Superior Hypogastric Plexus Nerve Block in Minimally Invasive Gynecology: A Randomized Controlled Trial.

Study Objective: To assess the efficacy of a superior hypogastric plexus nerve block in reducing opioid requirements in the first 24 hours after minimally invasive gynecologic surgery.

Design: Patient-blinded randomized controlled trial.

Setting: Single-center academic institution (Sydney Women's Endosurgery Centre).

Cultivating the Apprentice-Mentor Model for Minimally Invasive Gynaecology in the Era of Surgically Scarce Training: A Case Report of Laparoscopic Cornuostomy for Interstitial Ectopic Pregnancy by a Trainee.

Over the last few years, there is an apparent growing concern amongst O&G trainees of the inadequacy in exposure to minimally invasive gynaecology surgical training, which has been inadvertently compounded by the more stringent working hour regulations and disproportionately increasing number of trainees relative to surgical volume. Therefore, it is vitally important for trainees to maximise opportunities in the operating theatre and develop autonomy in carrying out more complex surgical procedures. This case report outlines the step-by-step approach of laparoscopic excision of a cornual ectopic pregnancy performed by a trainee under the supervision of a surgical mentor.

Long-term patient-reported outcomes after laparoscopic Burch colposuspension.

Background: The negative media attention surrounding vaginal mesh procedures has seen a rise in demand for minimally invasive non-mesh options for the treatment of stress urinary incontinence (SUI). The laparoscopic Burch colposuspension (LBC) is a non-mesh alternative to synthetic midurethral slings (MUS) with similar short-term outcomes. However, long-term outcomes are not well established.

Laparoscopic Myomectomy of a 4.2 kg Fibroid with Assistance of a Minilaparotomy.

The improved cosmesis and recovery from minimally invasive techniques has seen a dramatic rise in its popularity. Unfortunately, the laparoscopic myomectomy for large fibroids presents a unique challenge to the surgeon. It is reputed to be difficult and time consuming, with a high risk of conversion to laparotomy.

Surgical Management of Complete Procidentia in a Female Patient with Bladder Exstrophy-epispadias Complex: Case Report and Literature Review.

We herein describe the operative approach of a postmenopausal woman with a history of surgically corrected congenital bladder exstrophy-epispadias who presented with long-standing complete procidentia. The patient was initially treated by laparoscopic sacral colpopexy in conjunction with a modified Elevate mesh kit anterior vaginal repair with and posterior vaginal wall repair in the form of native tissue suture plication repair. Her prolapse recurred 8 months' later due to a detachment of the mesh at the level of the promontorium.

Sydney contained in bag morcellation for laparoscopic myomectomy.

Study Objective: To demonstrate a new technique of contained in bag morcellation of a myoma after laparoscopic myomectomy.

Design: Step-by-step explanation of the technique in a narrated video.

Intervention: Contained In Bag Morcellation of myoma after laparoscopic myomectomy.

The Sydney Contained In Bag Morcellation technique.

Study Objective: To demonstrate a modification of the Shibley single-port technique suitable for morcellation of large myomatous uteri after total laparoscopic hysterectomy in a contained environment within the abdominal cavity [1].

Design: Step-by-step explanation of the technique using descriptive text and an educational video.

Setting: In light of recent concern about the use of power morcellators and increasing the risk of disseminating occult leiomyosarcomatous myoma fragments throughout the abdominal cavity, we propose this new technique for management of morcellation of large myomatous uteri after total laparoscopic hysterectomy, to contain the morcellation process and minimize the risk.

Bowel resection for iatrogenic parasitic fibroids with preoperative investigations suggestive of malignancy.

Objective: To describe a case in which a midline laparotomy for two presumed malignant masses instead revealed parasitic fibroids.

Design: Case report.

Setting: Tertiary-level private hospital.

Purse-string suture technique to enable laparoscopic management of the interstitial gestation of a heterotopic pregnancy.

Objective: To describe the laparoscopic management of an interstitial gestation of a heterotopic pregnancy.

Design: Case report and technique description.

Setting: Tertiary-level private practice.

Uterine perfusion following laparoscopic clipping of uterine arteries at myomectomy.

Laparoscopic clipping of uterine arteries facilitates laparoscopic myomectomy with minimal blood loss. This paper shows the return to normal myometrial perfusion following this procedure with literary evidence of the safety and efficacy of this technique.

Is hysterectomy necessary for laparoscopic pelvic floor repair? A prospective study.

Study Objective: To evaluate whether the addition of hysterectomy to laparoscopic pelvic floor repair has any impact on the short-term (perioperative) or long-term (prolapse outcome) effects of the surgery.

Design: A controlled prospective trial (Canadian Task Force classification II-1).

Setting: Private and public hospitals affiliated with a single institution.

Major complications arising from 1265 operative laparoscopic cases: a prospective review from a single center.

Study Objective: To identify the volume and type of laparoscopic surgery being performed. To review the incidence, nature of associated complications, and reasons for conversion to laparotomy.

Design: A multicenter, prospective case load analysis and chart review, identifying operations performed by 6 advanced laparoscopic surgeons over a 12-month period (1/1/05 to 12/31/05).

Total laparoscopic hysterectomy: a tried and tested technique.

Gynecologists are increasingly adopting total laparoscopic hysterectomy as their preferred method for performing a hysterectomy. The laparoscopic approach offers a superior view of the anatomy, facilitates meticulous hemostasis, enables the surgeon to perform adnexal surgery and pelvic reconstructive surgery, and reduces morbidity associated with large abdominal incisions. During the last 10 years, the surgeons at the Sydney Women's Endosurgery Centre (SWEC) have developed a laparoscopic technique using the same well-known steps as in the open abdominal approach.