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Recent Advances in Minimally Invasive Gynecologic Surgery (MIGS)
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Recent Advances in Minimally Invasive Gynecologic Surgery (MIGS)

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 2962

Special Issue Editors

Prof. Dr. Laurenţiu Cornel Pirtea

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Guest Editor
Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
Interests: laparoscopy; endometrial cancer; cervical cancer; pelvic organ prolapse
Dr. Dominic Iliescu

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
Interests: prenatal diagnosis; obstetrics; gynecology
Dr. Răzvan Ciortea

E-Mail Website
Guest Editor
Department of Obstetrics and Gynaecology, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
Interests: laparoscopy; obstetrics; gynecology

Special Issue Information

Dear Colleagues,

Advances in the surgical management of gynecological malignancies have revolutionized treatment approaches, enhancing both survival rates and quality of life for patients. With innovative techniques and technologies, surgeons can now offer more precise and less invasive procedures tailored to individual cases.

Minimally invasive surgery, including laparoscopy and robotic-assisted surgery, has become increasingly popular. These techniques enable surgeons to perform complex procedures with smaller incisions, reducing pain, blood loss, and recovery time. Additionally, they allow for better visualization and manipulation of tissues, leading to improved outcomes.

Furthermore, advances in imaging modalities such as MRI and PET-CT have enhanced preoperative planning and staging accuracy, enabling surgeons to better assess the tumor’s extent and plan surgical approaches accordingly. This has led to more personalized treatment strategies and improved patient outcomes.

In addition to surgical techniques, there have been significant developments in adjuvant therapies such as targeted therapies and immunotherapy, which can be combined with surgery to achieve better results, particularly in advanced or recurrent cases.

Overall, these advances represent a paradigm shift in the management of gynecological malignancies, offering patients new hope and improved prospects for long-term survival and quality of life. As research continues and technology evolves, the future of surgical oncology holds even more promise for further enhancing patient care.

The purpose of this Special Issue is to present the new knowledge and recent advances in this topic and provide evidence-based literature to be used in daily clinical practice.

Prof. Dr. Laurenţiu Cornel Pirtea
Dr. Dominic Gabriel Iliescu
Dr. Răzvan Ciortea
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • laparoscopy
  • urogynecology
  • oncologic surgery
  • minimally invasive surgery

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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12 pages, 621 KiB  
Article
Can a Continuous Wound Infiltration System Replace Intravenous Patient-Controlled Analgesia for Postoperative Pain Management after a Single-Port Access Laparoscopy?
by Jun-Hyeok Kang, Yumi Seo, Hyunji Lee, Woo Young Kim and E Sun Paik
J. Clin. Med. 2024, 13(19), 5718; https://doi.org/10.3390/jcm13195718 - 25 Sep 2024
Viewed by 883
Abstract
Background: The aim of this study was to determine whether continuous wound infiltration (CWI) can replace intravenous patient-controlled analgesia (IV PCA) and to investigate effective pain control strategies after a single-port access (SPA) laparoscopy for adnexal disease. Methods: A total of 470 [...] Read more.
Background: The aim of this study was to determine whether continuous wound infiltration (CWI) can replace intravenous patient-controlled analgesia (IV PCA) and to investigate effective pain control strategies after a single-port access (SPA) laparoscopy for adnexal disease. Methods: A total of 470 patients (the CWI group [n = 109], the IV PCA group [n = 198], and the combined group [n = 163]) who underwent an SPA adnexal laparoscopy and who received CWI or IV PCA for postoperative pain management were retrospectively reviewed. The numeric rating scale (NRS) pain score at 6, 12, 24, and 48 h (h) after surgery and the total amount of fentanyl administered via IV PCA were collected. The incidence of postoperative nausea and vomiting (PONV) and the total amount of rescue antiemetic drugs administered were also evaluated. Results: The mean NRS pain scores at 6 h (combined vs. PCA vs. CWI, 3.08 vs. 3.44 vs. 3.96, p < 0.001), 12 h (2.10 vs. 2.65 vs. 2.82, p < 0.001), and 24 h (1.71 vs. 2.01 vs. 2.12, p < 0.001) after surgery were significantly lower in the combined group. CWI showed a similar pain-reduction effect after surgery compared to IV PCA, except for the acute phase (within 6 h after surgery). The incidence of PONV during the entire hospitalization period was significantly lower in the CWI group compared to the groups using IV PCA (p < 0.05). The combined group had a significantly lower incidence of PONV and use of rescue antiemetics than the IV PCA group (p < 0.05). The combined group required significantly less total PCA fentanyl compared to the IV PCA group (combined vs. PCA, 622.1 μg vs. 703.1 μg, p < 0.001). Conclusions: CWI is an effective alternative to IV PCA and has fewer side effects. Combined use of CWI and IV PCA may be an ideal pain management strategy, offering a strong pain-reduction effect and only moderate side effects. Full article
(This article belongs to the Special Issue Recent Advances in Minimally Invasive Gynecologic Surgery (MIGS))
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9 pages, 1876 KiB  
Article
Charting Proficiency: The Learning Curve in Robotic Hysterectomy for Large Uteri Exceeding 1000 g
by Jihyun Lee and Seongmin Kim
J. Clin. Med. 2024, 13(15), 4347; https://doi.org/10.3390/jcm13154347 - 25 Jul 2024
Cited by 1 | Viewed by 1073
Abstract
Background/Objectives: This study evaluates the safety and surgical outcomes of performing robotic hysterectomy on uteri weighing over 1000 g, with a focus on the surgeon’s learning curve. Methods: A retrospective analysis was conducted on 44 patients who underwent hysterectomy by a single surgeon [...] Read more.
Background/Objectives: This study evaluates the safety and surgical outcomes of performing robotic hysterectomy on uteri weighing over 1000 g, with a focus on the surgeon’s learning curve. Methods: A retrospective analysis was conducted on 44 patients who underwent hysterectomy by a single surgeon from January 2020 to February 2024 using the DaVinci Xi System. Surgical procedures included total hysterectomy with bilateral salpingectomy, and specimens were removed via transvaginal manual morcellation. Operative times were segmented into docking, console, morcellation, and conversion times. Results: Results indicated an inflection point in the 20th case, suggesting proficiency after 20 surgeries. Comparison between early (Group A, cases 1–20) and later cases (Group B, cases 21–44) showed significant reductions in console time (CT) and morcellation time (MT) in Group B, leading to a shorter overall operative time (OT). Although estimated blood loss was higher in Group A, it was not statistically significant. Hemoglobin differences were significantly higher in Group B. No significant differences were observed in transfusion rates, postoperative analgesic usage, or complications between the groups. Conclusions: The study concludes that robotic hysterectomy for large uteri is safe and that surgical proficiency improves significantly after 20 cases, enhancing overall outcomes. Full article
(This article belongs to the Special Issue Recent Advances in Minimally Invasive Gynecologic Surgery (MIGS))
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Review

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14 pages, 634 KiB  
Review
Quality of Life Assessment After Pelvic Prolapse Surgery With and Without Mesh: A Literature Review
by Marilena Pirtea, Oana Balint, Cristina Secoșan, Dan Costăchescu, Alexandru Dabîca and Dan Navolan
J. Clin. Med. 2025, 14(4), 1325; https://doi.org/10.3390/jcm14041325 - 17 Feb 2025
Viewed by 535
Abstract
Background/Objectives: The quality of life (QoL) in patients undergoing pelvic prolapse surgery is a critical area of research in urogynecology. Pelvic organ prolapse (POP) is a prevalent condition affecting a significant number of women, leading to various physical and psychological symptoms that [...] Read more.
Background/Objectives: The quality of life (QoL) in patients undergoing pelvic prolapse surgery is a critical area of research in urogynecology. Pelvic organ prolapse (POP) is a prevalent condition affecting a significant number of women, leading to various physical and psychological symptoms that can severely impact their quality of life. Surgical intervention aims not only to correct the anatomical defects but also to enhance the overall well-being of patients. Methods: A comprehensive literature search in the main databases was conducted for studies evaluating quality of life after surgical treatment using techniques with and without mesh. Results: A total of 35 studies met the inclusion criteria, involving a total of 4603 patients. Twenty-two distinct patient-reported outcomes (PRO) questionnaires have been identified as post-surgical QoL assessment tools. Conclusions: Quality of life is significantly improved by surgical treatment of pelvic organ prolapse. Post-surgical PRO scores do not seem to be influenced by the surgical technique used, with no significant differences between methods using mesh or not. Full article
(This article belongs to the Special Issue Recent Advances in Minimally Invasive Gynecologic Surgery (MIGS))
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