Linnea Ekdahl, Emelie Wallin, Emilia Alfonzo, Petur Reynisson, Celine Lönnerfors, Pernilla Dahm-Kähler, Henrik Falconer, Jan Persson
The aim of this study was to evaluate the impact of institutional surgical experience on recurrence following robotic radical hysterectomy (RRH) for early stage cervical cancer. All women in Sweden who underwent an RRH for stage IA2-IB1 cervical cancer at tertiary referral centers from its implementation in December 2005 until June 2017 were identified using a Swedish nationwide register and local hospital registers. Registry data were controlled by a chart review of all women. Recurrence rates and patterns of recurrence were compared between early and late (≤50 vs...
November 19, 2020: Journal of Clinical Medicine
Guangmin Zhang, Hongyou Chen, Yanying Liu, Liyan Niu, Liming Jin, Dong Li, Lihua Song, Lifei Shang, Xiangya Lin, Fei Wang, Fengtong Li, Xinyu Zhang, Xiaoyu Zhang, Yan Gao, Dongyu Qiu, Yunpu Zhang, Ren Na, Riguge Su
BACKGROUND: Whether routine lymph node dissection for early endometrial cancer is beneficial to survival is still controversial. However, surgeons usually perform lymph node dissection on all patients with early endometrial cancer. This study aimed to prove that the risk of lymph node metastasis, as defined by our standard, is very low in such patients and may change the current surgical practice. METHODS: 36 consecutive patients who had staged surgery for endometrial cancer were collected...
November 19, 2020: BMC Women's Health
Jordi Ponce, Sergi Fernandez-Gonzalez, Antonio Gil-Moreno, Pluvio J Coronado, Jesús De la Rosa, Henrique Nabais, Ginés Hernández, Anna Taltavull, Juan Gilabert-Estelles, Sergio Martínez-Román, Manel Barahona, Marc Barahona, María Ángeles Martínez-Maestre
This retrospective analysis aimed to assess the risk factors for recurrence in patients diagnosed with early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009) undergoing robot-assisted radical hysterectomy in Spain and Portugal between 2009 and 2018. A second primary objective was to audit the oncological outcomes according to quality indicators (QI) proposed by the European Society of Gynecology Oncology (ESGO). The study population included 239 women. After a median follow-up of 51 months, recurrence occurred in 26 patients (10...
November 16, 2020: Cancers
Iwona Gabriel, Anthony Kalousdian, Luiz Gustavo Brito, Talar Abdalian, Allison F Vitonis ScM, Vatche Arakel Minassian
BACKGROUND: There are various indications and approaches for hysterectomy; yet, the difference in long-term risk of subsequent prolapse after surgery is not well studied. OBJECTIVE: To assess the risk of prolapse after abdominal, vaginal and laparoscopic/robotic hysterectomy for up to 17 years from surgery. STUDY DESIGN: A retrospective chart review study of women undergoing hysterectomy across all indications (benign and malignant) between 2001-2008 was conducted...
November 15, 2020: American Journal of Obstetrics and Gynecology
Levon Badiglian-Filho, Carlos Chaves Faloppa, Ademir Narciso de Oliveira Menezes, Henrique Mantoan, Lillian Yuri Kumagai, Glauco Baiocchi
OBJECTIVE: To compare vNOTES hysterectomy with salpingectomy/salpingo-oophorectomy to standard laparoscopic access. METHODS: Medical records for patients undergoing hysterectomy with adnexectomy for benign disease indication between 1 February 2019 and 1 February 2020 were retrospectively examined. Exclusion criteria were endometriosis, previous pelvic radiotherapy, inflammatory pelvic disease history, any other concurrent surgery, laparotomy, robotic surgery, and/or traditional vaginal hysterectomy...
November 15, 2020: International Journal of Gynaecology and Obstetrics
Hélène Courcier, Henri Azaïs, Jérémie Belghiti, Catherine Uzan, Geoffroy Canlorbe
INTRODUCTION: The Laparoscopic Approach to Cervical Cancer (LACC) trial recently showed a significant inferiority of the minimally invasive surgery when we considered them both equivalent in the treatment of cervical cancer. The objective of this article is to describe and discuss the interest of the Schautheim procedure. SURGICAL TECHNIQUE: The Schautheim is the association of a radical hysterectomy by laparoscopy/robot assisted or not as described by Wertheim after a primary vaginal closure, like the first step of Schauta's hysterectomy...
November 10, 2020: Journal of Gynecology Obstetrics and Human Reproduction
Paul Buderath, Peter Rusch, Pawel Mach, Rainer Kimmig
OBJECTIVE: Peritoneal mesometrial resection (PMMR) plus targeted compartmental lymphadenectomy (TCL) aims at removal of the locoregional cancer field in endometrial cancer (EC). Optimal locoregional control without adjuvant radiotherapy and acceptable surgical morbidity should be achieved concomitantly sparing systematic lymphadenectomy (LNE) for most of the patients. METHODS: We evaluated data from 132 patients treated for EC. Out of these, between January 2017 and June 2020 we performed robotic PMMR and TCL on 51 women...
October 14, 2020: Journal of Gynecologic Oncology
Shiori Yanai, Kiyoshi Kanno, Kiyoshi Aiko, Masaaki Ando
OBJECTIVE: In comparison with laparoscopic transperitoneal para-aortic lymphadenectomy, the advantages of laparoscopic extraperitoneal para-aortic lymphadenectomy (ePAL) are that the operative field is not obstructed by bowel and the Trendelenburg position is not required [1]. The ePAL technique has been adopted to the robotic surgery with the da Vinci Xi. There are only a few reports demonstrating the technical feasibility of robot-assisted ePAL (RAePAL) [2 3]. This report describes the new surgical technique of RAePAL with the bipolar cutting method...
October 22, 2020: Journal of Gynecologic Oncology
Clémence Klapczynski, Camille Sallée, Antoine Tardieu, Clémence Peschot, Manon Boutot, Nadia Mohand, Aymeline Lacorre, François Margueritte, Tristan Gauthier
PURPOSE: To assess feasibility of a standardized robot-assisted hysterectomy managed by resident and supervised by senior surgeon using dual-console on a 21-step grid (max score = 42) assessing resident autonomy. METHODS: A total of seven patients managed between September 2019 and March 2020 by six residents in gynecology and obstetrics were included. Standardized robot-assisted hysterectomy for endometrial cancer or adenomyosis was performed. RESULTS: No conversion to laparotomy, no intra- or post-operative incidents were reported...
November 12, 2020: Archives of Gynecology and Obstetrics
Jennifer Weishaupt, Samir Saidi, Jonathan Carter
BACKGROUND: The Laparoscopic Approach to Cervical Cancer (LACC) trial is the first phase III randomised, multicentred trial to compare oncologic outcomes associated with open radical hysterectomy vs minimally invasive surgery (MIS) for treatment of early cervical cancer. AIM: To evaluate our surgical experience in patients with early cervical cancer. METHODS AND MATERIALS: The Lifehouse Gynaecologic Oncology database was queried based upon the eligibility criteria of the LACC study and included all FIGO 2009 stage (1A1 with lymph vascular space invasion, 1A2, 1B1) cervical cancer women from 2008-2018...
July 27, 2020: Australian & New Zealand Journal of Obstetrics & Gynaecology
Maria C Cusimano, Danielle Vicus, Katherine Pulman, Manjula Maganti, Marcus Q Bernardini, Genevieve Bouchard-Fortier, Stephane Laframboise, Taymaa May, Liat F Hogen, Allan L Covens, Lilian T Gien, Rachel Kupets, Marjan Rouzbahman, Blaise A Clarke, Jelena Mirkovic, Matthew Cesari, Gulisa Turashvili, Aysha Zia, Gabrielle E V Ene, Sarah E Ferguson
Importance: Whether sentinel lymph node biopsy (SLNB) can replace lymphadenectomy for surgical staging in patients with high-grade endometrial cancer (EC) is unclear. Objective: To examine the diagnostic accuracy of, performance characteristics of, and morbidity associated with SLNB using indocyanine green in patients with intermediate- and high-grade EC. Design, Setting, and Participants: In this prospective, multicenter cohort study (Sentinel Lymph Node Biopsy vs Lymphadenectomy for Intermediate- and High-Grade Endometrial Cancer Staging [SENTOR] study), accrual occurred from July 1, 2015, to June 30, 2019, with early stoppage because of prespecified accuracy criteria...
November 11, 2020: JAMA Surgery
Jessica Rahme, Amrish Rajkomar, Jose Tomas Larach, Ramin Shayan, Joseph Kong, Alexander Heriot, Satish Warrier
In this video we describe our method for performing a robotic abdominoperineal resection, posterior vaginectomy and distal sacrectomy. We present the case of a 75y female with a recurrence of her rectal cancer on a background of extensive abdominal operations. She was initially diagnosed in 2014 at which time she underwent chemoradiotherapy. This was followed by two liver resections and a Hartmann's procedure. She received radiotherapy in 2018 for a metastatic right upper lobe lung lesion. She has also had a hysterectomy and cholecystectomy and has hypothyroidism and hypertension...
November 5, 2020: Colorectal Disease
Kelli M McEntee, Kaitlin D Crawford, Machelle D Wilson, Mr Matthew D Ponzini, Brenda T Wu, Bahareh M Nejad, L Elaine Waetjen
STUDY OBJECTIVE: To examine opioid prescribing and consumption patterns after hysterectomy and identify factors associated with post-operative opioid consumption. DESIGN: Prospective cohort study. SETTING: Single university medical center. PATIENTS: Women undergoing hysterectomy for benign, non-obstetric indications. INTERVENTIONS: Participant pre-operative and surgical characteristics were obtained through chart review and patient report of baseline pain score...
November 2, 2020: Journal of Minimally Invasive Gynecology
Greg Marchand, Ali Azadi, Sienna Anderson, Stacy Ruther, Sophia Hopewell, Giovanna Brazil, Katelyn Sainz, Hannah Wolf, Alexa King, Jannelle Vallejo, Kelly Ware, Kaitlynne Cieminski, Anthony Galitsky
In the field of minimally invasive surgery, there is constant drive to devise and execute the most minimally invasive surgeries possible. By the very nature of laparoscopy and robotic surgery, what one can accomplish with several ports of a given size will invariably be studied and attempted with fewer ports and with ports of smaller sizes. After researching the literature, we were not able to find any single port hysterectomies performed through a port size of smaller than 15 millimeters. We were able to describe and perform a technique for performing laparoscopic hysterectomy through only a single port of 11mm in diameter...
November 4, 2020: Journal of the Turkish German Gynecological Association
Han-Ying Chen, Bor-Ching Sheu, Wen-Chun Chang
Purpose: Vaginal cuff dehiscence with evisceration was defined as expulsion of intraperitoneal organs through the separated incision. Prolapsed epiploica of the colon is a rare complication after hysterectomy. The most common organ to prolapsed out from the dehiscence vaginal cuff is terminal ileum. We reported the first known case of prolapsed epiploica of the colon after robotic hysterectomy. Case: This is a case who had prolapse of a vaginal tumor after sexual intercourse 5 months after robotic hysterectomy...
December 2020: Annals of Medicine and Surgery
Lior Lowenstein, Omer Mor, Emad Matanes, Roy Lauterbach, Sari Boulus, Zeev Weiner, Jan Baekelandt
OBJECTIVE: The Hominis® surgical system is a novel robotic-assisted system, designed specifically for robotic vaginal natural orifice transluminal endoscopic surgery (RvNOTES). We presented our experience of the first 30 RvNOTES hysterectomies assessing the feasibility and safety of this technology. STUDY DESIGN: A two-center prospective study. SETTING: Academic tertiary referral centers. Ethics committee approved the study in both centers...
October 31, 2020: Journal of Minimally Invasive Gynecology
Daniela Ulrich, Oliver Preyer, Vesna Bjelic-Radisic, Franz Roithmeier, Stephan Kropshofer, Hansjörg Huemer, Wolfgang Umek, Johannes Angleitner-Flotzinger, Evi Reinstadler, Karl Tamussino, Andrea Mazanek, Zoltan Nemeth, Martina Strobl, Thomas Aigmüller
STUDY OBJECTIVE: Sacrocolpopexy (SCP) has become a standard procedure to correct uterovaginal prolapse in women, but techniques and approaches are not standardized. We report the results of the Austrian Sacrocolpopexy Registry, which aimed to collect data on surgical techniques and perioperative outcomes. DESIGN: The Austrian Urogynecology Working Group (AUB) initiated a registry to assess surgical variability and perioperative safety of SCP. SETTING: The study was performed at 14 centers (13 in Austria,1 in Switzerland)...
October 31, 2020: Journal of Minimally Invasive Gynecology
Evelyn F Hall, Amy J Bregar, Katina Robison, Merima Ruhotina, Christina A Raker, Kyle Wohlrab
To describe OB/GYN fellowship directors' (FDs) observations, expectations, and preferences of incoming fellow's robotic surgery preparedness. Cross-sectional study. OB/GYN FDs in gynecologic oncology, minimally invasive gynecologic surgery, female pelvic medicine and reconstructive surgery, and reproductive endocrinology and infertility in the United States. 60 FDs answered the questionnaire. Participants completed an online questionnaire about their preferences and expectations of robotic surgery experience for incoming fellows...
November 3, 2020: Journal of Robotic Surgery
G Panico, G Campagna, L Vacca, D Caramazza, S Pizzacalla, V Rumolo, G Scambia, A Ercoli
The aim of this case report was to evaluate the feasibility, efficacy, and safety of nerve-sparing laparoscopic sacrocolpopexy (SCP) performed with a minimally invasive approach by using 2.9-mm Senhance ® surgical robotic system (Senhance ® , TRANSENTERIX Inc., USA). A 60-year-old Caucasian woman with symptomatic pelvic organ prolapse-Q (POP-Q) Aa: 2, Ba: 3, C: +4, Bp:2, Ap: 2, TVL:10 underwent subtotal hysterectomy with bilateral salpingo-oophorectomy, with nerve-sparing SCP performed using the Senhance surgical robotic system...
October 8, 2020: Facts, Views & Vision in ObGyn
Perrine Capmas, Eva Suarthana, Maryse Larouche
OBJECTIVES: To evaluate the conversion rate of laparoscopic or robotic to open sacrocolpopexy and to identify associated factors in a large population-based database. METHODS: We used Health Care Cost and Utilization Project-National Inpatient Sample (HCUP-NIS) databases 2005-2014. We extracted data on apical suspension and synthetic mesh with laparoscopy or robot in adult women using International Classification of Diseases, ninth edition, Clinical Modification (ICD-9-CM) codes...
October 26, 2020: International Urogynecology Journal
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