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Here, BJS Editor, Paul Sutton, explains what to look for in a scientific article that will help judge whether or not it has scientific credibility sufficient for publication, and in which journal.
How to review a paper - How to undertake a peer-review? (part 2/4)
Dr. B East, MD, PhD has the following potential conflicts of interest to disclose, receiving research grants from AZV and EHS, as well as speakers' fees from Medtronic. However, industrial companies were never committed to the elaboration and running organization of this webinar. There is neither commercial publicity nor commercial promotion in this webinar. Dr. B East is Secretary for (e)Quality at the EHS and Secretary of the AWS section at the UEMS; she will be the EHS 2024 Conference President, and she is co-producer of the Hernia Basecamp.
Dr. B East declares that she is fully committed to maintaining professional autonomy and independence in relation with the medical device Industry.
This webinar is aimed to promote education among its learners, and Dr. B East, MD, PhD declares that this webinar is fair, balanced, and free of commercial bias.
Dr. B. East has no financial affiliations that would affect the content of her talks.
EHS midline incisional hernia guidelines
Bibliography:
1. Ye Y, Wang Y, Tian W, et al. Burch colposuspension for stress urinary
incontinence: a 14-year prospective follow-up. Sci China Life Sci. 2022;65(8):1667-
1672. doi:10.1007/s11427-021-2042-9
2. Bulent Tiras M, Sendag F, Dilek U, Guner H. Laparoscopic burch colposuspension:
comparison of effectiveness of extraperitoneal and transperitoneal techniques. Eur J
Obstet Gynecol Reprod Biol. 2004;116(1):79-84. doi:10.1016/j.ejogrb.2004.02.003
3. Obaid AA, Al-Hamzawi SA, Alwan AA. Laparoscopic and open burch
colposuspension for stress urinary incontinence: advantages and disadvantages. J
Popul Ther Clin Pharmacol. 2022;29(2):e20-e26. Published 2022 Jun 16.
doi:10.47750/jptcp.2022.926
Extraperitoneal laparoscopic Burch colposuspension
Non-puerperal uterine inversion (NPUI) is a rare gynecologic condition with diagnostic and surgical challenges, characterized by the turning inside out of the uterus in women who are not pregnant or have recently given birth. It is unrelated to the postpartum period and can happen at any time.
The actual incidence is unknown and most of the published literature on NPUI is in the form of case reports. There have been 170 cases reports in the literature since 1940.
The mechanism of non-puerperal inversion is not so clear. However, it is often associated with the presence of benign or malignant tumors within or attached to the uterus, such as fibroids or polyps.
Clinical case presentation: This video presents the case of a 48-year-old woman with NPUI stage 4 associated with a large uterine myoma managed with a combined laparoscopic and vaginal approach.
The technical steps for its laparoscopic and vaginal management are demonstrated.
Conclusion:
The laparoscopic and vaginal management of NPUI is feasible with satisfying results.
Bibliography:
1. Rosa Silva, B., de Oliveira Meller, F., Uggioni, M. L., Grande, A. J., Chiaramonte Silva, N., Colonetti,T., ... & da Rosa, M. I. (2018). Non-puerperal uterine inversion: a systematic review. Gynecologic and Obstetric Investigation, 83(5), 428-436.
2. Kesrouani A, Cortbaoui E, Khaddage A, Ghossein M, Nemr E. Characteristics and Outcome in Non-Puerperal Uterine Inversion. Cureus. 2021 Feb 15;13(2):e13345. doi: 10.7759/cureus.13345. PMID: 33754086; PMCID: PMC7971731.
3. Thakur M, Thakur A. Uterine Inversion. 2022 Nov 28. In: StatPearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2023 Jan–. PMID: 30247846.
4. Moshayedi F, Seidaei HS, Salehi AM. A Case Report of Non-puerperal Uterine Inversion due to Submucosa Leiomyoma in a Young Virgin Woman. Case Rep Surg. 2022 Aug 16;2022:5240830. doi:10.1155/2022/5240830. PMID: 36017477; PMCID: PMC9398870.
Non-puerperal uterine inversion managed using a combined laparoscopic and vaginal approach
Take-home messages:
Conventionally, anterior compartment recurrence has been higher when compared to apical and posterior compartment recurrence. Synthetic meshes aiming to decrease such recurrence rates have been the subject of much controversy. They led to an improvement in the staging of pelvic support in relation to the Pelvic Organ Prolapse Quantification System (POP-Q) and to provide a subjective sensation of relief from the vaginal mass, yet with an increase in complications and no improvement in quality-of-life surveys as compared to surgery with native tissue. Likewise, the rates of reoperation for prolapse are similar between the two groups. Similarly, apical suspension has been shown to be an essential factor for the successful treatment of the anterior compartment.
Sacral colpopexy via laparotomy or laparoscopy has become the gold standard for treatment of vaginal vault prolapse with a greater anatomical success and a lower probability of reoperation, when compared to surgery performed vaginally. This technique has been extrapolated to hystero-preservation surgeries or in patients with uterine prolapse, with similar results. Likewise, in this group of patients, there is controversy as to whether to perform a total hysterectomy or a subtotal hysterectomy.
Some authors report a decrease of up to 4 times regarding the probability of synthetic material exposure in the larger group of patients that were submitted to a sub-total hysterectomy with the same anatomical and subjective success rates.
In this patient with recurrent anterior prolapse and associated apical prolapse, this surgery was chosen, considering that it uses a multicompartmental surgical technique. It also addresses the three compartments and allows adequate correction of the anterior prolapse if the mesh is advanced to the bladder trigone. Likewise, the laparoscopic approach allows reduced intraoperative bleeding, diminished recovery time with similar results to an open approach. In this group of patients, it is essential to rule out any cervical pathology and to screen for cervical cancer.
Bibliography:
1. Rosati, M., Bramante, S. and Conti, F. (2014) ‘A review on the role of Laparoscopic Sacrocervicopexy’, Current Opinion in Obstetrics & Gynecology, 26(4), pp. 281–289. doi:10.1097/gco.0000000000000079.
2. Lang, P. and Whiteside, J.L. (2017) ‘Anterior compartment prolapse: What’s new?’, Current Opinion in Obstetrics & Gynecology, 29(5), pp. 337–342. doi:10.1097/gco.0000000000000392.
3. Geoffrion, R. and Larouche, M. (2021) ‘Guideline no. 413: Surgical management of apical pelvic organ prolapse in women’, Journal of Obstetrics and Gynaecology Canada, 43(4), pp. 511–523. doi: 10.1016/j.jogc.2021.02.001.
4. Campagna, G. et al. (2021) ‘Laparoscopic sacral hysteropexy versus laparoscopic sacral colpopexy plus supracervical hysterectomy in patients with pelvic organ prolapse’, International Urogynecology Journal, 33(2), pp. 359–368. doi:10.1007/s00192-021-04865-0.
Supracervical laparoscopic sacrocolpopexy for recurrent prolapse and abnormal uterine bleeding
This event was a collaborative effort by IRCAD, EAES, and the CLASSICA team to bring together experts and practitioners in a comprehensive discussion about the future of cancer treatment.
This webinar gathers a panel of experts delving into the state-of-the-art of rectal polyp treatment, biophysics-inspired artificial intelligence (AI) for colorectal cancer characterization, liability, and legal concerns when using AI decision support in the operating room (OR), and guidance and training in intraoperative use. For any further information, please visit: https://classicaproject.eu/
Webinar program:
Introduction - A Arezzo, R Cahill, P Mascagni, R Rodríguez-Luna, S Perretta
State-of-the-art (SOA) for rectal cancer polyps - F Aigner
Biophysics-inspired AI for colorectal cancer (CRC) characterization - A Moynihan
Liability and legal concerns when using AI decision support in the OR - M Nunez Duffourc
Guidance and training in the intraoperative use of AI - P Mascagni
Panel discussion and concluding remarks
Validating artificial intelligence (AI) in classifying cancer in real-time surgery, CLASSICA webinar, March 26, 2024
Bibliography:
1. Mondal R, Bhave P. Accessory cavitated uterine malformation: Enhancing awareness about this unexplored perpetrator of dysmenorrhea. Int J Gynaecol Obstet. 2023 Aug;162(2):409-432. doi: 10.1002/ijgo.14681. Epub 2023 Feb 7. PMID: 36656754.
2. Peters A, Rindos NB, Guido RS, Donnellan NM. Uterine-sparing Laparoscopic Resection of Accessory Cavitated Uterine Masses. J Minim Invasive Gynecol. 2018 Jan;25(1):24-25. doi: 10.1016/j.jmig.2017.06.001. Epub 2017 Jul 21. PMID: 28599883.
3. Arya S, Burks HR. Juvenile cystic adenomyoma, a rare diagnostic challenge: Case Reports and literature review. F S Rep. 2021 Feb 10;2(2):166-171. doi: 10.1016/j.xfre.2021.02.002. PMID: 34278349; PMCID: PMC8267394.
Accessory cavitated uterine mass, a rare Mullerian anomaly: laparoscopic excision
The patient underwent a total hysterectomy with a bilateral salpingectomy using the Anovo™ Surgical System (Momentis Surgical) at the HCA Florida Kendall Hospital, Miami, Florida, United States.
This surgical robotic platform is a novel system, specifically designed for robotic vaginal natural orifice transluminal endoscopic surgery (RvNOTES), which represents the enhancement of the disruptive and more common approach, namely Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) [1, 2].
This is the first articulated humanoid-shaped robot, which mimics the surgeon’s entire upper extremity with every joint, namely shoulder, elbow, and wrist. The surgeon controls the two arms with two joystick controllers. In this video, the authors show the technology of RvNOTES performing a total hysterectomy with a bilateral salpingectomy in all its aspects, using the Anovo™ Surgical System [3]. The patient was placed in a dorsal lithotomy position with both legs in Allen® stirrups. A 30-degree Trendelenburg tilt was also used.
The surgical procedure was performed using a standardized technique.
No intraoperative complication was observed. The patient was discharged on the same day of surgery with no postoperative complications.
Final pathological findings showed the presence of adenomyosis, fibroids, and negative evidence of hyperplasia or malignancy.
Bibliography:
[1] Lowenstein, Lior et al. “Robotic transvaginal natural orifice transluminal endoscopic surgery for bilateral salpingo oophorectomy.” European journal of obstetrics & gynecology and reproductive biology: X vol. 7 100113. 23 Jun. 2020, doi:10.1016/j.eurox.2020.100113
[2] Lerner, Veronica T et al. “Vaginal Natural Orifice Transluminal Endoscopic Surgery Revolution: The Next Frontier in Gynecologic Minimally Invasive Surgery.” JSLS : Journal of the Society of Laparoendoscopic Surgeons vol. 27,1 (2023): e2022.00082. doi:10.4293/JSLS.2022.00082
[3] Lowenstein, Lior et al. “Robotic Vaginal Natural Orifice Transluminal Endoscopic Hysterectomy for Benign Indications.” Journal of minimally invasive gynecology vol. 28,5 (2021): 1101-1106. doi:10.1016/j.jmig.2020.10.021
Robot-assisted transvaginal total hysterectomy and bilateral salpingectomy with the Anovo™ Surgical System
IRCAD News
IRCAD hosts the Académie Nationale de Pharmacie
We were honored to welcome the Académie Nationale de Pharmacie to IRCAD. Professor Marescaux presented our institute and organized a virtual tour of the laparoscopic and robotic blocks, following the request of the President of the Academy, Philippe LIEBERMANN.World virtual university
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