Facts Views and Vision in ObGyn最新文献_第7页

The importance of rotation to teach secure half-hitch sequences in surgery. 旋转对外科手术中讲授安全半结序列的重要性。

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Facts Views and Vision in ObGyn Pub Date : 2023-12-01 Epub Date: 2013-11-14 DOI: 10.52054/FVVO.15.4.101

A Romeo, I Cipullo, W Kondo, C Benedetto, B Amro, A Ussia, A Wattiez, P R Koninckx

{"title":"The importance of rotation to teach secure half-hitch sequences in surgery.","authors":"A Romeo, I Cipullo, W Kondo, C Benedetto, B Amro, A Ussia, A Wattiez, P R Koninckx","doi":"10.52054/FVVO.15.4.101","DOIUrl":"10.52054/FVVO.15.4.101","url":null,"abstract":"Background: Knot security of half-knot (H) sequences varies with rotation, but half-knots risk destabilisation.Objectives: To investigate the rotation of half-hitch (S) sequences on knot security.Materials and methods: The loop and knot security of symmetrical and asymmetrical sliding and blocking half-hitch sequences was measured using a tensiometer.Results: Loop security of symmetrical sliding half-hitch sequences is much higher than asymmetrical sequences, increasing from 6+2 to 21+2 and from 27+6 to 48+5 Newton (N) for 2 and 4 half-hitches respectively (both P<0.0001). Symmetrical sliding sequences are more compact and remain in the same plane, squeezing the passive thread, while asymmetrical sequences rotate loosely around the passive end. Blocking sequences are superior when asymmetrical since changing the passive end acts like changing rotation, transforming the asymmetrical sliding into a symmetrical blocking half-hitch on the new passive thread. The knot security of 2 sliding and 1 blocking half-hitch doubles from 52+3 to 98+2 N for the worst (asymmetric sliding and symmetric blocking, SSaSsb) or best rotation sequences (SSsSab). Adding a second asymmetric blocking half-hitch (Sab) increases security further to 105+3 N. The overall knot security of four-throw, correctly rotated, half-hitch (SSsSabSab) or half-knot (H2H1sH1s, H2H2a and H2H2s) sequences is similar for four suture diameters.Conclusion: Rotation affects the security of half-hitch sequences, which should be symmetrical when sliding, and asymmetrical when blocking.What is new?: Half-hitch sequences are clinically superior to half-knot sequences. They do not risk destabilisation, and loop security improves approximation of tissues under traction, permitting tight knots.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"15 4","pages":"317-324"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10832652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92156935","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}

引用次数: 0

Laparoscopic Posterior Vaginal Plication plus Sacral Colpopexy for Severe Posterior Vaginal Prolapse: a Step-by-Step Video- Article. 腹腔镜阴道后壁成形术加骶骨结肠切除术治疗严重阴道后壁脱垂：分步骤视频-文章。

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Facts Views and Vision in ObGyn Pub Date : 2023-12-01 DOI: 10.52054/FVVO.15.4.103

A Morciano, G Scambia, A Tinelli, G Marzo

引用次数: 0

Xanthogranulomatous endometritis. 黄疽性子宫内膜炎。

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Facts Views and Vision in ObGyn Pub Date : 2023-12-01 DOI: 10.52054/FVVO.15.4.106

A Morales Vicente, Y García Sánchez, N Santonja López, J Gilabert Estellés

引用次数: 0

Cavernous haemangioma and mid trimester pregnancy loss leading to severe haemorrhage and hysterectomy: a case report and review of literature. 海绵状血管瘤和中期妊娠流产导致大出血和子宫切除：病例报告和文献综述。

IF 2

Facts Views and Vision in ObGyn Pub Date : 2023-12-01 DOI: 10.52054/FVVO.15.4.111

A Gallo, R D'Alisa, V Foreste, G Saccone, M C De Angelis, A Di Spiezio Sardo, B Zizolfi

{"title":"Cavernous haemangioma and mid trimester pregnancy loss leading to severe haemorrhage and hysterectomy: a case report and review of literature.","authors":"A Gallo, R D'Alisa, V Foreste, G Saccone, M C De Angelis, A Di Spiezio Sardo, B Zizolfi","doi":"10.52054/FVVO.15.4.111","DOIUrl":"10.52054/FVVO.15.4.111","url":null,"abstract":"Background: Cavernous haemangiomas are benign vascular tumours that are known to occasionally involve the female genital tract, including the uterus. They are often underdiagnosed during pregnancy, although they can also lead to severe postpartum or antepartum haemorrhage.Objectives: Describe our case of an uncommon second-trimester pregnancy loss in a woman with a diffuse cavernous haemangioma of the uterus and cervix and review the wider literature.Methods: The review was conducted using MEDLINE, Scopus and PubMed electronic databases from beginning of the database to May 2023, using the following keywords: arteriovenous malformation; cavernous haemangioma/hemangioma; uterine neoplasms; pregnancy complications; abnormal vaginal bleeding.Main outcome measures: Description of the characteristics of cavernous haemangioma during pregnancy as well as diagnostic criteria and treatment options.Results: Twenty publications were included in the review, which included English-language case reports over a period from 1959 to 2022. No pathognomonic symptoms for cavernous haemangioma of the uterus in a pregnant woman were noted. Complications including massive secondary postpartum haemorrhage, haemoperitoneum, and severe thrombocytopenia with anaemia after delivery were reported.Conclusions: Diagnosis and management during pregnancy can be challenging and requires considerable attention, with a multidisciplinary approach including gynaecologists, radiologists, and pathologists to avoid major complications.What is new?: An additional case of diffuse cavernous haemangioma of the uterus and cervix is described, that adds to the little existing literature.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"15 4","pages":"339-349"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10832656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832220","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}

引用次数: 0

Clinical guidelines for managing menopausal symptoms in women with (a history of) breast cancer. 有乳腺癌(病史)妇女绝经期症状管理的临床指南。

IF 2

Facts Views and Vision in ObGyn Pub Date : 2023-12-01 Epub Date: 2013-11-14 DOI: 10.52054/FVVO.15.4.102

J Servayge, A C Verduyn, A Page, L Lagaert, W A A Tjalma

{"title":"Clinical guidelines for managing menopausal symptoms in women with (a history of) breast cancer.","authors":"J Servayge, A C Verduyn, A Page, L Lagaert, W A A Tjalma","doi":"10.52054/FVVO.15.4.102","DOIUrl":"10.52054/FVVO.15.4.102","url":null,"abstract":"Background: One in eight women will be diagnosed with breast cancer. At the time of diagnosis, 75% of patients are postmenopausal. Many will receive anti-hormone therapy, which often induces menopausal symptoms. Premenopausal breast cancer patients frequently become postmenopausal as a result of the treatment and often experience menopausal symptoms. The increased incidence of breast cancer, combined with longer survival, has led to an increase in the number of women experiencing menopausal symptoms. Therefore, the management of menopausal symptoms in women with a history or current breast cancer is a relevant and common clinical problem.Objectives: To provide a clinically useful overview of the steps in the management of menopausal symptoms in women with (a history of) breast cancer.Materials and methods: A comprehensive literature review was conducted by authors JS and WT using the PubMed and Medline databases. Abstracts were critically appraised and, where appropriate, the full text was analysed.Main outcome measures: Not applicable.Results: Depending on the condition, either meta-analyses, randomised controlled trials or retrospective cohorts were identified. No evidence was found for some proposed treatments.Conclusions: Menopausal symptoms in women with (a history of) breast cancer require a patient-tailored approach. Shared decision making is paramount and adequate up-to-date knowledge can help the breast cancer specialist to advise and guide patients accordingly.What is new?: A comprehensive, clinically-based overview of evidence-based treatment options for menopausal symptoms in women with (a history of) breast cancer.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"15 4","pages":"297-308"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10832648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592504","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}

引用次数: 0

The new surgical robot Hugo™ RAS for total hysterectomy: a pilot study. 用于全子宫切除术的新型手术机器人 Hugo™ RAS：一项试点研究。

IF 2

Facts Views and Vision in ObGyn Pub Date : 2023-12-01 DOI: 10.52054/FVVO.15.4.11

G Monterossi, L Pedone Anchora, R Oliva, A Fagotti, F Fanfani, B Costantini, A Naldini, D Giannarelli, G Scambia

{"title":"The new surgical robot Hugo™ RAS for total hysterectomy: a pilot study.","authors":"G Monterossi, L Pedone Anchora, R Oliva, A Fagotti, F Fanfani, B Costantini, A Naldini, D Giannarelli, G Scambia","doi":"10.52054/FVVO.15.4.11","DOIUrl":"10.52054/FVVO.15.4.11","url":null,"abstract":"Background: With the rising popularity of robotic surgery, Hugo™ RAS is one of the newest surgical robotic platforms. Investigating the reliability of this tool is the first step toward validating its use in clinical practice; and presently there arelimited data available regarding this. The literature is constantly enriched with initial experiences, however no study has demonstrated the safety of this platform yet.Objectives: This study aimed to investigate its reliability during total hysterectomy.Materials and methods: A series of 20 consecutive patients scheduled for minimally invasive total hysterectomy with or without salpingo-oophorectomy for benign disease or prophylactic surgery were selected to undergo surgery with Hugo™ RAS. Data regarding any malfunction or breakdown of the robotic system as well as intra- and post-operative complications were prospectively recorded.Results: Fifteen of the twenty patients (75.0%) underwent surgery for benign uterine diseases, and five (25.0%) underwent prophylactic surgery. Among the entire series, an instrument fault occurred in one case (5.0%). The problem was solved in 4.8 minutes and without complications for the patient. The median total operative time was 127 min (range, 98-255 min). The median estimated blood loss was 50 mL (range:30-125 mL). No intraoperative complications were observed. One patient (5.0%) developed Clavien-Dindo grade 2 post-operative complication.Conclusions: In this pilot study, Hugo™ RAS showed high reliability, similar to other robotic devices.What is new?: Present findings suggest that Hugo™ RAS is a viable option for major surgical procedures and deserves further investigation in clinical practice.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"15 4","pages":"331-337"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10832655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832228","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}

引用次数: 0

Postoperative adhesions: are we close to finding a solution? 术后粘连：我们即将找到解决方案吗？

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Facts Views and Vision in ObGyn Pub Date : 2023-12-01 DOI: 10.52054/FVVO.15.4.112

P R Koninckx, E Saridogan, V Gomel

引用次数: 0

Junctional zone thickening: an endo-myometrial unit disorder. 交界区增厚：子宫内膜单元紊乱。

IF 2

Facts Views and Vision in ObGyn Pub Date : 2023-12-01 DOI: 10.52054/FVVO.15.4.109

S Gordts, G Grimbizis, V Tanos, P Koninckx, R Campo

{"title":"Junctional zone thickening: an endo-myometrial unit disorder.","authors":"S Gordts, G Grimbizis, V Tanos, P Koninckx, R Campo","doi":"10.52054/FVVO.15.4.109","DOIUrl":"10.52054/FVVO.15.4.109","url":null,"abstract":"Adenomyosis is a disease defined by histopathology, mostly of hysterectomy specimens, and classification is challenged by the disagreement of the histologic definition. With the introduction of Magnetic Resonance Imaging (MRI) and two- and three-dimensional ultrasound, the diagnosis of adenomyosis became a clinical entity. In MRI and US, adenomyosis ranges from thickening of the inner myometrium or junctional zone to nodular, cystic, or diffuse lesions involving the entire uterine wall, up to a well-circumscribed adenomyoma or a polypoid adenomyoma. The absence of an accepted classification and the vague and inconsistent terminology hamper basic and clinical research. The sub-endometrial halo seen at US and MRI is a distinct entity, differing from the outer myometrium by its increased nuclear density and vascular structure. The endometrium and the sub-endometrial muscularis or archimetra are of Müllarian origin, while the outer myometrium is non-Mullerian mesenchymal. The junctional zone (JZ) is important for uterine contractions, conception, implantation, and placentation. Thickening of the JZ can be considered inner myometrium adenomyosis, with or without endometrial invasion. Changes in the JZ should be considered a different entity than myometrial clinically associated with impaired conception, implantation, abnormal uterine bleeding, pelvic pain and obstetrical outcome. Pathology of the basal endometrium and JZ is a separate entity and should be identified as an endo-myometrial unit disorder (EMUD).","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"15 4","pages":"309-316"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10832651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832222","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}

引用次数: 0

Suture-fixation of a levonorgestrel-releasing intrauterine device under hysteroscopic guidance. 在宫腔镜引导下缝合固定左炔诺孕酮释放宫内节育器。

IF 2

Facts Views and Vision in ObGyn Pub Date : 2023-12-01 DOI: 10.52054/FVVO.15.4.107

P G Paul, M Shah, V Sridivya Chowdary, A Anusha Raaj, G Paul

{"title":"Suture-fixation of a levonorgestrel-releasing intrauterine device under hysteroscopic guidance.","authors":"P G Paul, M Shah, V Sridivya Chowdary, A Anusha Raaj, G Paul","doi":"10.52054/FVVO.15.4.107","DOIUrl":"10.52054/FVVO.15.4.107","url":null,"abstract":"Background: Abnormal uterine bleeding (AUB) is a common gynaecological condition. The levonorgestrel-releasing Intrauterine device (LNG-IUD) is an effective medical treatment. option which carries a small risk of device expulsion. For those who experience expulsion, some may benefit from a more robust surgical approach.Objectives: To demonstrate the technique for suture fixation of an LNG-IUD under hysteroscopic guidance. Materials and methods: Stepwise video demonstration of the technique using a 5mm hysteroscope and a 3mm laparoscopic needle holder. The Institutional Ethical Committee was consulted, and the requirement for approval was waived because the video described a modified surgical technique. Informed consent was obtained from the patient.Main outcome measures: A 35yr old parous woman with a nine-month history of AUB and severe dysmenorrhoea had an LNG-IUD sited with effective symptom relief. Unfortunately, the device was expelled six months after insertion, and she responded poorly to other medical treatments. Transvaginal ultrasonography (TVUS) suggested posterior wall adenomyosis. Considering her relief of symptoms with the LNG-IUD and history of expulsion, the patient was counselled regarding suture-fixation of the LNG-IUD.Results: She was followed-up at 6 months post insertion. The LNG-IUD was noted in the uterine cavity without displacement or expulsion.Conclusion: Hysteroscopy-guided suture fixation of an LNG-IUD is a minimally invasive, effective option for patients with a history of expulsion of an IUD. However, further studies are required to establish the safety and efficacy of this approach.Learning objective: To demonstrate LNG -IUD suture fixation technique using hysteroscopy for patients diagnosed with AUB and a history of device expulsion.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"15 4","pages":"355-358"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10832649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832227","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}

引用次数: 0

En-block butterfly excision of posterior compartment deep endometriosis: The first experience with the new surgical robot Hugo™ RAS. 后腔深部子宫内膜异位症蝶形切除术：新型手术机器人Hugo™ RAS的首次使用体验。

IF 2

Facts Views and Vision in ObGyn Pub Date : 2023-12-01 DOI: 10.52054/FVVO.14.5.104

M Pavone, M Goglia, F Campolo, G Scambia, M M Ianieri

{"title":"En-block butterfly excision of posterior compartment deep endometriosis: The first experience with the new surgical robot Hugo™ RAS.","authors":"M Pavone, M Goglia, F Campolo, G Scambia, M M Ianieri","doi":"10.52054/FVVO.14.5.104","DOIUrl":"10.52054/FVVO.14.5.104","url":null,"abstract":"Background: Minimally invasive surgery is the gold standard treatment for deep endometriosis when medical management fails. In selected cases, such as when bowel or urinary tract are involved, robotic assisted surgery can be useful due to its characteristics of high dexterity and manoeuvrability. This is the first case of robotic en-bloc excision of posterior compartment deep endometriosis performed with the new HugoTM RAS system.Objective: The purpose of this video article is to show for the first time the feasibility of bowel surgery for deep endometriosis with this new robotic device.Materials and methods: A 24-years-old woman affected by severe dysmenorrhea, chronic pelvic pain, dyschezia and dyspareunia underwent to deep endometriosis excision using the new robotic platform HugoTM RAS system at the Unit of Gynaecological Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.Main outcome measures: Intraoperative data, docking set up, post-operative outcomes up to three months follow up were evaluated.Results: The surgical procedure was carried out without intra-operative or post-operative complications, operative time (OT) was 200 minutes, while docking time was 8 minutes. No system errors or faults in the robotic arms were registered. Post-operative complete disease-related symptoms relief was reported.Conclusion: According to our results, the introduction of this new robotic platform in the surgical management of deep endometriosis seems to be feasible, especially in advanced cases. However, further studies are needed to demonstrate the benefits of this surgical system and the advantages of robotic surgery compared to laparoscopy in this subset of patients.","PeriodicalId":46400,"journal":{"name":"Facts Views and Vision in ObGyn","volume":"15 4","pages":"359-362"},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10832646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832221","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}

引用次数: 0