Journal of minimally invasive gynecology
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J Minim Invasive Gynecol · Nov 2010
Comparative StudyLearning curve and surgical outcome for robotic-assisted hysterectomy with lymphadenectomy: case-matched controlled comparison with laparoscopy and laparotomy for treatment of endometrial cancer.
To determine the learning curve for robotic-assisted hysterectomy with lymphadenectomy for surgical treatment of endometrial cancer. ⋯ The learning curve for robotic-assisted hysterectomy with lymph node dissection seems to be easier compared with that for laparoscopic hysterectomy with lymph node dissection for surgical management of endometrial cancer.
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J Minim Invasive Gynecol · Nov 2010
Isobaric laparoendoscopic single-site assisted extracorporeal cystectomy in treatment of selected adnexal tumors: initial experience and technique.
Laparoscopic-assisted ovarian cystectomy with exteriorization is a minimally invasive procedure. However, applicability of this procedure for transumbilical laparoendoscopic single-site (LESS) surgery is not well established. ⋯ Two dermoid cysts required intracorporeal LESS cystectomy because of poor mobility of the adnexal tissue. No conversion to either conventional laparoscopic surgery or laparotomy was necessary in this series.
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J Minim Invasive Gynecol · Sep 2010
ReviewRisk factors for uterine rupture after laparoscopic myomectomy.
Case reports for uterine rupture subsequent to laparoscopic myomectomy were reviewed to determine whether common causal factors could be identified. Published cases were identified via electronic searches of PubMed, Google Scholar, and hand searches of references, and unpublished cases were obtained via E-mail queries to the AAGL membership and AAGL Listserve participants. Nineteen cases of uterine rupture after laparoscopic myomectomy were identified. ⋯ No plausible contributing factor could be found in one case [corrected]. It seems reasonable for surgeons to adhere to techniques developed for abdominal myomectomy including limited use of electrosurgery and multilayered closure of the myometrium. Nevertheless, individual wound healing characteristics may predispose to uterine rupture.
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J Minim Invasive Gynecol · Jul 2010
ReviewBrachial plexus injury after laparoscopic and robotic surgery.
The objective of this article was to review the literature regarding brachial plexus injury (BPI) in laparoscopic and robotic surgery. BPI complicates gynecologic laparoscopic surgery with an estimated incidence of 0.16%. Nevertheless, as the numbers of advanced laparoscopic and robotic procedures increase, the anticipated risk of this complication may rise as well. ⋯ In this article we review the anatomy, pathophysiology, diagnosis, and treatment of position-related BPI in the context of laparoscopic and robotic gynecologic surgery. We suggest a multidisciplinary approach to the diagnosis and treatment of BPI. Recommendations for prevention of this complication are also provided.
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J Minim Invasive Gynecol · Jul 2010
One-year outcome of concurrent anterior and posterior transvaginal mesh surgery for treatment of advanced urogenital prolapse: case series.
To estimate the safety and efficacy of performing concurrent anterior and posterior transvaginal mesh surgery using a commercially available kit (Gynecare PROLIFT Pelvic Floor Repair System; Ethicon, Inc., Somerville, NJ) for treatment of advanced urogenital prolapse (stage III or higher, Pelvic Organ Prolapse Quantification [POP-Q] system staging). ⋯ Using concurrent anterior and posterior transvaginal mesh for pelvic reconstructive surgery is a safe and an effective method for treating advanced pelvic prolapse. Mesh-related complications are likely minimal, and mesh protrusion at the apex is likely to not occur. Further studies with longer follow-up are required to evaluate long-term effectiveness.