Facts Views and Vision in ObGyn最新文献

{"title":"Robotic-assisted hysterectomy using DEXTER^®: the first prospective multicentre study.","authors":"Sara Imboden, Chahin Achtari, Jérôme Léderrey, Marie-Lucile Bodet, Damien Emeriau, Ibrahim Alkatout, Nicolai Maass, Michael D Mueller","doi":"10.52054/FVVO.2025.203","DOIUrl":"10.52054/FVVO.2025.203","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive hysterectomy is increasingly performed robotically as new systems expand options and address limitations of traditional platforms, including financial, infrastructure, and workflow demands. The DEXTER^® Robotic Surgery System was designed to address some of these challenges.</p><p><strong>Objectives: </strong>To confirm perioperative and early postoperative safety, and evaluate the clinical performance of DEXTER in hysterectomy.</p><p><strong>Methods: </strong>This prospective multicentre study included 34 patients who underwent robotic-assisted hysterectomy for benign or low-risk malignant diseases between November 2022 and November 2023. DEXTER was integrated into the surgical workflows of the four participating centres, which used their existing laparoscopic towers.</p><p><strong>Main outcome measures: </strong>Primary outcomes were procedural conversions and Clavien-Dindo grade III-V events up to 30 days post-surgery.</p><p><strong>Results: </strong>Median patient age was 45.5 years; median body mass index was 26.0 kg/m². There were no conversions to laparotomy, intraoperative complications or transfusions, with a median estimated blood loss of 100 mL. Median skin-to-skin operative time was 125.5 min, including a median docking time of 5 minutes. Median length of hospitalisation was 2 days. Two Clavien-Dindo grade IIIb adverse events were recorded, neither of which was device-related. In 3 cases, the surgeons decided to finish the procedure laparoscopically.</p><p><strong>Conclusions: </strong>Hysterectomy assisted with DEXTER can be safely performed even in the early learning phase. DEXTER facilitated an adaptable OR workflow allowing greater flexibility in procedural approaches. Further investigation with a larger cohort and a longer follow-up is required to evaluate long-term outcomes.</p><p><strong>What is new?: </strong>First prospective multicentre study to confirm robotic-assisted hysterectomy using DEXTER is a feasible and safe approach for treating benign and low-risk malignant conditions.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"329-337"},"PeriodicalIF":1.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709829","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":"Light at the end of the tunnel: design, implementation and outcomes of a pelvic pain management programme.","authors":"Gemma Bentham, Kelly Paull, Jessica Preshaw","doi":"10.52054/FVVO.2025.34","DOIUrl":"10.52054/FVVO.2025.34","url":null,"abstract":"<p><strong>Background: </strong>Chronic pelvic pain (CPP) is a complex, prevalent condition that significantly impacts quality of life, work, relationships, and healthcare resources. Management remains challenging, with variation in practice and no national consensus. Evidence supports a multidisciplinary approach to treatment.</p><p><strong>Objectives: </strong>To describe the design, implementation, and outcomes of a multidisciplinary Pelvic Pain Management Programme (PPMP), reporting results from four programme cycles.</p><p><strong>Methods: </strong>The PPMP was developed using behaviour-change principles and delivered over 12 weekly sessions. Participants completed validated psychometric questionnaires at baseline, programme completion, and 3-month follow-up. Change was analysed using repeated-measures ANOVA and clinical significance assessed using the Minimal Clinically Important Difference or the Reliable Change Index.</p><p><strong>Main outcome measures: </strong>Psychometric questionnaires assessed the following outcome measures: pain intensity, pain self-efficacy, kinesiophobia, anxiety, depression, patient activation, health-related quality of life, pain acceptance, and catastrophising.</p><p><strong>Results: </strong>Thirty-three participants completed the programme, with 19 full datasets. A statistically significant improvement was recorded across all measures, except for anxiety. At the 3-month follow-up, 79% of participants reported a clinically significant improvement in several areas. Notably, 82% of participants showed clinically significant improvement in pain self-efficacy, 74% in depression, and 81% in pain catastrophising at programme completion.</p><p><strong>Conclusions: </strong>A PPMP is feasible, acceptable, and associated with significant and sustained improvements across biopsychosocial outcomes. Tailored PMPs may address gaps in CPP care and support long-term recovery.</p><p><strong>What is new?: </strong>This represents the largest published dataset evaluating a PPMP. These results highlight the potential of PPMPs to achieve pain reduction and sustainable improvement in quality of life for individuals with CPP.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"338-348"},"PeriodicalIF":1.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758057","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":"Perceptions of endometriosis surgery on TikTok: quality and implications for patient counselling.","authors":"Jaya Prakash, Amber T Lalla, Andrea Pelletier, Golnaz Namazi","doi":"10.52054/FVVO.2025.198","DOIUrl":"10.52054/FVVO.2025.198","url":null,"abstract":"<p><strong>Background: </strong>TikTok is a popular platform for sharing health experiences, including those related to endometriosis. However, the quality and tone of the surgical information shared remain unclear.</p><p><strong>Objectives: </strong>To characterise TikTok content regarding perceptions of surgical management for endometriosis and analyse content for information quality and differences between healthcare professionals and patients.</p><p><strong>Methods: </strong>A cross-sectional analysis of the top 100 most-viewed TikTok videos under the search term \"endometriosis surgery\" was conducted on September 22, 2024. Videos were included if in English, referenced \"endometriosis,\" and mentioned \"surgery,\" \"operation,\" or \"laparoscopy.\" Two independent reviewers assessed creator identity, tone, and content. The brief DISCERN tool evaluated information quality.</p><p><strong>Main outcome measures: </strong>Primary outcomes included the perceived benefits and drawbacks of surgery, tone towards surgical intervention, and thematic content. Secondary outcomes included DISCERN scores and comparison of content across creator identities.</p><p><strong>Results: </strong>Of the included videos (2021-2024), 80% were created by patients. Most conveyed a neutral tone (41%) towards surgery. Perceived benefits included therapeutic effects (68%) and diagnostic clarity (61%). Reported drawbacks were postoperative recovery (58%) and symptom persistence (22%). Common themes among patients included barriers to surgery (35%), medical gaslighting (30%), delayed diagnosis/misdiagnosis (25%), and inadequate presurgical counselling (20%). Median DISCERN scores were significantly lower for patient videos (1.00) vs. healthcare professionals (1.96; <i>P</i><0.001).</p><p><strong>Conclusions: </strong>TikTok content on endometriosis surgery is largely driven by patient narratives that highlight both hope and frustration. The low quality of information underscores the need for accessible, evidence-based educational content. Our findings represent a cross-sectional snapshot subject to algorithmic ranking and platform dynamics.</p><p><strong>What is new?: </strong>This is the first study to systematically evaluate TikTok content focused on surgical management of endometriosis, demonstrating that patient-generated videos overwhelmingly drive the conversation. While patients frequently describe benefits such as diagnostic clarity and symptom relief, they also highlight barriers to surgery, postoperative challenges, recurrent symptoms, and experiences of medical gaslighting. Patient-created videos had significantly lower information quality than provider-generated content, underscoring a critical gap in evidence-based surgical education on social media and an opportunity for clinician engagement.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"349-355"},"PeriodicalIF":1.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783167","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":"Reply: Iatrogenic breaching of the junctional zone: the unintended path to placenta accreta spectrum?","authors":"Evy Gillet, Panayiotis Tanos, Helena Van Kerrebroeck, Stavros Karampelas, Marion Valkenburg, Istvan Argay, Alessa Sugihara, Stephan Gordts, Rudi Campo","doi":"10.52054/FVVO.2025.279.answer","DOIUrl":"10.52054/FVVO.2025.279.answer","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"417-418"},"PeriodicalIF":1.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662328","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":"Da Vinci Single-Port surgery in an obese woman affected by endometrial cancer.","authors":"Benedetta Alberghetti, Elena Casetta, Antonell Biscione, Filippo M Capomacchia, James M Hughes, Riccardo Ponzone, Riccardo Oliva, Francesco Fanfani, Giovanni Scambia, Luigi C Turco","doi":"10.52054/FVVO.2025.23","DOIUrl":"10.52054/FVVO.2025.23","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Minimally invasive surgery in obese patients is advantageous in terms of postoperative recovery and estimated blood loss. In literature several retrospective studies comparing robot-assisted and laparoscopic surgery are present, while a randomised case-control study will better define the advantages prospectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Here we present the video of the surgical radical management for endometrial cancer in an obese woman using the Da Vinci Single-Port (SP) robotic platform.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participant: &lt;/strong&gt;A 66-year-old woman with a body mass index (BMI) of 44 kg/m² and hypertension, diagnosed with grade 1 endometrioid endometrial cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;The patient underwent a SP Robotic assisted radical class a hysterectomy (as per the Querleu-Morrow classification), bilateral salpingo-oophorectomy and sentinel lymph-node biopsy. A 2.7 cm umbilical incision was performed, and the single port robotic trocar was easily positioned. A uterine manipulator was not employed; traction was achieved using vaginal valves. Due to her constitution, a pneumoperitoneum with an intra-abdominal pressure greater than 8 mmHg and a Trendelenburg inclination greater than 19° could not be achieved.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Docking time was 8 minutes, the console time was 84 minutes, and the total operation time was 128 minutes. The estimated blood loss was 200 mL. The pain scores were irrelevant. The duration of hospitalisation was 2 days. No perioperative early complications were recorded. The aesthetic result was good.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;To our knowledge, this is the first Da Vinci SP endometrial cancer treatment in an obese woman presented in a step-by-step video. Robotic surgeries were successfully performed, the triangulation of the instrument allowed for comfortable surgery. Therefore, this surgical system may also be applicable to patients with a high BMI; however, further studies are required to confirm these preliminary findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is new?: &lt;/strong&gt;Minimally invasive surgery offers important benefits in terms of recovery, pain control, and reduced blood loss; however, its application in obese patients often remains challenging. The technical limitations imposed by body habitus-restricted working space, limited Trendelenburg positioning, and difficulties in trocar placement-can compromise both surgical exposure and oncologic radicality. In this context, the introduction of the Da Vinci SP robotic platform may represent a meaningful evolution in the management of this increasingly common patient population. The flexibility of the multi-jointed SP instruments and the ergonomic advantages of robotic control allow surgeons to overcome the typical restrictions encountered in this population. We believe that this report highlights an important step toward expanding the accessibility of minimally invasive radical surgery to all patients, reg","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"407-408"},"PeriodicalIF":1.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702292","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 role of pre-operative gonadotrophin-releasing hormone agonists (GnRHa) on pain, bowel and bladder symptoms in rectovaginal/colorectal endometriosis surgery: a multicenter cohort study.","authors":"Munazzah Rafique, Christian Becker, Jonathan Lewin, Arvind Vashisht, Ertan Sarıdoğan, Martin Hirsch","doi":"10.52054/FVVO.2025.39","DOIUrl":"10.52054/FVVO.2025.39","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The efficacy of medical and surgical treatment of endometriosis-associated pain is a source of ongoing controversy. There is a lack of evidence about gonadotropin-releasing hormone agonists (GnRHa) use on long-term pain control, bladder and bowel symptoms for patients having surgery for deep rectovaginal/colorectal endometriosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effect of preoperative GnRHa (pre-GnRHa) use on pain, bowel and bladder symptoms for patients undergoing surgery for deep rectovaginal/colorectal endometriosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study evaluated data from the British Society for Gynaecological Endoscopy database, a large international multicentre prospective cohort of patients who underwent deep rectovaginal/colorectal endometriosis surgery between 2009-2021. We included 9433 patients from 101 accredited endometriosis centres. Multivariable logistic regression analysis was used to evaluate the association between pre-GnRHa use and postoperative pain, bowel and bladder symptoms at different time points, controlling for confounders like patient age, body mass index, smoking status, and hysterectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Rate of cyclical and non-cyclical pelvic and menstrual pain, bowel and bladder symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of the patients was 36 years (18-55). Pre-GnRHa use was associated with significant postoperative improvement in premenstrual pain [odds ratio (OR): 0.30, 95% confidence interval (CI): -0.57 - -0.034, &lt;i&gt;P&lt;/i&gt;=0.02*], menstrual pain (OR: 0.41/10, 95% CI: -0.7 - -0.13, &lt;i&gt;P&lt;/i&gt;=&lt;0.001*), non-cyclical pain (OR: 0.27/10, 95% CI: -0.5 - -0.04, &lt;i&gt;P&lt;/i&gt;=0.021*) and lower backache (OR: 0.30, 95% CI: -0.532 - -0.087, &lt;i&gt;P&lt;/i&gt;=0.006*) up to 12 months postoperatively. Moreover, bladder pain was significantly reduced in the pre-GnRHa group at 12 months (OR: 0.24, 95% CI: -0.451 - -0.039, &lt;i&gt;P&lt;/i&gt;=0.01*). Significant improvements were observed in bowel symptoms including frequent bowel movements (OR: 0.10, 95% CI: -0.194 - -0.012, P=0.02*), incomplete emptying sensation (OR: 0.10, 95% CI: -0.196 - -0.023, &lt;i&gt;P&lt;/i&gt;=0.01*), cyclical dyschezia (OR: 0.43, 95% CI: -0.724 - -0.142, &lt;i&gt;P&lt;/i&gt;=0.003*) and non-cyclical dyschezia (OR: 0.28, 95% CI: -0.504 - -0.075, &lt;i&gt;P&lt;/i&gt;=0.008*) up to 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Pre-GnRHa use is associated with a significant reduction in postoperative menstrual pain and non-menstrual pain as well as improved bowel and bladder symptoms lasting up to two years. It is also valuable to improve the quality of life for patients undergoing surgery for deep rectovaginal/colorectal endometriosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is new?: &lt;/strong&gt;This is the largest prospective international study evaluating pre-GnRHa use in deep rectovaginal/colorectal endometriosis surgery. It provides evidence supporting the role of pre-GnRHa as an adjuvant to surgical treatment, to reduce postoperative pai","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"222-231"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125821","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 scientific gap.","authors":"Harald Krentel, Rudy Leon de Wilde, Maya Sophie de Wilde","doi":"10.52054/FVVO.2025.260925","DOIUrl":"10.52054/FVVO.2025.260925","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"17 3","pages":"216-217"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201782","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":"Race and ethnicity reporting in endometriosis literature: a systematic review.","authors":"Antonio Raffone, Marisol Doglioli, Alberto Aguzzi, Ludovica Girardi, Lucia De Meis, Daniele Neola, Antonio Travaglino, Matteo Giorgi, Maria Giovanna Vastarella, Luigi Cobellis, Renato Seracchioli, Diego Raimondo","doi":"10.52054/FVVO.2025.153","DOIUrl":"10.52054/FVVO.2025.153","url":null,"abstract":"<p><strong>Background: </strong>Accurate reporting of participants' race and ethnicity is essential for assessing the representativeness of study populations and for identifying potential disparities in diagnosis, treatment, and outcomes.</p><p><strong>Objectives: </strong>To assess the quantity and quality of race and/or ethnicity reporting in the endometriosis literature.</p><p><strong>Methods: </strong>A systematic review of all human studies reporting data about endometriosis as the primary objective published in 2022. Studies were identified from electronic searches of MEDLINE, Google Scholar, Web of Science, Scopus, ClinicalTrials.gov, and the Cochrane Library databases.</p><p><strong>Main outcomes measures: </strong>The frequency and quality of participants' race and/or ethnicity reporting based on compliance with the guidelines set by the ICMJE. Study characteristics that influenced the reporting of race and/or ethnicity were assessed. Publications from journals that followed ICMJE recommendations were compared with those from journals that did not.</p><p><strong>Results: </strong>648/2054 (31.6%) articles met the inclusion criteria. Sixty-five studies (10.0%) reported participants' race and/or ethnicity, and the overall quality of this reporting was poor. The frequency of reporting did not differ between journals adhering to ICMJE guidelines and those that did not (24, 11% vs. 41, 9.5%; <i>P</i>=0.52), between studies involving national versus international populations (60, 92.3% vs. 5, 7.7%; <i>P</i>=0.28), or between male and female authors (33, 50.8% vs. 32, 49.2%; <i>P</i>=0.38) respectively. Race and/or ethnicity were reported more often in prospective than in retrospective studies (37, 56.9% vs. 18, 27.7%; <i>P</i><0.001), and in multicentre compared to single-centre studies (44, 67.7% vs. 21, 32.3%; <i>P</i><0.001).</p><p><strong>Conclusions: </strong>The reporting of race and/or ethnicity in human-based endometriosis research remains both infrequent and inconsistent, including in journals claiming adherence to ICMJE standards. These results highlight the need for improved and uniform documentation of racial and ethnic data in endometriosis research.</p><p><strong>What is new?: </strong>Human-based articles focusing on endometriosis have a low frequency and quality of race and/or ethnicity reporting, even in journals claiming to follow ICMJE recommendations.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"17 3","pages":"263-270"},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201818","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":"Reply: Pre-operative GnRH agonists in deep endometriosis: insights beyond the current evidence.","authors":"Munazzah Rafique, Ertan Sarıdoğan, Justin Clark, Martin Hirsch","doi":"10.52054/FVVO.2025.010925","DOIUrl":"10.52054/FVVO.2025.010925","url":null,"abstract":"","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"300-301"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114731","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":"Innovative laparoscopic technique for #ENZIAN C3 intestinal endometriotic nodule and concurrent uterine fibroids: NOSES.","authors":"Lucia Chaul, Ramiro Cabrera Carranco, Ana Gabriela Sierra Brozon, Eder Gabriel Rivera Rosas, Armando Menocal Tavernier, William Kondo, Alvaro Ovando, Jhanneth Chura Paco","doi":"10.52054/FVVO.2025.46","DOIUrl":"10.52054/FVVO.2025.46","url":null,"abstract":"<p><strong>Background: </strong>Deep infiltrating endometriosis (DIE) is a severe condition which requires innovative surgical approaches to address complex anatomical distortions, reduce operative risks, and enhance outcomes.</p><p><strong>Objectives: </strong>To demonstrate the effectiveness of integrating three advanced surgical techniques-reverse laparoscopic technique, natural orifice specimen extraction surgery (NOSES), and advanced intraoperative bleeding control strategies-in managing a complex case of DIE.</p><p><strong>Participant: </strong>A 29-year-old nulligravida patient presented with hypermenorrhea, dysmenorrhea, urinary symptoms, and bowel dysfunction. Magnetic resonance imaging revealed a 3.3 cm #ENZIAN C3 intestinal nodule, bilateral ovarian endometriomas and multiple uterine fibroids.</p><p><strong>Intervention: </strong>Advanced techniques reverse laparoscopic technique, associated with intraoperative bleeding control strategies such as vasopressin injection, temporary ligation of uterine arteries, and infundibulopelvic ligaments; combined with NOSES for specimen extraction. Patient included in this video gave consent for the publication of this video article and its online posting, including social media, journal's website, scientific literature websites, and other applicable sites. Operative time, estimated blood loss, preservation of anatomical structures, postoperative recovery time, symptom resolution, and complications were assessed. Surgery was completed in 180 minutes, with minimal blood loss (40 cc). The patient tolerated a general anti-inflammatory diet by postoperative day two and was discharged without complications. One month postoperatively, the patient showed significant symptom improvement.</p><p><strong>Conclusions: </strong>The combination of different techniques in the same surgery can clearly lead to favourable results and outcomes, ensuring optimal recovery with superior cosmetic and functional outcomes, particularly in fertility-preserving surgeries.</p><p><strong>What is new?: </strong>The combination of NOSES, the reverse laparoscopic technique, and advanced bleeding control strategies ensures optimal management for complex procedures in DIE surgeries with fertility preservation.</p>","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":" ","pages":"285-288"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151688","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}