Comparison of laparoscopic myomectomy using in situ morcellation with and without uterine artery ligation for treatment of symptomatic myomas.

Study Objective: To evaluate the efficacy of laparoscopic uterine artery ligation (LUAL) before in situ morcellation (ISM) compared with ISM alone.

Design: Prospective study (Canadian Task Force classification II-1).

Setting: University-affiliated hospital.

Operating time and blood loss during laparoscopic-assisted vaginal hysterectomy with in situ morcellation.

Objective: To develop a regression-based prediction equation for operative time and estimated blood loss in laparoscopically assisted vaginal hysterectomy (LAVH) for large uteri, as required, by combined laparoscopic in situ and vaginal morcellation.

Design: Prospective study (Canadian Task Force classification II-1).

Setting: University-affiliated hospitals.

Simultaneous laparoscopic uterine artery ligation and laparoscopic myomectomy for symptomatic uterine myomas with and without in situ morcellation.

Background: To determine the optimal surgical approach for laparoscopic uterine artery ligation (LUAL) combined with myomectomy in the management of women with symptomatic uterine fibroids.

Methods: This is a prospective study. One hundred and six women with symptomatic uterine myomas underwent LUAL + laparoscopic morcellation after enucleation (enucleation group) (n = 51) or LUAL + laparoscopic in situ morcellation (ISM group) (n = 55).

An easy new approach to the laparoscopic treatment of large adnexal cysts.

We describe a technique for laparoscopically assisted extracorporeal cystectomy or adnexectomy of large adnexal cysts without spillage of the cyst contents. At open laparoscopy, a suction tube decompressed the adnexal cyst from the 2-cm umbilical incision and the puncture hole was closed by the purse string tie, which was followed by extra-corporeal excision of the cyst. With this method, we prevent cyst spillage in three ways.

Simultaneous enucleation and in situ morcellation of myomas in laparoscopic myomectomy.

Objective: To evaluate the outcome of myoma enucleation by morcellation while it is attached to the uterus (in situ morcellation) in laparoscopic myomectomy.

Materials And Methods: A total of 82 patients diagnosed with myoma or adenomyosis in 2007 were enrolled. The patients were divided into three groups according to the myoma weight.

Clinical significance of regulatory T cells and CD8+ effector populations in patients with human endometrial carcinoma.

Background: A study was carried out to determine the functional attributes of CD4(+) CD25(+) regulatory T cells in cancer progression by suppressing antitumor immunity.

Methods: Triple-color flow cytometry was used to study the phenotype expression of CD4(+) CD25(+) regulatory T cells and CD8(+) T cells in the peripheral blood lymphocytes (PBLs) and tumor-infiltrating lymphocytes (TILs) of 57 cases of stage I to IV endometrial carcinoma. The expression of T cell subsets was correlated with clinical prognostic parameters.

Comparison between transumbilical and transabdominal ports for the laparoscopic retrieval of benign adnexal masses: a randomized trial.

Objective: To compare the feasibility, operative time, specimen retrieval time, and effect on postoperative pain of laparoscopic retrieval of benign adnexal masses between a 10-mm transumbilical and a 10-mm transabdominal port.

Study Design: Fifty women with adnexal masses who were scheduled for a laparoscopic procedure between July 2008 and April 2009 were enrolled. The patients were randomized into two groups; these were patients where a transumbilical port was used for specimen retrieval (transumbilical group, n=25) and patients where a transabdominal port was used for specimen retrieval (transabdominal group, n=25).

Clinical outcome of transvaginal sacrospinous fixation with the Veronikis ligature carrier in genital prolapse.

Objective: To evaluate the clinical outcome of sacrospinous fixation (SSF) using the Veronikis ligature carrier (VLC) for genital prolapse.

Study Design: A retrospective longitudinal study was performed. From December 2003 through June 2008, SSF was performed in 76 patients using the VLC as part of their site-specific reconstructive pelvic surgery.

Strategy of cervical myomectomy under laparoscopy.

Objective: To evaluate a strategy of laparoscopic excision of a cervical myoma (CM).

Design: Prospective study.

Setting: University-affiliated hospital.

Laparoscopic resection of an ovarian strumal carcinoid tumor with dramatic relief of severe constipation.

Primary ovarian strumal carcinoid tumors associated with severe constipation are extremely rare. A woman with acquired constipation was suspected to have a right ovarian strumal carcinoid tumor preoperatively. The severe constipation was relieved dramatically after successful laparoscopic resection of the tumor.

Postoperative transvaginal tape mobilization in preventing voiding difficulty after tension-free vaginal tape procedures.

Introduction And Hypothesis: The purpose of the study was to evaluate the efficacy of postoperative transvaginal tape mobilization (TM) in treating urinary retention after tension-free vaginal tape (TVT) procedures.

Methods: A 3-0 Vicryl loop was made at the midpoint of the vaginal tape for tension adjustment. If urinary retention occurred postoperatively, TM was applied in the ward under local anesthesia.

Laparoscopically assisted vaginal hysterectomy following previous kidney transplantation.

Objective: With improvements in immunosuppression and surgical techniques, more women are undergoing kidney transplantation (KT) for management of end-stage renal disease. Location of the transplanted pelvic kidney and transplanted ureter must be taken into consideration when performing pelvic surgery. We demonstrate that laparoscopically assisted vaginal hysterectomy (LAVH) can be successfully performed in patients who had previously undergone KT.

Use of three-dimensional ultrasonography in the evaluation of uterine perfusion and healing after laparoscopic myomectomy.

Objective: To evaluate vascular perfusion and uterine healing after laparoscopic myomectomy using three-dimensional power Doppler ultrasound (3D-PDU).

Design: Prospective study.

Setting: University-affiliated hospital.

Laparoscopic-assisted vaginal hysterectomy with in situ morcellation for large uteri.

Study Objective: To estimate whether laparoscopic in situ morcellation (LISM) can facilitate laparoscopic-assisted vaginal hysterectomy (LAVH) for large uteri.

Design: Prospective study (Canadian Task Force classification II-1).

Setting: University-affiliated hospital.

Lysophosphatidic acid mediates interleukin-8 expression in human endometrial stromal cells through its receptor and nuclear factor-kappaB-dependent pathway: a possible role in angiogenesis of endometrium and placenta.

Lysophosphatidic acid (LPA) is a pleiotropic phospholipid molecule involved in inflammation, angiogenesis, would healing, and cancer invasion. Whereas serum lysophospholipase D activity increases in women with pregnancy, the role of LPA in pregnancy remains unclear. We investigated the expression of LPA receptors and function of LPA in endometrial stromal cells.

Effect of simultaneous morcellation in situ on operative time during laparoscopic myomectomy.

Background: Laparoscopic myomectomy (LM) is technically difficult and time consuming procedure that requires surgical skill and modifications. The aim of this study was to assess factors which affect operative times in LM.

Methods: From March 2003 to June 2007, 174 women, who underwent LM for symptomatic myomas, were enrolled.

Cytokine regulation networks in the cancer microenvironment.

During carcinoma formation, cancer cells release various cytokines and growth factors into their surroundings and recruit and reprogram many other types of cells in order to establish a tumor microenvironment. Consequently, the tumor tissues almost always contain a large number of endothelial cells, fibroblasts, and infiltrating inflammatory cells that in turn produce a variety of cytokines. The cytokines produced by these cells have been posited as key factors in modulating immune response either against or in favor of tumorigenesis in the microenvironment.

LAVH for large uteri by various strategies.

Background: To study if there are specific problems in laparoscopically assisted vaginal hysterectomy (LAVH) for a certain weight of bulky uteri and the strategies to overcome such problems.

Methods: One hundred and eighty-one women with myoma or adenomyosis, weighing 350-1,590 g, underwent LAVH between August 2002 and December 2005. Key surgical strategies were special sites for trocar insertion, uterine artery or adnexal collateral pre-ligation, laparoscopic and transvaginal volume reduction technique.

Laparoscopic-assisted vaginal hysterectomy for patients with extensive pelvic adhesions: a strategy to minimise conversion to laparotomy.

Aim: To evaluate a strategy for successful laparoscopic-assisted vaginal hysterectomy (LAVH) in patients with extensive pelvic adhesion.

Methods: Two hundred and thirty-six patients who underwent LAVH at National Taiwan University Hospital were retrospectively enrolled. Twenty-three patients (9.

Tuboovarian abscess caused by Candida in a woman with an intrauterine device.

Candida infection should be considered in an individual with a pelvic abscess that is unresponsive to conventional antibiotic therapy, particularly in the presence of an intrauterine device. We present a case of a tuboovarian abscess caused by Candida species in a woman with an intrauterine device for >10 years. Surgical intervention followed by antifungal therapy resulted in a favorable outcome.

Using Veronikis ligature carrier to simplify transvaginal sacrospinous colpopexy.

Background: Pelvic organ prolapse is a common problem in women and often requires surgical management. Sacrospinous colpopexy (SSC) requires significant expertise, especially in placement of the suture into sacrospinous ligament (SSL).

Methods: Veronikis ligature carrier (VLC) designed for SSC was used to facilitate suture placement and retrieval under direct visualization within the confines of the pararectal space.

Visceral sliding technique is useful for detecting abdominal adhesion and preventing laparoscopic surgical complications.

Study Objective: Introduce a non-invasive method preoperatively to prevent bowel injury by the Veres needle and trocar during laparoscopy.

Design: Case-controlled study.

Setting: A hospital-based study.

Increased interleukin-6 messenger RNA expression in macrophage-cocultured endometrial stromal cells in adenomyosis.

Problem: To determine the effects of macrophage on endometrial stromal cells (ESCs) in women with adenomyosis.

Method Of Study: Eutopic endometrium was obtained and separated into single ESC in 10 women with adenomyosis (study group) and 11 without adenomyosis (control group). ESCs were then cultured alone or with macrophage for 24 hr.

Transvaginal hysterectomy or laparoscopically assisted vaginal hysterectomy for nonprolapsed uteri.

Background: To define a rational guideline for the use of either laparoscopically assisted vaginal hysterectomy (LAVH) or transvaginal hysterectomy in dealing with a nonprolapsed uterus.

Methods: A total of 452 patients receiving LAVH or transvaginal hysterectomy were retrospectively studied between October 2002 and October 2004. The operative time, estimated blood loss, uterine weight, and complications were all recorded for analysis.

Laparoscopic-assisted vaginal hysterectomy with uterine artery ligation through retrograde umbilical ligament tracking.

Study Objective: To evaluate the clinical outcomes of uterine artery ligation through retrograde tracking of the umbilical ligament (RUL) in laparoscopic-assisted vaginal hysterectomy (LAVH).

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

Setting: University-affiliated hospital.