diagnosed with the International Federation of Gynecology and Obstetrics G0-G3 fibroids who underwent hysteroscopic myomectomy, to identify factors that may influence the feasibility of single step myomectomy.</p><p><strong>Methods: </strong>The study included all consecutive symptomatic patients, diagnosed with G0-G3 fibroid. Surgical procedure was performed by a single experienced surgeon. All patients underwent postoperative hysteroscopic control 30-40 days after the procedure.</p><p><strong>Main outcomes measures: </strong>Evaluation of feasibility of hysteroscopic myomectomy in a single surgical step.</p><p><strong>Results: </strong>One hundred and twenty-five patients were included. In 97 women (77.6%) the fibroid was removed in one single step; 28 patients (22.4%) had a residual fibroid. Of these patients, in 10 cases (35.7%) the residual fibroid was removed during the office hysteroscopic control, 16 (57.2%) and 2 (7.1%) patients required II- and III-time myomectomy, respectively. 85.6% of patients did not need a second time surgery under general anaesthesia. At univariate and multivariate analysis, diameter was found to be the parameter most related to single-step fibroid removal with <i>P</i>=0.001 and <i>P</i><0.001 respectively. For G0-3 fibroids <3 cm in 72% (66/92) of cases the 15 Fr mini-resectoscope was used with one step myomectomy in 89.4% of cases.</p><p><strong>Conclusions: </strong>In expert hands, single step hysteroscopic myomectomy is feasible for G0-3 fibroids. The possibility to use miniaturized instruments for myomectomy may improve the surgical outcomes and prevent intra- and post-operative complications, in particular uterine perforation by avoiding cervical dilation. Further studies are needed to evaluate the true efficacy of 15 Fr mini-resectoscope in the removal of G0-G3 fibroids <3 cm.</p><p><strong>What is new?: </strong>Hysteroscopic myomectomy in a single surgical step is feasible for G0-G3 fibroids, with diameter being the only independent factor influencing the success of the procedure. In expert hands, the success rate of single step myomectomy by using miniaturized instruments in fibroids ≤3 cm, is 89.4%.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}