Facts Views and Vision in ObGyn最新文献

{"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":"121-129"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369403","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":"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":"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":"170-179"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259023","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":"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":"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":"192-203"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477166","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":"Pre-operative GnRH agonist use and surgical outcomes in rectovaginal/colorectal endometriosis: an international multicentre prospective cohort study.","authors":"Munazzah Rafique, Christian Becker, Jonathan Lewin, Arvind Vashisht, Ertan Sarıdoğan, Martin Hirsch","doi":"10.52054/FVVO.2025.12990","DOIUrl":"10.52054/FVVO.2025.12990","url":null,"abstract":"<p><strong>Background: </strong>Rectovaginal/colorectal endometriosis is severe form of endometriosis requiring complex surgery, where pre-operative gonadotrophin releasing hormone agonists (GnRHa) are used to improve the surgical outcomes but the evidence supporting this is limited.</p><p><strong>Objectives: </strong>To evaluate the association between pre-operative use of GnRHa and perioperative and postoperative complications in patients undergoing surgery for rectovaginal or colorectal endometriosis.</p><p><strong>Methods: </strong>We analysed prospectively collected data from British Society for Gynaecological Endoscopy-accredited endometriosis centres between 2009 and 2021. Multivariable logistic regression analysis was performed to model the odds of each complication by pre-operative GnRHa use, controlling for patient age, body mass index, smoking status, whether a hysterectomy was performed, history of previous endometriosis surgery and surgical complexity.</p><p><strong>Main outcome measures: </strong>The association of GnRHa use with perioperative and postoperative complications.</p><p><strong>Results: </strong>We included 9,433 patients aged 18-55 years from 101 specialist endometriosis centres from six countries including UK, USA, Sri Lanka, Saudi Arabia, Turkey and Iran. Patients receiving pre-operative GnRHa were associated with higher rate of perioperative complications [odds ratio (OR): 1.31, 95% confidence interval (CI): 1.08-1.59, <i>P</i>=0.007], late complications (OR: 1.477, 95% CI: 1.15-1.9, <i>P</i>=0.002) and pelvic haematoma (OR: 2.251, 95% CI: 1.41-3.64, <i>P</i><0.001). After controlling for confounding factors, GnRHa use remained significantly associated with colostomy (aOR: 4.05: 95% CI: 1.51-12.7, <i>P</i>=<0.001] pelvic haematoma (aOR: 3.08, 95% CI: 1.72-5.75, <i>P</i><0.001) and abscess (aOR: 2.25, 95% CI: 1.10-4.79, <i>P</i>=0.029). Health related quality of life (HR-QOL) improved in the Pre-GnRHa group at 12 months and 24 months (mean difference 2.09/100, 95% CI, 0.27-3.92, <i>P</i>=0.025) and (mean difference 2.85/100, 95% CI 0.55-5.16, <i>P</i>=0.015).</p><p><strong>Conclusions: </strong>Pre-operative use of GnRHa has been associated with a higher incidence of perioperative and late complications, including significantly increased odds of colostomy, pelvic hematoma and abcess formation. There is need of careful patient counselling and further prospective research to clarify the pre-operative use of GnRHa in rectovaginal/colorectal endometriosis.</p><p><strong>What is new?: </strong>There is need of caution use of pre-operative GnRHa in deep rectovaginal/colorectal endometriosis surgery due to increased association of the risks of complications such as colostomy, pelvic haematoma and abcess. Despite long-term improvement in HR-QOL, there is need for careful patient selection and counselling.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"101-109"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112062","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":"A total endoscopic levonorgestrel-releasing intrauterine system (LNG-IUS) placement: a novel approach for obese patients with early-stage endometrial cancer.","authors":"Ursula Catena, Emma Bonetti, Omer Moore, Eleonora La Fera, Federica Bernardini, Giorgia Dinoi, Giovanni Scambia, Francesco Fanfani","doi":"10.52054/FVVO.2025.11","DOIUrl":"10.52054/FVVO.2025.11","url":null,"abstract":"<p><strong>Background: </strong>Endometrioid adenocarcinoma is a common endometrial cancer, linked to excess oestrogen exposure. Obesity, a major risk factor, can lead to unopposed oestrogen and endometrial cancer. Surgery is the standard treatment for early-stage disease. However, obese patients with a high body mass index (BMI) may be unsuitable due to surgical risks.</p><p><strong>Objectives: </strong>We present a novel completely endoscopic technique for placing a levonorgestrel-releasing intrauterine system (LNG-IUS) in an obese patient with early-stage endometrioid adenocarcinoma (FIGO 2009 stage IA, grade 1) who was not a surgical candidate due to multiple comorbidities.</p><p><strong>Participant: </strong>An 82-year-old obese woman (BMI: 48.9 kg/m²) with abnormal uterine bleeding was referred to our gynaecological department. Endometrial thickening, without spread beyond the uterus, was observed by transvaginal ultrasound and magnetic resonance imaging, and final diagnosis of early stage endometrioid adenocarcinoma was confirmed by hysteroscopic endometrial biopsy. Due to her high-risk status and anatomical challenges, initial management involved oral medication and regular biopsies. After a year of presence of a stable disease, a new technique for LNG-IUS placement was attempted.</p><p><strong>Intervention: </strong>The LNG-IUS was successfully placed within the uterine cavity using a 5 mm XL Bettocchi hysteroscope and a 5 Fr grasping forceps, without needing vaginal speculum or cervical grasping. The patient tolerated the procedure well. Follow-up at six months was negative, without signs of recurrence.</p><p><strong>Conclusions: </strong>This case demonstrates the feasibility and safety of a total endoscopic LNG-IUS placement as an alternative for obese patients with early-stage endometrioid adenocarcinoma who are not surgical candidates.</p><p><strong>What is new?: </strong>This is the first description of a total endoscopic technique for LNG-IUS placement performed without speculum or anesthesia.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"212-215"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129106","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 management of caesarean scar pregnancy in 10 steps.","authors":"Nikolaos Kathopoulis, Konstantinos Kypriotis, Athanasios Douligeris, Michael Panagiotopouloz, Ioannis Chatzipapas, Athanasios Protopapas","doi":"10.52054/FVVO.2025.14","DOIUrl":"10.52054/FVVO.2025.14","url":null,"abstract":"<p><strong>Background: </strong>Caesarean scar pregnancy (CSP) is a pathologic entity with rising incidence over recent years. So far, there are many treatment methods and protocols suggesting surgical or medical interventions and their combinations. More and more laparoscopic surgery is applied to treat scar pregnancy with excellent results. A proper surgical strategy is a key point for optimal surgical outcome.</p><p><strong>Objectives: </strong>To present a standardised technique for the laparoscopic management of CSP.</p><p><strong>Participant: </strong>Patients with CSP having the indication of laparoscopic treatment.</p><p><strong>Intervention: </strong>The video presents a systematic approach of the laparoscopic treatment of CSP clearly divided into 10 steps: 1. Prepare the surgery; 2. Inspection of the pelvis; 3. Bladder dissection; 4. Preventive haemostasis; 5. Hysterotomy; 6. Evacuation of conception products; 7. Excision of niche scar tissue; 8. Evacuation of the uterine cavity; 9. Suturing of the uterine defect; 10. Removal of the uterine artery clips. The main outcome measures are the efficacy of the laparoscopic management of CSP and the postoperative uterine reconstruction in terms of ultrasonic measurement of the isthmic myometrial layer thickness. Patients are released from the hospital the day after the surgery, and a follow-up ultrasound is scheduled three months post-operatively. In the case presented in the video, the myometrial wall is increased from 3 mm preoperatively to 13 mm three months postoperatively.</p><p><strong>Conclusions: </strong>The main advantage of this technique is the ability to treat CSP, remove the uterine isthmocele, and reconstruct the lower uterine segment simultaneously. The 10 steps proposed in a logical sequence may shorten the surgery's learning curve and reduce possible complications.</p><p><strong>What is new?: </strong>We present a systematic approach that provides a safe and easily reproducible technique for managing CSP.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"208-211"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129108","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 presacral-uterosacral hysteropexy - a novel native tissue repair for pelvic organ prolapse.","authors":"Xiaojuan Wang, Jie Zhang, Keqin Hua, Yisong Chen","doi":"10.52054/FVVO.2025.75","DOIUrl":"10.52054/FVVO.2025.75","url":null,"abstract":"<p><strong>Background: </strong>Uterine-preserving procedures for pelvic organ prolapse (POP) are favoured and are becoming increasingly popular. Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) presacral-uterosacral hysteropexy is a novel native tissue repair for POP.</p><p><strong>Objectives: </strong>This study aimed to evaluate the safety of this uterine-preserving procedure and its midterm efficacy in treating POP.</p><p><strong>Methods: </strong>Between December 2020 and December 2022, patients with symptomatic POP who underwent vNOTES presacral-uterosacral hysteropexy at a tertiary teaching hospital were retrospectively analysed. The patient characteristics, follow-up outcomes, and complications were recorded and analysed.</p><p><strong>Main outcomes measures: </strong>We investigated anatomical success, subjective improvement, perioperative parameters, and operative complications.</p><p><strong>Results: </strong>Fifty-eight patients (median age 41 years) completed a mean 24.4-month (± 6.8) follow-up. There were two women (3.4%) who experienced recurrence. There was a significant improvement in POP-Q scores in all compartments at the last follow-up compared to the baseline (<i>P</i><0.001). 94.8% of patients were satisfied with their operations. The urinary and prolapse symptoms improved significantly (<i>P</i><0.001), and sexual function was significantly improved (<i>P</i><0.001). There were no intraoperative complications, and one patient experienced fever and delayed haemorrhage after surgery.</p><p><strong>Conclusions: </strong>vNOTES presacral-uterosacral hysteropexy may be a safe and feasible technique for women with POP who desire to preserve their uterus. This procedure demonstrates promising medium-term anatomical and subjective outcomes in treating POP.</p><p><strong>What is new?: </strong>This is a new mesh-free surgical procedure that combines the benefits of laparoscopic sacrohysteropexy and vNOTES uterosacral ligament hysteropexy to treat women with POP who desire uterine preservation, aiming to gain long-term anatomical success and minor complications.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"17 2","pages":"130-137"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576614","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":"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":"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":"180-191"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477167","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":"Virtual reality for pain relief in gynaecological care","authors":"Josep Estadella-Tarriel","doi":"10.52054/FVVO.2025.178","DOIUrl":"10.52054/FVVO.2025.178","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"99-100"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318361","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":"Unveiling the real benefits of robot-assisted surgery in gynaecology: from telesurgery to image-guided surgery and artificial intelligence.","authors":"Matteo Pavone, Marta Goglia, Andrea Rosati, Chiara Innocenzi, Nicolò Bizzarri, Barbara Seeliger, Pietro Mascagni, Filippo Alberto Ferrari, Antonello Forgione, Antonia Carla Testa, Anna Fagotti, Francesco Fanfani, Denis Querleu, Giovanni Scambia, Cherif Akladios, Jacques Marescaux, Lise Lecointre","doi":"10.52054/FVVO.2024.13522","DOIUrl":"https://doi.org/10.52054/FVVO.2024.13522","url":null,"abstract":"<p><strong>Background: </strong>Several new robotic platforms are being commercialised, with different features in terms of types of consoles, numbers of arms, and targeting transabdominal or natural orifice approaches. The benefits of robotic surgery over laparoscopy have yet to be conclusively demonstrated in gynaecology, as several studies comparing perioperative and postoperative patient outcomes have reported no significant differences, leading to a lack of precise recommendations in surgical guidelines for both gynaecologic oncology and benign gynaecology. In addition, these outcomes must be balanced against the high costs of robotic surgery, in particular when considering building an infrastructure for safe telesurgery to democratise access to telementoring and remote interventions.</p><p><strong>Objectives: </strong>Drawing from the expertise gained at the IRCAD Research and Training Center in Strasbourg, France, this article aims to provide an overview of the unveiled benefits of robotic-assisted surgery in gynaecology, investigating the role of digital surgery integration.</p><p><strong>Methods: </strong>The objective of this narrative review is to provide an overview of the latest advancement in digital robotic-assisted surgery in gynaecology and illustrate the benefits of this approach related to the easiest integration with new technologies. To illustrate such evidence, PubMed, Google Scholar, and Scopus databases were searched.</p><p><strong>Main outcome measures: </strong>In the era of surgical innovation and digital surgery, the potential of robotic surgery becomes apparent through the capacity to integrate new technologies. Image-guided surgery techniques, including the analysis of preoperative and intraoperative images, 3D reconstructions and their use for virtual and augmented reality, and the availability of drop-in robotic ultrasound probes, can help to enhance the quality, efficacy and safety of surgical procedures.</p><p><strong>Results: </strong>The integration of artificial intelligence, particularly computer vision analysis of surgical workflows, is put forward to further reduce complications, enhance safety, and improve operating room efficiency. Additionally, new large language models can assist during procedures by providing patient history and aiding in decision-making. The education and training of young surgeons will undergo radical transformations with robotic surgery, with telementoring and shared procedures in the side-by-side double-console setup.</p><p><strong>Conclusions: </strong>Robotic systems play a fundamental role in the transition towards digital surgery, aiming to improve patient care through integration of such new technologies.</p><p><strong>What is new?: </strong>While the advantages of robotic surgery in terms of perioperative outcomes have yet to be demonstrated, the benefits of its easiest integration with new technologies are evident.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"17 1","pages":"50-60"},"PeriodicalIF":1.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001214","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}