Subtotal hysterectomy by natural orifice transluminal endoscopic surgery.

Study Objective: To introduce the innovative surgical procedure of treating benign uterine pathology with subtotal hysterectomy by natural orifice transluminal endoscopic surgery (NOTES).

Design: Prospective observational study.

Setting: Tertiary referral medical center.

Natural orifice transluminal endoscopic surgery (NOTES) subtotal hysterectomy: A feasibility study.

Objective: Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery (NOTES) has been carried out for benign uterine diseases and nonprolapsed uteri in recent years. Subtotal hysterectomy was performed to remove the uterus with preservation of the cervix by abdominal, laparoscopic, or vaginal routes. The aim of this retrospective study is to gain insight into the feasibility and safety of subtotal hysterectomy through transvaginal NOTES.

The Power Law of Learning in Transumbilical Single-Port Laparoscopic Subtotal Hysterectomy.

Study Objective: To analyze the surgical outcomes and learning curve of transumbilical single-port laparoscopic subtotal hysterectomy, which requires sutures of the cervical stump.

Design: A prospective observational study (Canadian Task Force classification II-2).

Setting: A university-affiliated center.

Massively parallel sequencing and genome-wide copy number analysis revealed a clonal relationship in benign metastasizing leiomyoma.

Benign metastasizing leiomyoma (BML) is a rare disease entity typically presenting as multiple extrauterine leiomyomas associated with a uterine leiomyoma. It has been hypothesized that the extrauterine leiomyomata represent distant metastasis of the uterine leiomyoma. To date, the only molecular evidence supporting this hypothesis was derived from clonality analyses based on X-chromosome inactivation assays.

Robot-assisted natural orifice transluminal endoscopic surgery for hysterectomy.

Objective: To describe the surgical procedures of robot-assisted natural orifice transluminal endoscopic surgery (NOTES) for hysterectomy and to evaluate its feasibility.

Materials And Methods: From December 2014 to February 2015, four patients with benign diseases who were eligible for robot-assisted NOTES at Chang Gung Memorial Hospital were recruited to this study. Intraoperative and postoperative surgical outcomes were evaluated.

Accuracy of hysteroscopic biopsy, compared to dilation and curettage, as a predictor of final pathology in patients with endometrial cancer.

Objective: To compare the methods of transcervical resectoscopy versus dilation and curettage (D&C) for endometrial biopsy and to compare these methods for the percentage of histological upgrades at the final posthysterectomy pathology findings in endometrial cancer.

Materials And Methods: We retrospectively reviewed 253 cases of uterine cancer diagnosed from May 1995 to January 2014. Included in the study were patients who received transcervical resectoscopy (TCR) or D&C biopsy as the diagnostic method and underwent laparoscopic staging at our institution.

Accessibility and surgical outcomes of transumbilical single-port laparoscopy using straight instruments for hysterectomy in difficult conditions.

Objectives: To evaluate the accessibility of transumbilical single-port laparoscopy for hysterectomy in difficult conditions.

Materials And Methods: This prospective observational study recruited patients with benign diseases who were scheduled for laparoscopic hysterectomy between March 2010 and October 2011 to undergo the transumbilical single-port approach with straight instruments and a laparoscope.

Results: In total, 109 patients were included with a mean [± standard error of the mean (SEM)] age of 45.

Laparoendoscopic single-site herniorrhaphy after gynecologic surgery.

Background And Objectives: Increased interest in laparoendoscopic single-site surgery has instigated research into trials of novel techniques. The procedure we propose may potentially improve patient satisfaction and cosmetic results while diminishing the incidence of trocar-site herniation. We report our initial experience with laparoendoscopic single-site totally extraperitoneal herniorrhaphy for postoperative incisional hernia to determine the procedure's feasibility and safety.

Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (NOTES): a series of 137 patients.

Study Objective: To evaluate the feasibility and safety of hysterectomy in benign disease using transvaginal natural orifice transluminal endoscopic surgery (NOTES).

Design: Prospective observational study (Canadian Task Force classification II-3).

Setting: Tertiary referral medical center.

Early detection and minimally invasive management of intramural pregnancy.

Intramural pregnancy is a rare form of ectopic pregnancy, wherein the fetus is implanted within the myometrium, separate from the endometrial cavity. In the early reported cases, a diagnosis was only possible after an operation for uterine rupture; however, recent developments in ultrasonography and magnetic resonance imaging assist in early diagnosis. Early diagnosis prevents potential life-threatening hemorrhage and preserves fertility.

Single-port laparoscopic myomectomy: initial operative experience and comparative outcome.

Objective: To present the initial operative outcome and comparative data among patients undergoing single-port laparoscopic myomectomy (SPLM).

Materials And Methods: A prospective, observational study of all patients who underwent SPLM was performed. The demographic and operative data, including age, body mass index, operative indications, operative time, estimated blood loss, complications, and postoperative hospital stay were recorded.

Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery (NOTES): feasibility of an innovative approach.

Objective: To evaluate the feasibility and safety of performing a hysterectomy using the transvaginal natural orifice transluminal endoscopic surgery (NOTES).

Materials And Methods: From May through December 2010, 16 patients with benign uterine diseases who were eligible for laparoscopic hysterectomy were recruited to undergo transvaginal NOTES at a tertiary referral medical center. Intraoperative and postoperative surgical outcomes were measured.

Pierce and push: a simplified method to facilitate laparoscopic myomectomy.

Background: The aim of this study was to present our experience with a novel approach called the pierce and push (PP) method which uses a stainless steel centimeter probe instead of a 5 mm claw forceps to enucleate fibroids in a laparoscopic myomectomy (LM).

Methods: A retrospective chart review of 90 women with symptomatic uterine fibroids who underwent an LM was performed. Cases of LM with the PP method were compared with a matched control group of LM with a 5 mm claw forceps.

Outcome of laparoscopic repair of ureteral injury: follow-up of twelve cases.

Study Objective: To review the feasibility of laparoscopic repair in cases of ureteral injuries occurring during gynecologic laparoscopy.

Design: Retrospective study (Canadian Task Force classification II-3).

Setting: Institution-specific retrospective review of data from a tertiary referral medical center.

Comparison of the efficacy of the pulsed bipolar system and conventional electrosurgery in laparoscopic myomectomy - a retrospective matched control study.

Objective: Comparing the safety and effectiveness of the pulsed bipolar (PK) system and conventional electrosurgery in laparoscopic myomectomy (LM).

Materials And Methods: Retrospective chart review of 194 women with symptomatic uterine fibroids undertaken LM was performed. Cases of LMs with PK cutting forceps were compared with a matched control group of standard LMs with conventional electrosurgery.

Robot-assisted laparoscopic staging surgery for endometrial cancer--a preliminary report.

Objective: The robotic surgical system is reported to overcome some technical difficulties in traditional laparoscopic hysterectomy. This study aimed to evaluate the feasibility and surgical outcomes of a robotic surgery program for endometrial cancer.

Materials And Methods: Patients with endometrial cancer with the intention to receive treatment using robot-assisted laparoscopic staging surgery were recruited in a university hospital from July 2007 to August 2008.

A transient blocking uterine perfusion procedure to decrease operative blood loss in laparoscopic myomectomy.

Background: To evaluate the feasibility and effectiveness of reversible ligating clips to block uterine arteries and reduce operative blood loss during laparoscopic myomectomy (LM).

Methods: Twenty consecutive women with symptomatic uterine fibroids desiring to preserve the uteri underwent laparoscopic surgery with ligation of the uterine arteries with ligating clips, followed by myomectomy and removal of the clips.

Result: Laparoscopic uterine artery ligation with reversible ligating clips was successfully performed in all patients.

Diagnostic laparoscopy in ascites of unknown origin: Chang Gung Memorial Hospital 20-year experience.

Background: Ascites may appear with well-recognized disease but, in some situations, ascites is of unknown cause in spite of comprehensive study. The aim of this study was to assess the diagnostic accuracy of laparoscopy in patients with ascites of unknown origin, and evaluate the role of laparoscopy in this population after the advent of ultrasonography and computed tomography.

Methods: We collected 20 years' data of diagnostic laparoscopy from retrospective chart review at Chang Gung Memorial Hospital in Linkou and Taipei.

Reducing peritoneal vascular endothelial growth factor concentration and inhibiting cancer scattering in a mouse model of laparoscopy.

Objective: The objective of the study was to investigate the efficacy of early intraperitoneal (i.p.) paclitaxel administration in reducing vascular endothelial growth factor (VEGF) concentration in peritoneal fluid and preventing intraoperative cancer scattering during laparoscopy.

Management of primary abdominal pregnancy: twelve years of experience in a medical centre.

Background: The aim of this study was to evaluate our institution's 12-year experience in managing primary abdominal pregnancy by laparotomy or laparoscopy.

Methods: We identified 11 cases of primary abdominal pregnancy treated at our institution between January 1994 and December 2005, and separated the cases into 2 groups based on type of surgical management. The outcome measures we evaluated were operative time, blood loss and duration of hospital stay.

Oxytocin infusion in laparoscopic myomectomy may decrease operative blood loss.

Study Objective: To evaluate the influence of oxytocin on operative blood loss during laparoscopic myomectomy (LM).

Design: Prospective clinical study (Canadian Task Force classification I).

Setting: Tertiary care university hospital.

A new approach for laparoscopic ovarian transposition before pelvic irradiation.

Objective: To evaluate and describe our special design of laparoscopic ovarian transposition to a high anterolateral position using Lee-Huang point as first entrance and landmark before pelvic irradiation in premenopausal patients with a gynecologic malignancy.

Methods: Laparoscopic surgery was conducted to transpose bilateral ovaries in consecutive cases of premenopausal women with a gynecologic malignancy requiring pelvic irradiation in a university-based, tertiary-level training center for endoscopic surgery. Ovaries were transposed to a high anterolateral position, 3-4 cm above umbilical line.