Publications by authors named "Alex Ades"

Importance: Port-site hernia is an iatrogenic complication with a documented incidence between 0.65% and 2.8%.

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We present the findings of a prospective cohort study in a single tertiary hospital to review the patient experience and economic benefit of ambulatory hysteroscopy (AH). Data were collected between May 2017 and February 2020. Patient satisfaction was measured with qualitative survey.

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Importance: Cervical insufficiency (CI) is a serious complication of pregnancy, which can cause preterm birth. Identifying how to most effectively treat CI has the potential to maximize neonatal survival in this population of women.

Objective: To determine whether transabdominal cervical cerclage should be offered as a first-line treatment option in high-risk women.

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Background: Detailed pre-operative description of endometriotic lesions by non-invasive methods is an important tool for accurate diagnosis and effective treatment of the disease. Transvaginal ultrasound (TVUS) is a sensitive method for diagnosis of deep infiltrating endometriosis (DIE); however, it is highly operator-dependent and consistent results require adequately trained and experienced clinicians.

Aims: The aim of the study is to assess the accuracy of TVUS in predicting DIE by comparing it with laparoscopic findings.

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Most adnexal masses are benign, incidental findings of pregnancy which resolve spontaneously. They may present clinically due to haemorrhage, rupture, torsion and mass effect. Aetiological classification includes ovarian benign, ovarian malignant, non-ovarian, gynaecological, non-ovarian non-gynaecological and an additional subset of pathologies unique to pregnancy.

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A 65-year-old woman was referred with an incidental finding of a flurodeoxyglucose-avid uterine lesion, following excision of a local lung adenocarcinoma. MRI had features concerning for an atypical fibroid or smooth muscle tumour of uncertain malignant potential. She underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy.

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Objective: To evaluate obstetric outcomes of subsequent pregnancies in women who had a laparoscopic transabdominal cerclage.

Methods: A prospective observational study of consecutive women who became pregnant a second or third time after a laparoscopic transabdominal cerclage. Eligible women were considered not suitable for a transvaginal cerclage or had previously failed a transvaginal cerclage.

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Background: Transabdominal cerclage can reduce the risk of preterm birth in women with cervical insufficiency.

Aims: This study evaluated outcomes following insertion of a laparoscopic transabdominal cerclage in pregnant women.

Materials And Methods: A retrospective observational study.

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Objectives: There are no current established pathognomonic diagnostic features for uterine leiomyosarcomas in the pre- or perioperative setting. Recent inadvertent upstaging of this rare malignancy during laparoscopic morcellation of a presumed fibroid has prompted widespread debate among clinicians regarding the safety of current surgical techniques for management of fibroids. This study aims to conduct a systematic review investigating significant diagnostic features in magnetic resonance imaging (MRI) of uterine leiomyosarcomas.

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Background: Cervical insufficiency is a significant cause of morbidity and mortality. Cervical cerclage is one option in the management of cervical insufficiency.

Aim: To evaluate obstetric outcomes following insertion of a pre-pregnancy laparoscopic transabdominal cerclage in women at high risk for pre-term labour and/or mid-trimester pregnancy loss.

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Study Objective: To demonstrate a technique for the laparoscopic surgical management of cesarean section scar ectopic pregnancy.

Design: Step-by-step presentation of the procedure using video (Canadian Task Force classification III).

Setting: Cesarean section scar ectopic pregnancy is a rare form of ectopic pregnancy with an incidence ranging from 1:1800 to 1:2216.

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Background: Uterine leiomyomas, or fibroids, represent a large proportion of gynaecological presentations in both general and specialist gynaecology practice. The diagnosis is relatively simple with current imaging modalities. The management of fibroids, however, is not always straightforward and can present many challenges.

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The incidence of uterus didelphys is around 3/10,000 women. It is a class III Müllerian duct anomaly resulting from a complete non-fusion of the paired Müllerian ducts between the 12th and 16th weeks of gestation. Although the prevalence of cervical insufficiency in women with uterus didelphys is unknown, the incidence of cervical insufficiency in women with Müllerian anomalies has been reported as high as 30%.

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Study Objective: To evaluate the obstetric outcome, surgical morbidity, and pre-abdominal cerclage characteristics of women undergoing transabdominal cerclage (TAC) via laparotomy or laparoscopy.

Design: Prospective cohort study (Canadian Task Force classification II-2).

Setting: University hospital.

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Background: Cervical cerclage has been used as a treatment for cervical insufficiency for over 60 years. Transabdominal cerclage is indicated for cervical insufficiency not amenable to a transvaginal procedure, or following previous failed vaginal cerclage. A laparoscopic approach to abdominal cerclage offers the potential to reduce the morbidity associated with laparotomy.

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Background: Transabdominal cervical cerclage has been performed via laparotomy for over four decades. A laparoscopic approach has recently been developed and offers the potential for lower morbidity.

Aims: The experience of one operator with transabdominal cervical cerclage via laparotomy is reviewed to establish a baseline with which to compare results from the laparoscopic approach.

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