Harefuah
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Robot-assisted laparoscopic surgery is a rapidly evolving technology, becoming widely applied as an alternative to open or laparoscopic gynecologic surgeries. The penetration of robot-assisted laparoscopic surgery into gynecologic surgeries in the past 6 years has been remarkable. The greatest advantages of this surgical technique are smaller incisions, leading to lower morbidity, less postoperative pain and shorter hospital stays. ⋯ In Israel, approximately 45,000 gynecological surgeries are performed every year, and about tenth of these are hysterectomies. In this issue, Mejia-Gomez et al. describe the results of the first experience with robot-assisted Laparoscopic hysterectomy in Israel in 14 women in Hadassah Ein Kerem Hospital. Whilst debate continues about the evidence-based superiority of robot-assisted Laparoscopic hysterectomy, it appears that where robot-assisted systems exist, most patients will opt for the robotic-assisted approach and gynecologists will step forward to fill this niche because of its minimally invasive characteristics and clinical benefits, despite the lack of level I evidence.
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Varicose veins have been described as early as the classical period of ancient Greece, and continue to affect the quality of life of up to one third of the population in the industrialized world. In recent years considerable progress has been achieved in understanding the pathological basis of this condition and in the development of new treatment modalities. The treatment of varicose veins of the lower limbs is primarily aimed at alleviating the symptoms, which include pain, pruritus, heaviness, ulceration, hemorrhage, and at improving unaesthetic appearance, but has also been shown to significantly improve measurable parameters of patients' quality of life and functional scales. ⋯ The remaining invasive interventions are equally efficacious but differ considerably in their demand of skilled personnel and equipment, their adverse effects, the length of expected recovery and their economic costs. The new endovenous interventions can be performed in an ambulatory clinic under local anesthesia. They are at least as efficacious as surgery in short- and medium-term follow-up, but evidence on their long-term efficacy is still Lacking.