Journal of minimally invasive gynecology
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Morcellation at laparoscopy is a commonly used minimally invasive method to extract bulky tissue from the abdomen without extending abdominal incisions. Despite widespread use of morcellation, complications still remain underreported and poorly understood. We performed a systematic review of surgical centers in the United States to identify, collate and update the morcellator-related injuries and near misses associated with powered tissue removal. ⋯ These complications are largely unreported, likely because of publication bias associated with catastrophic events. Surgeon experience likely confers some protection against these injuries. Understanding and implementing safe practices associated with the use of the laparoscopic morcellator will reduce these iatrogenic injuries.
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J Minim Invasive Gynecol · May 2014
Randomized Controlled TrialUse of music to reduce anxiety during office hysteroscopy: prospective randomized trial.
To investigate the effects of music on anxiety and perception of pain during office hysteroscopy. ⋯ Music can be useful as a complementary method to control anxiety and reduce perception of pain. The patient is more relaxed and experiences less discomfort.
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J Minim Invasive Gynecol · May 2014
Clinical TrialUltrasound-guided percutaneous microwave ablation for submucosal uterine fibroids.
To prospectively evaluate the efficiency and safety of ultrasound-guided percutaneous microwave ablation (PMWA) in treating symptomatic submucosal uterine myomas. ⋯ PMWA seems to be effective and safe for treatment of submucosal myomas.
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J Minim Invasive Gynecol · May 2014
Comparative StudyA comparison of quality outcome measures in patients having a hysterectomy for benign disease: robotic vs. non-robotic approaches.
To measure procedure-related hospital readmissions within 30 days after discharge for patients who have a hysterectomy for benign disease. Secondary outcome quality measures evaluated were cost, estimated blood loss, length of stay and sum of costs associated with readmissions. ⋯ Patients who undergo robotic-assisted laparoscopic hysterectomy have a significantly lower chance of readmission <30 days after surgery compared with those who undergo laparoscopic, abdominal (open) hysterectomy, and vaginal approaches. Patients in the robotics cohort also experienced a shorter length of stay, less estimated blood loss, and a cost savings associated with readmissions when compared to non-robotic approaches. Prospective registries describing quality outcomes, total sum of costs including 30 days follow-up, as well as patient-related quality of life benefits are recommended to confirm these findings and determine which surgical route offers the highest patient and societal value.
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J Minim Invasive Gynecol · May 2014
Observational StudyPelvic pain and patient satisfaction after laparoscopic supracervical hysterectomy: prospective trial.
To evaluate the occurrence and intensity of cyclic pelvic pain and patient satisfaction after laparoscopic supracervical hysterectomy and to explore the effect of the procedure on pelvic pain relief in women with perioperative detection of endometriosis and in women with histologic confirmation of adenomyosis. ⋯ Laparoscopic supracervical hysterectomy is associated with high patient satisfaction and reduces cyclic pelvic pain to a minimum by 12 months after the procedure.