SOS save our surgeons: Stress levels reduced by robotic surgery
This study is an analytical, within subjects, crossover design study. Sixteen surgically inexperienced medical students performed tasks with both SLS and RALS instrumentation. Blood pressure (BP) was taken before and after task performance. Skin conductance level (SCL), heart rate (HR) and HR variability (HRV) were measured continuously during task performance. Pre- and post-task saliva samples were collected to determine cortisol levels using ELISA. SCL was significantly lower during RALS in comparison to SLS task performance (p < 0.05). HR was significantly lower during RALS vs. SLS tasks (p < 0.01). Both H...
Source: Gynecological Surgery - May 15, 2015 Category: OBGYN Source Type: research
Total laparoscopic hysterectomy with previous cesarean section using a standardized technique: experience of Pontificia Universidad Catolica de Chile
Abstract
Total laparoscopic hysterectomy (TLH) in the presence of patients with previous cesarean section (CS) is becoming increasingly common. When performing TLH in these patients, bladder adhesions to the uterus may make dissection much more difficult with higher complication rates. The aim of this study was to assess the safety of TLH in patients with previous CS in an OBGYN residence program. Retrospective study of all TLH performed at our center for either benign or malignant conditions. Of our study cohort, 40 % had undergone one or more previous CS. Average surgical time was 128 min for patients...
Source: Gynecological Surgery - May 15, 2015 Category: OBGYN Source Type: research
Anxiety at outpatient hysteroscopy
Abstract
This review summarises current understanding and research on the association between anxiety and outpatient hysteroscopy. Women undergoing hysteroscopy suffer from significant levels of anxiety, with repercussions on pain perception, success rates and satisfaction. Using validated tools such as the Spielberger State-Trait Anxiety Index (STAI) or the Hospital Anxiety and Depression Scale (HADS) in the outpatient hysteroscopy setting, average state anxiety scores similar or greater than those measured before more invasive procedures under general anaesthesia have been consistently reported. This cl...
Source: Gynecological Surgery - May 13, 2015 Category: OBGYN Source Type: research
Pictorial blood loss assessment chart for quantification of menstrual blood loss: a systematic review
Abstract
To evaluate the diagnostic accuracy of pictorial blood loss assessment chart (PBLAC) compared to objective measurements of menstrual blood loss (MBL), a systematic search of MEDLINE, EMBASE, Cumulative Index to Nursing & Allied Health Literature (CINAHL), Web of Science, and EBM Reviews-Cochrane Central Register of Controlled Trials from inception until September 30, 2014 was performed. Terms referring to “pictorial blood loss assessment chart,” “menstrual blood loss evaluation,” and “alkaline hematin” were used. The ability of PBLAC to predict significant blood loss, compared to ...
Source: Gynecological Surgery - May 6, 2015 Category: OBGYN Source Type: research
Conservative laparoscopic electrocoagulation adenomyolysis for the management of symptomatic adenomyosis
The objective of the study was to assess the safety and efficacy of conservative laparoscopic electrocoagulation adenomyolysis (CLEA) in the management of women with symptomatic adenomyosis. The study design is prospective observational study. The setting was Department of Obstetrics and Gynecology, Mansoura University Hospital. Thirty-nine premenopausal women, complaining of chronic pelvic pain and/or menorrhagia, were diagnosed to have adenomyosis by transvaginal ultrasonography (TVS) and/or magnetic resonance imaging (MRI), between June 2008 and June 2011. They were subjected to laparoscopic multiple uterine unipolar el...
Source: Gynecological Surgery - May 6, 2015 Category: OBGYN Source Type: research
Belgian consensus on adhesion prevention in hysteroscopy and laparoscopy
Abstract
Intrauterine and intraabdominal adhesions are a major cause for infertility. The most recent investigations have demonstrated the potential of intraperitoneal adhesion barriers combined with good surgical technique to reduce adhesion formation. For intrauterine adhesions we suggest to minimize unipolar and bipolar instrumentation whenever possible. We advocate the use of estrogens for 10 days after adhesiolysis: 2dd two tablets of estradiol 2 mg. Instillation of Hyalobarrier Gel Endo actually is not reimbursed but may have a beneficial effect after myomectomy or adhesiolysis. Concerning laparos...
Source: Gynecological Surgery - April 22, 2015 Category: OBGYN Source Type: research
A study to compare the pain, discomfort and tiredness between straight stick and single-incision laparoscopic surgery: an in vitro study
This study compares pain and tiredness experienced by a student and gynaecological surgeons of varying experience between straight sticks (SS) and single-incision laparoscopic surgery (SILS) in vitro. Data was collected prospectively with randomization of the mode sequence. Participants from two hospitals performed identical exercise of cutting circles using SS and SILS in vitro. Questionnaires (Borg CR10 scale scores) were completed at 0, 30 and 60 min, respectively. Wilcoxon’s signed ranked tests were performed on matched pairs of SS and SILS on the number of circles cut and the mistakes between 0–30 and 30–60 mi...
Source: Gynecological Surgery - April 10, 2015 Category: OBGYN Source Type: research
Large ovarian cysts assumed to be benign treated via laparoscopy
Abstract
The aim of this study was to assess the feasibility and outcome of laparoscopic surgery in the management of large ovarian cysts in patients treated at a university hospital. Twelve patients with large (diameter >10 cm) ovarian cysts were managed laparoscopically from November 2009 to July 2014. The cystic masses were not associated with ascites or enlarged lymph nodes on ultrasound. Serum CA-125 levels were within the normal range (35 U/ml). Preoperative evaluation included history, clinical examination, sonographic images, and serum markers. The management of these ovarian cysts included a...
Source: Gynecological Surgery - April 6, 2015 Category: OBGYN Source Type: research
Low-cost total laparoscopic hysterectomy by single-incision laparoscopic surgery using only reusable standard laparoscopic instruments
Abstract
The purpose of this study was to demonstrate the feasibility and safety of total laparoscopic hysterectomy (TLH) by single-incision laparoscopic surgery (SILS) with conventional, reusable laparoscopic instruments, inserted through an inexpensive, self-constructed single-port device. Between June 2013 and April 2014, 15 TLHs by SILS were performed by a single surgeon (BJ). Only conventional, reusable laparoscopic instruments were used. The self-constructed single-port device was made by assembling a surgical glove, a wound protector, one reusable 10-mm trocar, and four reusable 5-mm trocars. The v...
Source: Gynecological Surgery - March 6, 2015 Category: OBGYN Source Type: research
The GELPOINT (Applied Medical) port is a suitable instrument for salpingo-oophorectomy with good rates of patient satisfaction, in particular body image
(Source: Gynecological Surgery)
Source: Gynecological Surgery - February 25, 2015 Category: OBGYN Source Type: research
Options on fibroid morcellation: a literature review
This article has the objective to review the literature related to complications by power morcellation of uterine fibroids in laparoscopy and offer recommendations to laparoscopic surgeons in gynaecology. This project was initiated by the executive board of the European Society of Gynaecological Endoscopy. A steering committee on fibroid morcellation was installed and experienced ESGE members requested to chair an action group to address distinct clinical questions. Clinical questions were formulated with regards to the sarcoma risk in presumed uterine fibroids, diagnosis of sarcoma, complications of morcellation and futur...
Source: Gynecological Surgery - February 7, 2015 Category: OBGYN Source Type: research
Cross-linked xenogenic collagen implantation in the sheep model for vaginal surgery
Abstract
The properties of meshes used in reconstructive surgery affect the host response and biomechanical characteristics of the grafted tissue. Whereas durable synthetics induce a chronic inflammation, biological grafts are usually considered as more biocompatible. The location of implantation is another determinant of the host response: the vagina is a different environment with specific function and anatomy. Herein, we evaluated a cross-linked acellular collagen matrix (ACM), pretreated by the anti-calcification procedure ADAPT® in a sheep model for vaginal surgery. Ten sheep were implanted with a c...
Source: Gynecological Surgery - February 4, 2015 Category: OBGYN Source Type: research
Morcellation of presumed benign uterine tumors: abandon the technique or patient triage?
(Source: Gynecological Surgery)
Source: Gynecological Surgery - February 4, 2015 Category: OBGYN Source Type: research
Patient satisfaction and amenorrhea rate after endometrial ablation by ThermaChoice III or NovaSure: a retrospective cohort study
Abstract
Heavy menstrual bleeding poses an important health problem, which can be managed, besides other treatments, with endometrial ablation. Nowadays, the bipolar radio frequency device (NovaSure) is the most commonly used device for endometrial ablation, followed by the thermal balloon device (ThermaChoice III). Thus far, studies looking at treatment outcomes have mainly been done comparing NovaSure with the older ThermaChoice (I–II) devices. The aim of this study is to compare the effectiveness of the improved ThermaChoice III with NovaSure. Patients treated with ThermaChoice III at the Ziekenhuisg...
Source: Gynecological Surgery - February 4, 2015 Category: OBGYN Source Type: research
Feasibility of laparoendoscopic single-site surgery in supracervical hysterectomy: technique and retrospective case-control comparison
This study involved literature search and personal experience regarding single-port hysterectomy and a retrospective case-control study of 34 patients who underwent supracervical hysterectomy between April 2011 and November 2012. Operating time, blood loss, and length of hospital stay were similar in the two groups. Patient’s evaluation of the cosmetic result was in favor of LESS, however not significant. LESS represents a new frontier in minimally invasive surgery. New instrumentation and recommendations have been developed which are expected to make the technique more feasible. This study demonstrates that LESS suprace...
Source: Gynecological Surgery - February 2, 2015 Category: OBGYN Source Type: research
