Facts Views and Vision in ObGyn最新文献

{"title":"Functional intrauterine surgery: restoring uterine potential to enable natural fertility.","authors":"Ursula Catena","doi":"10.52054/FVVO.2026.375","DOIUrl":"10.52054/FVVO.2026.375","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"1-2"},"PeriodicalIF":1.5,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349138","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 prospective trial comparing the effect of preoperative information given verbally with the use of an explanatory animated video before outpatient hysteroscopy on patients' anxiety and pain.","authors":"Neta Eisenberg-Kogan, Maayan Gal-Kochav, Maya Naor-Dovev, Hilla Segal, Matan Mor, Noam Smorgick","doi":"10.52054/FVVO.2026.265","DOIUrl":"10.52054/FVVO.2026.265","url":null,"abstract":"<p><strong>Background: </strong>Hysteroscopy without anaesthesia is a routine gynaecological procedure but is commonly associated with patient anxiety and pain.</p><p><strong>Objectives: </strong>To compare preoperative information provision using usual verbal interaction with the use of an animated video on patients' anxiety and pain associated with outpatient hysteroscopy.</p><p><strong>Methods: </strong>Patients were allocated to receive verbal explanations immediately prior to the outpatient hysteroscopy or via an informative short, animated video.</p><p><strong>Main outcome measures: </strong>Proportion of patients with moderate-high preoperativee anxiety levels as assessed by the State-Trait Anxiety Inventory questionnaire. Secondary outcomes included maximal intraoperative pain levels recorded on a 10 cm visual analogue scale (VAS) completed directly after the procedure.</p><p><strong>Results: </strong>One hundred patients undergoing 78 diagnostic hysteroscopies and 22 operative hysteroscopies were included in the study, with 50 patients allocated to each intervention group. Preoperative moderate or high anxiety levels were reported by 28 participants who also had higher VAS pain scores (3.6±3.2 cm vs. 2.0±2.5 cm in the lower anxiety group, <i>P</i>=0.02). The rates of preoperative moderate/high anxiety levels were significantly higher in the standard verbal education group compared with the animated video group [19 (38.0%) vs. 9 (18.0%), respectively, <i>P</i>=0.04], although their VAS pain scores were not significantly different. The logistic regression analysis confirmed that a low level of anxiety was associated with education by an animated video (odds ratio: 2.9, 95% confidence interval: 1.1-7.6).</p><p><strong>Conclusions: </strong>Preoperative education by an animated video prior to hysteroscopy is associated with lower rates of moderate/high anxiety levels compared to the standard verbal education preparation.</p><p><strong>What is new?: </strong>Animated videos are an effective and easy-to-implement tool that may reduce anxiety before office hysteroscopy.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"25-31"},"PeriodicalIF":1.5,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349114","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":"Port placement and patient-specific docking strategies for robotic hysterectomy with the Hugo™ RAS system: an international Delphi consensus.","authors":"Diego Raimondo, Enrico Pazzaglia, Helder Ferreira, Meera Ragavan, Anne Katrine Friberg, Mads Nielsen-Breining, Giorgia Monterossi, Giovanni Panico, Andrea Rosati, Sara Mastrovito, Kristine Juul Hare, Danny Chou, Eric Francescangeli, Jordi Cassadò Garriga, Stefano Palmieri, Harald Krentel, Laurent de Landsheere, Dimitrios Balafoutas, Mohamed Mabrouk, Renato Seracchioli, Francesco Fanfani","doi":"10.52054/FVVO.2026.416","DOIUrl":"10.52054/FVVO.2026.416","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted hysterectomy is increasingly performed using modular platforms such as the Hugo™ roboticassisted surgery (RAS) system, but optimal or personalised docking strategies remain undefined.</p><p><strong>Objectives: </strong>To establish expert consensus on port placement and docking configurations for hysterectomy with the Hugo™ RAS system and to identify patient anthropometric factors requiring modification of standard setups.</p><p><strong>Methods: </strong>A modified Delphi consensus was conducted involving two iterative rounds of anonymous, structured questionnaires distributed to an international panel of gynaecological robotic surgeons experienced with the Hugo™ RAS system. Survey items addressed preferred docking configurations, the influence of patient anthropometry on docking strategy, and specific technical adjustments in non-standard scenarios. Consensus was predefined as ≥66.7% agreement.</p><p><strong>Main outcome measures: </strong>Expert agreement on docking setups, port placement modifications, and anthropometric variables influencing technical adjustments.</p><p><strong>Results: </strong>Seventeen experts completed round one and 16 completed round two. No single docking configuration reached consensus as universally optimal for standard hysterectomy. Ranking exercises identified the \"standard\" hysterectomy setup as the most preferred configuration, followed by the \"alternate\" and the \"three-arm\" setups. All experts agreed that patient anthropometry requires modification of port placement. Elevated body mass index (BMI), large uterine size and small pelvis were identified as key variables: increasing inter-port distance was recommended for BMI >30, cranial port displacement for large uteri, while no consensus emerged for patients with a small pelvis. A modified bridge configuration was proposed, and achieved strong expert agreement.</p><p><strong>Conclusions: </strong>No single docking configuration is deemed to be universally optimal for Hugo™ RAS hysterectomy. Expert practice combines a limited number of preferred setups with patient-tailored adjustments.</p><p><strong>What is new?: </strong>This study provides the first Delphi-based expert consensus on Hugo™ RAS docking strategies, emphasizing patient-specific adjustments and flexible preoperative planning.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 1","pages":"57-66"},"PeriodicalIF":1.5,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481975","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 proposed MRI classification of junctional zone morphology based on reproductive performance: the JZ-MRI ReproClass.","authors":"Rudi Campo, Stephan Gordts, Helena Van Kerrebroeck, Evy Gillet","doi":"10.52054/FVVO.2025.248","DOIUrl":"10.52054/FVVO.2025.248","url":null,"abstract":"<p><p>We propose the junctional zone- magnetic resonance imaging (JZ-MRI) ReproClass, a four-tiered MRI-based classification for describing JZ morphology, developed from more than a decade of clinical experience in women with recurrent implantation failure or pregnancy loss despite normal embryo quality. The system characterises the spectrum of JZ appearances -from normal architecture to complete loss of differentiation- and is particularly informative when ultrasound and hysteroscopy appear normal. By standardising MRI assessment of the JZ, the ReproClass may help identify morphological patterns associated with impaired reproductive performance and support more individualised diagnostic reasoning. It provides a foundation for future research into the role of JZ architecture in fertility outcomes.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"10-17"},"PeriodicalIF":1.5,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208030","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":"Salvage pectopexy using detached lateral suspension mesh arms.","authors":"Patrícia Pereira Amaral, Revaz Botchorichvili","doi":"10.52054/FVVO.2026.335","DOIUrl":"10.52054/FVVO.2026.335","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic lateral suspension is an alternative to sacrocolpopexy when access to the sacral promontory is restricted or unsafe. However, prolapse recurrence may occur due to mesh arm detachment or progressive fascial attenuation. Pectineal fixation is an alternative approach that may provide a stronger, more stable anchoring vector and improved force distribution.</p><p><strong>Objectives: </strong>To describe a minimally invasive salvage surgical strategy for managing recurrent anterior compartment prolapse in a patient with a history of laparoscopic lateral suspension and inaccessible sacral promontory.</p><p><strong>Participant: </strong>A 73-year-old woman presented with symptomatic vaginal bulging fifteen years after undergoing laparoscopic lateral suspension with subtotal hysterectomy and bilateral adnexectomy following an aborted promontofixation. Examination revealed a grade 2-3 cystocele and a grade 2 hysterocele without mesh exposure. Laparoscopy confirmed bilateral detachment of the anterior mesh arms from the lateral abdominal wall.</p><p><strong>Intervention: </strong>Laparoscopic anterior colporrhaphy was undertaken to reinforce the pubocervical fascia, with exposure supported by a device. The detached mesh arm was carefully trimmed and then secured using non-absorbable Ethibond® 1 sutures, with one fixation point anchored to the Cooper's ligament and the other to the mesh itself, in accordance with the principles of tension-free pectopexy bilaterally. Peritonisation was completed to fully cover the mesh.</p><p><strong>Conclusions: </strong>Recurrent anterior prolapse after lateral suspension where the sacral promontory is inaccessible promontory can be managed by reusing the detached mesh arms and refixing to Cooper's ligament as a salvage strategy.</p><p><strong>What is new?: </strong>Reinforcing the native fascia and refixing the mesh to the pectineal ligament provides an anatomically sound solution while avoiding the risks of sacral promontory dissection.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 1","pages":"67-68"},"PeriodicalIF":1.4,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482072","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":"Incisional hernia after specimen extraction in minimally invasive gynaecologic surgery: a systematic review.","authors":"Jolanda van Keizerswaard, Renée H Visser, Freek A Groenman, Renée M Barendse, Eva B Deerenberg, Judith A F Huirne, Robert A de Leeuw","doi":"10.52054/FVVO.2026.258","DOIUrl":"10.52054/FVVO.2026.258","url":null,"abstract":"<p><strong>Background: </strong>The location and size of abdominal incisions to enable tissue extraction might increase the risk of incisional hernia (IH).</p><p><strong>Objectives: </strong>To determine the reported incidence of IH after specimen extraction in gynaecological minimally invasive surgery.</p><p><strong>Methods: </strong>On January 9^th 2025 we performed a systematic literature review of PubMed, Embase, and Clarivate Analytics/Web of Science Core Collection from inception to 25 May 2023. Minimally invasive surgery, IH, specimen extraction, morcellation and gynaecology were used as search terms. All cohort studies and randomised controlled trials reporting IHs after minimally invasive gynaecological surgery with either morcellation or abdominal specimen extraction through an enlarged trocar site or mini-laparotomy were included.</p><p><strong>Main outcomes measures: </strong>The primary outcome was the incidence of IH. Secondary outcomes included incision length and location, time to diagnosis and risk factors for developing IH.</p><p><strong>Results: </strong>Thirty one studies were identified, of which three retrospective cohort studies met the inclusion criteria. The reported incidence of IH was between 0.02% and 8.3%, with a time to diagnosis spanning two days to two and a half years. Data were lacking or insufficient on the size and location of the incision and on the technique used for specimen extraction.</p><p><strong>Conclusions: </strong>There is a lack of evidence on the risk of developing IH in minimally invasive gynaecological surgery. Given the increasing use of minimally invasive surgical techniques, there is a pressing need for high-quality research on the prevalence and risk factors of IH, as well as on interventions aimed at mitigating this risk.</p><p><strong>What is new?: </strong>This review reveals a lack of high-quality evidence and consistent reporting on factors influencing IH after specimen extraction in minimally invasive gynaecological surgery.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 1","pages":"47-56"},"PeriodicalIF":1.5,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482056","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":"In outpatient hysteroscopy, experience matters.","authors":"Elizabeth Ball","doi":"10.52054/FVVO.2026.382","DOIUrl":"10.52054/FVVO.2026.382","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 1","pages":"7-9"},"PeriodicalIF":1.5,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475713","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":"From Preservation to Creation: The Expanding Frontier of Fertility Preservation - Proceedings of the 2^nd Montreux Reproductive Summit, 29-30 August 2025.","authors":"Alexandre Vallée, Ertan Saridogan, Michel D Mueller, Carlos Calhaz-Gorges, Christine Wyns, Marie-Madeleine Dolmans, Grigoris Grimbizis, Claudia Spits, Christiani A Amorim, Verena Nordhoff, Claus Yding Andersen, Mats Brännström, Gaby Moawad, Jean-Marc Ayoubi, Anis Feki","doi":"10.52054/FVVO.2026.260126","DOIUrl":"10.52054/FVVO.2026.260126","url":null,"abstract":"<p><p>Fertility preservation (FP) has become an essential dimension of modern medicine, reflecting the paradigm shift from survival alone to survivorship. Once confined to oncology, FP now spans a broad spectrum of medical, social, and technological contexts. Surgical innovations, including fertility-sparing surgery and ovarian transposition, allow reproductive potential to be safeguarded without compromising oncological safety. Cryobiology has been transformed by the transition from slow-freezing to vitrification, establishing oocyte and embryo cryopreservation as gold-standard approaches with outcomes comparable to fresh cycles. Alongside onco-fertility, \"social freezing\" has emerged as a tool of reproductive autonomy, though it raises counselling and ethical challenges related to age, expectations, and equity of access. Resilience in FP also requires psychosocial support: while emotional distress is common, evidence shows that interventions such as mindfulness and structured counselling improve mental health even if conception outcomes remain unchanged. In parallel, ovarian tissue cryopreservation for patients unable to undergo stimulation and immature testicular tissue banking extend possibilities, with early clinical successes highlighting future translational pathways. Uterus transplantation has emerged as the first-line treatment of congenital absence of a uterus and can restore fertility after a hysterectomy performed for cervical cancer. Looking ahead, regenerative approaches, including stem-cell-based strategies, 3D bio-printing of genital tissues, tissue engineering, and artificial uterus systems, signal the next frontier, while underscoring the need for further research as well as robust ethical, legal, and safety frameworks. FP thus represents a multidisciplinary and rapidly evolving field that integrates oncology, reproductive medicine, gynaecology, transplantation surgery, psychology, and laboratory disciplines. Its trajectory is defined by both technological innovation and the imperative to align medical progress with patient autonomy, equity, and long-term quality of life.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"18 1","pages":"1-14"},"PeriodicalIF":1.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12951526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327659","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":"From calculators to artificial intelligence: moving beyond rejection to responsible adoption.","authors":"Sergio Haimovich","doi":"10.52054/FVVO.2025.276","DOIUrl":"10.52054/FVVO.2025.276","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"303-305"},"PeriodicalIF":1.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662310","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 European Society for Gynaecological Endoscopy survey of hysteroscopic practice.","authors":"Branka Žegura Andrić, Milica Perović, Eva Timošek Hanželič, Mercedes Andeyro Garcia, Paolo Casadio, Carlo De Angelis, Helena Van Kerrebroeck, Amerigo Vitagliano, Ursula Catena","doi":"10.52054/FVVO.2025.167","DOIUrl":"10.52054/FVVO.2025.167","url":null,"abstract":"<p><strong>Background: </strong>Hysteroscopy is recognised as the gold standard for diagnosing and treating intrauterine pathologies. Despite its broad acceptance, management practices appear to be diverse.</p><p><strong>Objectives: </strong>To explore gynaecologists' approaches to managing intrauterine pathologies, assessing their diagnostic habits, therapeutic strategies, and the surgical techniques adopted in clinical practice.</p><p><strong>Methods: </strong>The project was undertaken by the European Society for Gynaecological Endoscopy (ESGE) Special Interest Group on hysteroscopy. All ESGE members were invited to participate in the study through an online questionnaire hosted on the SurveyMonkey platform.</p><p><strong>Main outcome measures: </strong>Procedural setting, equipment availability, preferred instruments, pain management, and satisfaction with hysteroscopic practices.</p><p><strong>Results: </strong>Four hundred and fifty-one of 4000 (11.25%) gynaecologists from 57 countries responded. Two hundred eighty one (74%) of the participants performed hysteroscopy using a vaginoscopic approach. Pain management practices varied, with 46% of respondents reporting minimal or no use of analgesics. Procedural settings were distributed across office-based environments 107 (23.7%), outpatient facilities 183 (40.6%), and operating rooms 161 (35.6%). Two hundred and ninety-nine (87.9%) of respondents reported that diagnostic facilities were well-equipped, and 282 (74.4%) expressed satisfaction with the available operative equipment. Polypectomy was the most frequently performed operative procedure.</p><p><strong>Conclusions: </strong>The observed variability in the practice of hysteroscopy among ESGE members highlights the need for standardised guidelines to improve consistency and patient outcomes.</p><p><strong>What is new?: </strong>This survey provides an overview of the hysteroscopic management of intrauterine pathologies among ESGE members.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"391-401"},"PeriodicalIF":1.5,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758054","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}