Facts Views and Vision in ObGyn最新文献

{"title":"Conventional laparoscopic segmental bowel resection with mini-laparotomy specimen extraction compared with Natural Orifice Specimen Extraction (NOSE) procedures in patients with colorectal endometriosis.","authors":"Alexander Popov, Solmaz Mamedova, Anton Fedorov, Ivan Kliushnikov, Timur Glebov, Julia Sopova, Renata Izmailova, Vlada Troshina","doi":"10.52054/FVVO.2026.299","DOIUrl":"10.52054/FVVO.2026.299","url":null,"abstract":"<p><strong>Background: </strong>In patients with colorectal endometriosis the optimal surgical approach for excising disease remains unknown.</p><p><strong>Objectives: </strong>To compare the safety and efficacy of classic colorectal resection with mini-laparotomy and extracorporeal specimen removal and anastomosis formation (CLS) and colorectal resection with natural orifice specimen (bowel segment) extraction (NOSE), which is performed entirely in the abdominal cavity.</p><p><strong>Methods: </strong>This is a single centre, retrospective observational study of 161 cases of colorectal endometriosis. Women underwent laparoscopic excision of deep endometriosis with segmental bowel resection between 2015 and 2023.</p><p><strong>Main outcome measures: </strong>Hospital stay, complication rate, infectious issues, pain measured on a 10 cm visual analogue scale (VAS) and quality of life [derived from Knowles-Eccersley-Scott-Symptom (KESS)] questionnaire were the outcomes of interest.</p><p><strong>Results: </strong>No differences in post-operative pain or bowel quality of life at 3 months were observed between CLS and NOSE surgical treatment of colorectal endometriosis (mean VAS score 2 vs. 1, (<i>P</i>=0.62) and mean KESS score 12.3 vs. 10.7 (<i>P</i>=0.28). No clinically significant differences between techniques for intra-abdominal sepsis were seen as judged by C-reactive protein elevation and bacterial contamination from peri-operative cultures.</p><p><strong>Conclusions: </strong>NOSE and CLS procedures appear comparable in safety and efficacy for removing colorectal endometriosis. Randomised trials are needed to compare these techniques.</p><p><strong>What is new?: </strong>The NOSE technique for removing colorectal endometriosis is not associated with poorer safety, inflammatory, infective or efficacy outcomes compared to the classical CLS approach. Randomised controlled trials are needed to compare these techniques.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 2","pages":"104-112"},"PeriodicalIF":1.5,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296746","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":"Research and audit are essential for improving women's experience of outpatient hysteroscopy.","authors":"Prathiba M de Silva, T Justin Clark","doi":"10.52054/FVVO.2026.488","DOIUrl":"10.52054/FVVO.2026.488","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 2","pages":"78-80"},"PeriodicalIF":1.5,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296866","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":"Following the NOSE: when surgical evolution outpaces the evidence.","authors":"Shaheen Khazali, Ahmed Karim","doi":"10.52054/FVVO.2026.473","DOIUrl":"10.52054/FVVO.2026.473","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 2","pages":"75-77"},"PeriodicalIF":1.5,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296828","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":"Erratum.","authors":"","doi":"10.52054/FVVO.2026.e001","DOIUrl":"10.52054/FVVO.2026.e001","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 1","pages":"73"},"PeriodicalIF":1.4,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482043","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":"V-NOSE en bloc laparoscopic hysterectomy with segmental bowel resection for deep infiltrating endometriosis (#ENZIAN C3).","authors":"Luis Angel Burgos Gamez, Ramiro Cabrera Carranco, William Kondo, Jordanna Diniz Osaki, Andres F Vigueras Smith, Jose D Eugenio-Colon, Perla Sofía Vera Hernandez","doi":"10.52054/FVVO.2026.300","DOIUrl":"10.52054/FVVO.2026.300","url":null,"abstract":"<p><strong>Background: </strong>Deep endometriosis (DE) with intestinal involvement occurs in up to 16% of patients with endometriosis, representing one of the most challenging manifestations of the disease.</p><p><strong>Objectives: </strong>To describe a laparoscopic technique for the management of DE with bowel involvement through an en bloc resection that includes hysterectomy, appendectomy, and segmental bowel resection, using natural orifice specimen extraction (V-NOSE).</p><p><strong>Participant: </strong>A 35-year-old woman presented with severe dysmenorrhea, deep dyspareunia, and intestinal symptoms. A pelvic magnetic resonance imaging revealed a 3.9 cm #ENZIAN C3 intestinal nodule.</p><p><strong>Intervention: </strong>A laparoscopic approach was employed to perform an en bloc resection of the C3 rectal nodule, including segmental bowel resection and end-to-end anastomosis, with the V-NOSE technique. The patient provided informed consent for the publication of this video article and its online posting. The total time for the operation was 100 minutes, and the estimated blood loss was 30 mL. The complete excision was accomplished without intraoperative complications. The postoperative course was uneventful: the patient tolerated oral intake at 48 hours and was discharged 76 hours after surgery.</p><p><strong>Conclusions: </strong>En bloc laparoscopic hysterectomy enables complete excision of DE with bowel involvement and could reduce operative time and complications, potentially contributing to favourable long-term outcomes.</p><p><strong>What is new?: </strong>The integration of a laparoscopic approach, anterior colpotomy with the uterus attached to the rectovaginal nodule, and V-NOSE specimen extraction could represent a safe and efficient strategy for complex cases of deep infiltrating endometriosis with intestinal involvement in carefully selected patients.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 1","pages":"71-72"},"PeriodicalIF":1.4,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482033","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":"Hysteroscopic ablation of type 2 and type 3 fibroids using radiofrequency or microwave energy.","authors":"Alfonso Manzi, Sabrina Reppuccia, Attilio di Spiezio Sardo, Danilo Borrelli, Serena Guerra, Brunella Zizolfi, Maurizio Guida, Maria Chiara de Angelis","doi":"10.52054/FVVO.2026.280","DOIUrl":"10.52054/FVVO.2026.280","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive, uterus-sparing radiofrequency (RF) and microwave (MW) ablation have been introduced under ultrasound or laparoscopic guidance to treat uterine fibroids. These technologies enable targeted coagulative necrosis, potentially minimising surgical time and trauma while shortening recovery. They can also be used under hysteroscopic guidance, although feasibility data is lacking.</p><p><strong>Objectives: </strong>To assess the feasibility and short-term outcomes of hysteroscopic RF and MW ablation for FIGO-type 2 and type 3 fibroids.</p><p><strong>Participant: </strong>Four patients were included: two with FIGO-type 2 fibroids and two with FIGO-type 3 fibroids, all presenting with heavy menstrual bleeding (HMB) and no desire for pregnancy.</p><p><strong>Intervention: </strong>Procedures were performed at a tertiary care university hospital under sedation. As no evidence-based guidelines define selection criteria between MW and RF, both modalities were employed in fibroids with similar presentation. Under direct hysteroscopic visualisation, the needles were inserted through the operative channel into the myoma, maintaining a 10-mm safety margin. Tissue necrosis was confirmed by hyperechogenicity of the treated area. Each procedure lasted approximately 4 minutes. All patients were discharged the same day without complications.</p><p><strong>Conclusions: </strong>Hysteroscopic ablation was technically feasible and safe in this limited case series. The procedure induced necrosis, reduced fibroid vascularisation, and resolved HMB without complications, scarring, or adhesions. Future studies are needed to evaluate long-term outcomes and determine whether it may serve as a standalone option.</p><p><strong>What is new?: </strong>Hysteroscopic myolysis may expand the therapeutic armamentarium for selected patients seeking uterine preservation. By using the natural intracavitary pathway, the technique allows precise ablation while preserving uterine integrity and minimising procedural invasiveness.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 1","pages":"69-70"},"PeriodicalIF":1.4,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482050","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":"Illuminating the surgical field: the expanding role of Indocyanine Green (ICG) in gynaecological surgery.","authors":"Lina Antoun, Gourab Misra, T Justin Clark","doi":"10.52054/FVVO.2026.403","DOIUrl":"10.52054/FVVO.2026.403","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 1","pages":"3-6"},"PeriodicalIF":1.5,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475638","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":"Surgical outcomes according to the degree of parametrial dissection with hysterectomy for deep endometriosis.","authors":"Manuel Maria Ianieri, Maria Vittoria Alesi, Antonella Carcagnì, Matteo Figà, Federica Campolo, Denis Querleu, Francesco Fanfani, Anna Fagotti","doi":"10.52054/FVVO.2026.241","DOIUrl":"10.52054/FVVO.2026.241","url":null,"abstract":"<p><strong>Background: </strong>There is no standardisation of the degree of parametrial dissection and excision with hysterectomy in the presence of deep endometriosis (DE).</p><p><strong>Objectives: </strong>To apply an anatomical classification of dorso-lateral parametrectomy to hysterectomy for DE and correlate with postoperative complications and functional outcomes.</p><p><strong>Methods: </strong>Women with histologically confirmed DE who underwent hysterectomy with varying degrees of parametrectomy were retrospectively identified. Dorso-lateral parametrectomy was classified as follows: superficial (medial to presacral fascia), deep type 1 (beyond the presacral fascia), type 2 (caudal to medial rectal artery), and type 3 (laterally and deeply the hypogastric fascia). Statistical analysis was performed to correlate the degree of parametrial dissection with operative complications and functional outcomes at 6 months.</p><p><strong>Main outcome measures: </strong>Incidence of intra- and postoperative complications; changes in gastrointestinal, urinary, and sexual function; pain improvement.</p><p><strong>Results: </strong>Eighty-nine patients underwent parametrectomy with hysterectomy: superficial extended hysterectomy (EH) with superficial parametrectomy (EHSP, n=52), deep EH with deep parametrectomy type 1 (EHDP1, n=19), deep type 2 (EHDP2, n=12), and deep type 3 (EHDP3, n=6). Eight patients (8.9%) had intraoperative complication of which 5/52 (9.6%) underwent EHSP, 1/19 (5.3%) EHDP1, 2/12 (16.7%) EHDP2. Bladder voiding dysfunction occurred in 11 patients (12.3%) with higher incidences of 6/19 (31.6%) undergoing EHDP1 and 1/6 (16.7%) EHDP3 (<i>P</i>=0.016). Pain outcomes significantly improved across all groups (<i>P</i><0.001).</p><p><strong>Conclusions: </strong>This classification of parametrectomy at the time of hysterectomy for DE offers a framework for assessing surgical complexity and outcomes. While substantial pain relief is observed, bladder dysfunction remains a significant concern, especially when parametrectomy extends beyond the presacral fascia.</p><p><strong>What is new?: </strong>This classification for modified radical hysterectomy provides a method to standardise the description of parametrectomy for DE, facilitating more precise correlations between the extent of disease in the parametria and functional outcomes.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 1","pages":"32-41"},"PeriodicalIF":1.5,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481997","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 past, present and future of uterine fibroids.","authors":"Fred Burbank, George A Vilos, Angelos G Vilos","doi":"10.52054/FVVO.2026.323","DOIUrl":"10.52054/FVVO.2026.323","url":null,"abstract":"<p><p>Human evolution -specifically the development of bipedalism- altered the shape of the pelvis so that legs alone provided locomotion across the ground. As a result, the forelimbs were freed from locomotion. Though speculative, hands freed from locomotion may have led to the expansion of hand tool use and brain enlargement. With a pelvis no longer optimised for childbirth and with larger fetal brains, childbirth became more challenging. An \"obstetrical dilemma\" was created. How could large-headed babies be pushed through a narrowed, convoluted pelvis? More uterine muscle, a \"neomyometrium,\" evolved in the uterus, to increase the force of contractions. Because fibroids develop from myometrial tissue, additional fibroids came along with the neomyometrium. Until recently, the fibroid burden that accompanied bipedalism did not become apparent until the advent of modern contraception. Mendelian randomisation studies have demonstrated causal links between women's reproductive histories and their risk of developing fibroids. Multiparity and infrequent menstruation, universally common until only recently, kept this fibroid risk hidden until socio-demographic changes and hormonal contraception unmasked fibroids that evolved with the neomyometrium. Simple therapeutic approaches that (i) periodically and temporarily emulate the clot formation that occurs within the blood vessels of the uterus following childbirth and that (ii) reduce the number of lifetime menstrual cycles may be able to reduce the current high incidence of fibroids.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 1","pages":"18-24"},"PeriodicalIF":1.5,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482022","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":"Intra-ureteric indocyanine green for ureteric visualisation in complex benign gynaecological surgery: a prospective series of 50 cases.","authors":"Bomee Kim, Julia Mazurek, Rakesh Thing, Thomas Kurka, Rebecca Mallick","doi":"10.52054/FVVO.2026.287","DOIUrl":"10.52054/FVVO.2026.287","url":null,"abstract":"<p><p>Ureteric injury is a serious complication of gynaecological surgery, particularly in cases involving deep endometriosis. This prospective cohort study assessed the feasibility and safety of intra-ureteric indocyanine green (ICG) for real-time ureteric visualisation in complex endometriosis surgery at a tertiary referral unit. Fifty consecutive patients undergoing laparoscopic procedures received cystoscopy-guided bilateral intra-ureteric ICG. Mean additional operative time was 160 seconds. Bilateral ureteric fluorescence was achieved in all cases and persisted throughout surgery. Guidewires and intra-operative stents were required in 2% and 4% of cases, respectively. No ICG-related adverse events or ureteric injuries occurred, demonstrating a rapid, safe and reproducible technique.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"42-46"},"PeriodicalIF":1.5,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349163","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}