Perioperative Opioid Use in Urogynecologic Mesh Removal.

Importance: Forty percent of patients with urogynecologic mesh pain complications are taking narcotics.

Objectives: We aimed to compare comorbidities and pain scores between patients with and without narcotic use and assess postoperative narcotic use rates.

Study Design: This was a secondary analysis of a prospective cohort study of patients undergoing urogynecologic mesh removal.

Impact of Age on Perioperative Complications After Obliterative Vaginal Surgery.

Importance: Obliterative vaginal surgery is often reserved for older patients with prolapse, but the effect of age as an independent risk factor for perioperative complications in this cohort is poorly understood.

Objective: The aim of this study was to assess the association between age and perioperative complications in women undergoing obliterative vaginal surgery.

Study Design: This was a retrospective cohort study that included 371 patients undergoing colpocleisis between 2010 and 2013 at a single academic medical center.

Surgical treatment of stress urinary incontinence: comparison of robotic-assisted Burch urethropexy with retropubic midurethral sling.

Synthetic retropubic midurethral slings (RMUS) and robotic-assisted Burch urethropexies (RA-Burch) are common surgical treatment options for stress urinary incontinence (SUI). Few data exist comparing the success of these two retropubic surgeries. This retrospective cohort study of RA-Burch and RMUS procedures compared the proportion of patients with subjective cure after RA-Burch compared to RMUS at our institution between 2016 and 2020.

Surgical cost of robotic-assisted sacrocolpopexy: a comparison of two robotic platforms.

Importance: Robotic assistance in pelvic organ prolapse surgery can improve surgeon ergonomics and instrument dexterity compared with traditional laparoscopy but at increased costs.

Objective: To compare total costs for robotic-assisted sacrocolpopexy (RSC) between two robotic platforms at an academic medical center.

Methods: Retrospective cohort of Senhance (Ascensus) RSC between 1/1/2019 and 6/30/21 who were matched 2:1 with DaVinci (Intuitive) RSC.

Operative Time for Minimally Invasive Sacrocolpopexy: Comparison of Conventional Laparoscopy versus Robotic Platform.

Study Objective: To evaluate the operative time for minimally invasive sacrocolpopexy using conventional laparoscopy vs robotic assistance. In addition, we sought to compare intraoperative complications, mesh complications, anatomic prolapse recurrence, and retreatment.

Design: Retrospective cohort study.

Sacrocolpopexy experience with a novel robotic surgical platform.

Introduction And Hypothesis: The objective was to describe early experience performing sacrocolpopexy using a novel robotic surgical platform.

Methods: This is a case series of all women who underwent robotic-assisted sacrocolpopexy using a new robotics platform (TransEnterix Senhance) between January 2019 and July 2021. All sacrocolpopexies were performed by a single Female Pelvic Medicine and Reconstructive surgeon at a large academic institution.

Surgeon satisfaction and outcomes of tele-proctoring for robotic gynecologic surgery.

Surgical proctoring requires increasing resources in growing healthcare systems. In addition, travel has become less safe in the era of COVID-19. This study demonstrates surgeon satisfaction and safety with tele-proctoring in robotic gynecologic surgery.

Prolapse Recurrence After Sacrocolpopexy Mesh Removal: A Retrospective Cohort Study.

Objectives: There is limited literature regarding outcomes after sacrocolpopexy mesh removal. We sought to compare the proportion of prolapse recurrence in women after sacrocolpopexy mesh removal with women who underwent sacrocolpopexy without subsequent mesh removal. We hypothesize that more women will experience prolapse recurrence after mesh removal.

The impact of fellowship surgical training on operative time and patient morbidity during robotics-assisted sacrocolpopexy.

Introduction And Hypothesis: Abdominal sacrocolpopexy is commonly performed for the surgical correction of pelvic organ prolapse (POP) in the USA. Over the last decade, fellowship programs have increased the number of these procedures performed robotically. Currently, there is a paucity of literature exploring the impact of fellowship training on outcomes of robotic-assisted sacrocolpopexy (RASC).

The Impact of a Dedicated Robotic Team on Robotic-Assisted Sacrocolpopexy Outcomes.

Background: Robotic-assisted sacrocolpopexy has been criticized for high cost. A strategy to increase operating room efficiency and decrease cost is implementation of a dedicated robotic team. Our objective was to determine if a dedicated robotic team decreases operative time.

The Impact of Individual Surgeon Volume on Hysterectomy Costs.

Background And Objective: Hysterectomy is one of the most common surgical procedures women will undergo in their lifetime. Several factors affect surgical outcomes. It has been suggested that high-volume surgeons favorably affect outcomes and hospital cost.

Evaluating the Impact of Intraoperative Surgical Team Handoffs on Patient Outcomes.

Objective: The aim of the study was to assess the impact of intraoperative personnel handoffs on clinical outcomes in patients undergoing minimally invasive sacrocolpopexy (SCP).

Methods: We retrospectively reviewed SCPs performed at an academic center between 2009 and 2014. We analyzed the number of staff handoffs, defined as any instance a scrub technician (tech) or circulating nurse handed off responsibility for a break or shift change.

Host response to synthetic mesh in women with mesh complications.

Background: Despite good anatomic and functional outcomes, urogynecologic polypropylene meshes that are used to treat pelvic organ prolapse and stress urinary incontinence are associated with significant complications, most commonly mesh exposure and pain. Few studies have been performed that specifically focus on the host response to urogynecologic meshes. The macrophage has long been known to be the key cell type that mediates the foreign body response.

Intraovarian oxidized cellulose (Surgicel) mimicking acute ovarian pathology after recent pelvic surgery.

Oxidized regenerated cellulose (Ethicon Surgicel) is often used during surgery to achieve hemostasis. The appearance of Surgicel on postoperative computed tomography (CT) may be mistaken for abscess. Meanwhile, the literature regarding its ultrasound appearance remains scant.

Cost analysis when open surgeons perform minimally invasive hysterectomy.

Background And Objective: The costs to perform a hysterectomy are widely variable. Our objective was to determine hysterectomy costs by route and whether traditionally open surgeons lower costs when performing laparoscopy versus robotics.

Methods: Hysterectomy costs including subcategories were collected from 2011 to 2013.

The routine use of cystoscopy with the Burch procedure.

Objective: We sought to determine the incidence of unsuspected injury to the lower urinary tract as detected by intraoperative cystoscopy when the Burch procedure is performed.

Study Design: We reviewed the records of 181 women who underwent pelvic surgery, which included a Burch retropubic urethropexy for genuine stress urinary incontinence, between Jan 1, 1998, and Dec 31, 1999. All patients underwent intraoperative cystoscopy at the completion of the Burch procedure after the administration of intravenous indigo carmine dye.

Production of laminin B2 chain protein and messenger RNA by a murine neutrophil precursor cell line, 32Dc13.

Laminin is a heterotrimeric glycoprotein that plays a central role in promoting neutrophil chemotaxis, motility, and attachment to basement membrane. Rabbit peritoneal exudate neutrophils stain positively for laminin, which is presumed to be of exogenous origin and bound to laminin receptors on the cell surface. We examined 32Dc13 cells, a murine neutrophil precursor cell line, by immunoprecipitation.