New Developments in Minimally Invasive Gynecologic Surgery

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

Deadline for manuscript submissions: closed (20 September 2022) | Viewed by 5832

Special Issue Editors


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Guest Editor
Department of Gynecology and Obstetrics, Tenon Hospital (AP-HP), Sorbonne University, 75020 Paris, France
Interests: endometriosis; gyneco-oncology

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Guest Editor
Service de Chirurgie Gynécologique et Oncologique, Obstétrique Hôpital Lyon Sud, 69310 Pierre-Bénite, France
Interests: gestational trophoblastic diseases; deep infiltrating endometriosis; mini-invasive treatment of ovarian and endometrial cancer

Special Issue Information

Dear Colleagues,

Laparoscopy was created in France in 1944 when the great gynecologic surgeon, Raoul Palmer, had the idea to introduce an optical camera inside the abdomen during operations. Since then, the steady progress made has revolutionized our approach to women's health care in terms of prognosis and quality of life in gynecological disorders. More recently, robotic-assisted laparoscopy has enabled even more complex procedures to be performed while improving surgeons’ comfort. In most conditions, whether benign or malignant, the minimally invasive approach has become the standard and is associated with reduced morbidity and improved post-operative outcomes.

New developments made in minimally invasive gynecologic surgery relate to different aspects of research, including materials and techniques, enhanced recovery after surgery (ERAS) protocols, anatomical considerations, surgical procedures, pre- or postoperative management, and virtual reality. However, this list is not definite. This issue aims to promote original works as well as reviews or meta analyses that could contribute to improving our standard of care and women’s health.

I cannot wait to read your interesting work!

Dr. Yohann Dabi
Dr. Pierre-Adrien Bolze
Guest Editors

Manuscript Submission Information

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Keywords

  • laparoscopy
  • minimally invasive surgery
  • robotics
  • gynecology

Published Papers (2 papers)

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Research

9 pages, 1441 KiB  
Article
New Efficient Method for Hysteroscopic Isthmoplasty: Four Simple Steps Lead to a Significant Improvement in Bleeding Status
by Chien-Chu Huang, Shao-Chih Chiu, Chih-Ming Pan, Chun-Chung Huang, Cherry Yin-Yi Chang, Shih-Chi Chao, Der-Yang Cho and Wu-Chou Lin
J. Clin. Med. 2022, 11(21), 6541; https://doi.org/10.3390/jcm11216541 - 4 Nov 2022
Cited by 4 | Viewed by 3784
Abstract
We demonstrate an effective reduction in postmenstrual spotting after our novel hysteroscopic isthmoplasty. This study included 66 patients with isthmocele-related postmenstrual spotting confirmed by sonography and diagnostic hysteroscopy between 2000 and 2017. Our new interventions included the following four steps: (1) make a [...] Read more.
We demonstrate an effective reduction in postmenstrual spotting after our novel hysteroscopic isthmoplasty. This study included 66 patients with isthmocele-related postmenstrual spotting confirmed by sonography and diagnostic hysteroscopy between 2000 and 2017. Our new interventions included the following four steps: (1) make a resection gradient of the distal edge of the isthmocele from the ape of the isthmocele down to the cervical outer orifice; (2) resect the distal and proximal niches of the isthmocele; (3) electrocauterize the distal and proximal sides (not only the niche bottom) of the small cave on the scar side of the isthmocele; (4) manage the isthmocele until it is largely connected to the cavity. In our results, all patients underwent extensive hysteroscopic repair of newly hysteroscopic isthmoplasty without any intra- or postoperative complications. After final hysteroscopic repair modification, prolonged menstrual spotting was significantly decreased in 98.2% (53/54) of the patients, and the total number of bleeding days per menstrual cycle significantly decreased from a mean of 15.38 ± 3.3 days to 6.4 ± 1.9 days postoperatively (p < 0.001). Our four-step hysteroscopic technique successfully resolved prolonged menstrual spotting in over 90% of the patients, exceeding the resolution rates of 60–85% achieved with other hysteroscopic techniques used to treat symptomatic isthmocele. No patients experience recurrence after long-term follow up. Four simple steps led to a significant improvement in bleeding status. Full article
(This article belongs to the Special Issue New Developments in Minimally Invasive Gynecologic Surgery)
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11 pages, 685 KiB  
Article
Total Hysterectomy by Low-Impact Laparoscopy to Decrease Opioids Consumption: A Prospective Cohort Study
by Yohann Dabi, Samia Ouasti, Hélène Didelot, Henri Wohrer, Dounia Skalli, Gregoire Miailhe, Jennifer Uzan, Clément Ferrier, Sofiane Bendifallah, Bassam Haddad, Emile Daraï and Cyril Touboul
J. Clin. Med. 2022, 11(8), 2165; https://doi.org/10.3390/jcm11082165 - 13 Apr 2022
Viewed by 1306
Abstract
Our objective was to evaluate postoperative pain and opioid consumption in patients undergoing hysterectomy by low-impact laparoscopy and compare these parameters with conventional laparoscopy. We conducted a prospective study in two French gynecological surgery departments from May 2017 to January 2018. The primary [...] Read more.
Our objective was to evaluate postoperative pain and opioid consumption in patients undergoing hysterectomy by low-impact laparoscopy and compare these parameters with conventional laparoscopy. We conducted a prospective study in two French gynecological surgery departments from May 2017 to January 2018. The primary endpoint was the intensity of postoperative pain evaluated by a validated numeric rating scale (NRS) and opioid consumption in the postoperative recovery unit on Day 0 and Day 1. Thirty-two patients underwent low-impact laparoscopy and 77 had conventional laparoscopy. Most of the patients (90.6%) who underwent low-impact laparoscopy were managed as outpatients. There was a significantly higher consumption of strong opioids in the conventional compared to the low-impact group on both Day 0 and Day 1: 26.0% and 36.4% vs. 3.1% and 12.5%, respectively (p = 0.02 and p < 0.01). Over two-thirds of the patients in the low-impact group did not require opioids postoperatively. Two factors were predictive of lower postoperative opioid consumption: low-impact laparoscopy (OR 1.38, 95%CI 1.13–1.69, p = 0.002) and a mean intraoperative peritoneum below 10 mmHg (OR 1.25, 95%CI 1.03–1.51). Total hysterectomy by low-impact laparoscopy is feasible in an outpatient setting and is associated with a marked decrease in opioid consumption compared to conventional laparoscopy. Full article
(This article belongs to the Special Issue New Developments in Minimally Invasive Gynecologic Surgery)
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