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Medicina
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Clinical Advances in Gynecological Surgery
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Clinical Advances in Gynecological Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: 30 November 2025 | Viewed by 555

Special Issue Editor

Dr. Vito Andrea Capozzi

E-Mail Website
Guest Editor
Azienda Ospedaliero, Universitaria di Parma, 43125 Parma, Italy
Interests: endometrial cancer; ovarian cancer; borderline ovarian tumors; surgery; laparoscopy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Recent advancements in gynecological surgery have significantly enhanced patient outcomes, reducing morbidity and improving recovery times. Minimally invasive techniques, particularly laparoscopic and robotic-assisted surgeries, have revolutionized the field. These methods offer reduced blood loss, shorter hospital stays, and lower postoperative pain compared to traditional open surgeries. Robotic-assisted surgery, with its enhanced precision and dexterity, has become especially prominent in complex gynecological procedures.

The adoption of enhanced recovery after surgery (ERAS) protocols has further optimized surgical outcomes, emphasizing preoperative nutrition, multimodal pain management, and early mobilization to accelerate recovery. Advances in imaging technologies, such as 3D ultrasound and MRI, have improved preoperative planning and intraoperative navigation, aiding in the accurate identification and treatment of gynecological pathologies.

The purpose of this Special Issue is to showcase a collection of original articles, meta-analyses, or systematic literature reviews in the field of the most updated gynecological surgery.

Dr. Vito Andrea Capozzi
Guest Editor

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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • gynecology
  • oncology
  • surgery

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Published Papers (2 papers)

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Research

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13 pages, 605 KiB  
Article
Predictors of Methotrexate Success and Fertility Outcomes in Tubal Ectopic Pregnancy: A Retrospective Cohort Study
by Elisa Scarpelli, Vito Andrea Capozzi, Licia Roberto, Asya Gallinelli, Alessandra Pezzani, Michela Monica and Roberto Berretta
Medicina 2025, 61(6), 1058; https://doi.org/10.3390/medicina61061058 - 9 Jun 2025
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Abstract
Background and Objectives: Ectopic pregnancy (EP) is a potentially life-threatening condition and the leading cause of maternal mortality in the first trimester. Although both surgical and medical approaches are effective, selection criteria for Methotrexate (MTX) treatment remain inconsistent across international guidelines. Additionally, [...] Read more.
Background and Objectives: Ectopic pregnancy (EP) is a potentially life-threatening condition and the leading cause of maternal mortality in the first trimester. Although both surgical and medical approaches are effective, selection criteria for Methotrexate (MTX) treatment remain inconsistent across international guidelines. Additionally, limited data on long-term reproductive outcomes are available. Materials and Methods: We conducted a single-center retrospective cohort study of 107 patients diagnosed with tubal EP and treated at the Obstetrics and Gynecology Unit of the University Hospital of Parma between 2019 and 2023. MTX (50 mg/m2) was offered to patients with β-hCG < 5000 mIU/mL, sac diameter < 40 mm, and no embryonic cardiac activity or hemoperitoneum; others underwent salpingectomy. Treatment outcomes, predictors of MTX success, and fertility outcomes were analyzed. Results: Medical treatment was offered to 36 patients (33.6%), with an overall success rate of 72%: in total, 20 resolved after a single dose and 6 after a second dose. Surgical conversion was necessary in 10 patients. The remaining 71 patients (66.4%) underwent primary salpingectomy. Initial β-hCG levels and gestational age did not significantly predict MTX failure (p 0.14 and 0.73, respectively), whereas gestational sac diameter was identified as a reliable predictor of treatment success (p = 0.01). In particular, a gestational sac maximum diameter of <2 cm emerged as a positive factor for MTX success (OR 1.13, 95% CI: 1.1–1.3, p = 0.04). Among the 50 patients with follow-up data, 68% achieved a term live birth, with no significant difference between the MTX (52.9%) and surgical (75.8%) groups (p 0.12). Most of the pregnancies (90%) occurred spontaneously, while only 10% required assisted reproductive technologies. Conclusions: MTX is a safe and effective treatment for tubal EP when patients are appropriately selected. Gestational sac diameter appears to be a reliable predictor of success. Both medical and surgical treatments yielded comparable reproductive outcomes, supporting individualized care models that prioritize fertility preservation. Full article
(This article belongs to the Special Issue Clinical Advances in Gynecological Surgery)
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Review

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12 pages, 492 KiB  
Review
Minimally Invasive Surgery for the Excision and Repair of Cesarean Scar Defect: A Scoping Review of the Literature
by Surico Daniela, Vigone Alessandro, Monateri Carlotta, Tortora Mario and Aquino Carmen Imma
Medicina 2025, 61(7), 1123; https://doi.org/10.3390/medicina61071123 (registering DOI) - 21 Jun 2025
Abstract
Background and Objectives: The isthmocele is a pouch-shaped defect in the anterior uterine wall, site of a previous cesarean section, due to a scar defect or dehiscence. The prevalence could be underestimated, but the rate of cesarean section is still high in [...] Read more.
Background and Objectives: The isthmocele is a pouch-shaped defect in the anterior uterine wall, site of a previous cesarean section, due to a scar defect or dehiscence. The prevalence could be underestimated, but the rate of cesarean section is still high in the world. The preferable technique to correct this anomaly is not clearly indicated in the literature. Our objective is to evaluate the literature on the surgical treatment of isthmocele in pre-Cesarean women treated with minimally invasive technique. Our hypothesis is that robotic treatment is more effective than other procedures in women desirous of having children. Materials and Methods: The words “isthmocele”, “laparoscopy”, “robot” and “cesarean scar pregnancy” were searched on the main online scientific search sources (PubMed, Google Scholar, Scopus, WES, and Embase, etc.). We included articles in English and French, chosen for the relevance to the topic. We have decided to include also surgical corrections of isthmocele linked to pregnancies at the site of the defect, with particular attention to video training explanation. Results: We analyzed the literature about the minimally invasive surgery for the repair of an isthmocele, evaluating 20 articles. Comparing several surgical techniques, robotic-assisted laparoscopy could be an effective method to correct the defect, without high risk of intraoperative complications. Conclusions: As indicated in the literature, robotic tailored excision and repair of isthmocele (and of concomitant cesarean scar pregnancy) could be advantageous and safe, and it is necessary to promote video-training about this technique. Full article
(This article belongs to the Special Issue Clinical Advances in Gynecological Surgery)
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