Exploring Adverse Events and Utilization of Topical Hemostatic Agents in Surgery.

Background And Objectives: This retrospective study provides preliminary qualitative assessment of the adverse events (AEs), focusing on pelvic and abdominal AEs and patient outcomes reported for three hemostatic agents used in gynecologic surgery.

Methods: Utilization rates for oxidized regenerated cellulose powder (ORC), polysaccharide powder (PSP), and fibrin sealant solution (FSS) were obtained from hospitals via the Premier Healthcare databases for all surgical procedures from January 1, 2018 to September 30, 2020. All reported cases were extracted from the Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database for ORC and PSP and from the FDA Adverse Event Reporting System (FAERS) database for FSS.

Total Laparoscopic Hysterectomy: Making It Safe and Successful for Obese Patients.

Objective: To investigate outcomes and ascertain the safety and efficacy on patients having total laparoscopic hysterectomy (TLH), stratified by body mass index (BMI), focusing on high-BMI patients.

Methods: This was a retrospective cohort study that reviewed 2,266 patients with benign gynecologic diagnoses, early cervical, endometrial, and ovarian carcinoma from September 1996 to October 2017. BMI was from 14.

Biological origins of sexual orientation and gender identity: Impact on health.

Gynecologic Oncologists are sometimes consulted to care for patients who present with diverse gender identities or sexual orientations. Clinicians can create more helpful relationships with their patients if they understand the etiologies of these diverse expressions of sexual humanity. Multidisciplinary evidence reveals that a sexually dimorphic spectrum of somatic and neurologic anatomy, traits and abilities, including sexual orientation and gender identity, are conferred together during the first half of pregnancy due to genetics, epigenetics and the diversity of timing and function of sex chromosomes, sex-determining protein secretion, gonadal hormone secretion, receptor levels, adrenal function, maternally ingested dietary hormones, fetal health, and many other factors.

Comprehensive laparoscopic lymphadenectomy from the deep circumflex iliac vein to the renal veins: Impact on quality of life.

Objective: Compare quality of life metrics for consecutive patients having total laparoscopic hysterectomy, bilateral salpingo-oophorectomy (TLHBSO) with and without comprehensive pelvic/aortic lymphadenectomy (CPALND) from proximal to the distal circumflex iliac nodes and vessels to the renal vessels.

Methods: Analysis of mailed survey responses with 25 validated questions regarding musculoskeletal/lower extremity, gastro-intestinal, abdominal, urological, and energetic/activities of daily living. Data analyzed with Chi-Square tests of Association, Mann-Whitney U tests and follow up regression analysis.

Analysis of a Standardized Technique for Laparoscopic Cuff Closure following 1924 Total Laparoscopic Hysterectomies.

Objective. To review the vaginal cuff complications from a large series of total laparoscopic hysterectomies in which the laparoscopic culdotomy closure was highly standardized. Methods.

Infrarenal lymphadenectomy for gynecological malignancies: two laparoscopic approaches.

Objective: Compare two approaches for laparoscopic infrarenal lymphadenectomy.

Methods: Retrospective chart review. Statistical analyses with SPSS.

Comprehensive, therapeutic retroperitoneal pelvic and infrarenal aortic lymphadenectomy for advanced cervical carcinoma.

This 49-year-old female with stage III cervical carcinoma presented with a PET/CT scan showing bilateral pelvic and common ileac adenopathy. A retroperitoneal approach to resect the nodes well above the highest documented PET positive region was employed in July 2011. The bilateral infrarenal, bulky inframesenteric and pelvic nodes were comprehensively removed, revealing bilaterally positive nodes in 5/36 pelvic nodes, 13/25 inframesenteric nodes, and 3/20 infrarenal nodes (these latter not detected on PET).

Quality improvement: single-field sterile scrub, prep, and dwell for laparoscopic hysterectomy.

The vulva and vaginal interior are considered a contaminated surgical area, and current OR guidelines require surgeons who are gloved and gowned at the abdominal field to avoid contact with the urethral catheter, the uterine manipulator, and the introitus or to change their gloves and even regown if contact occurs. It is our belief that the perception of the vaginal field as contaminated reflects a lack of specific standards for the preoperative cleansing of the deeper vagina and a lack of preoperative prep instructions for the combined fields. We developed a comprehensive single-field prep technique designed to improve surgical efficiency and prevent contamination of the sterile field.

Total laparoscopic hysterectomy: evaluation of an evidence-based educational strategy using a novel simulated suture and knot-tying challenge, the "holiotomy".

Objective. The purpose of this study was to evaluate perceptions of skills and practice patterns of gynecologists attending a course on total laparoscopic hysterectomy (TLH). This course employed extensive use of pelvic trainer boxes to accomplish the Holiotomy Challenge.

Single-field sterile-scrub, preparation, and dwell for laparoscopic hysterectomy.

Type VII laparoscopic hysterectomy is classified as a "clean-contaminated" procedure because the surgery involves contact with both the abdominal and vaginal fields. Because the vulva has traditionally been perceived as a separate but contaminated field, operating room guidelines have evolved to require that surgeons gloved and gowned at the abdominal field either avoid contact with the urethral catheter, the uterine manipulator, and the introitus or change their gloves and even re-gown after any contact with those fields. In the belief that the perception of the vaginal field as contaminated stems from inadequate preoperative preparation instructions, we have developed a rigorous abdomino-perineo-vaginal field preparation technique to improve surgical efficiency and prevent surgical site infections.

Laparoscopic hysterectomy: impact of uterine size.

Objective: To analyze surgical results of women having Type VII laparoscopic hysterectomy to determine whether differences in outcomes exist on the basis of uterine size.

Methods: This is an analysis of data from 983 cases of type VII laparoscopic hysterectomy performed from September 1996 through August 2010. Demographic and surgical data were stratified by uterine weight (range 14-3,131 g) less than 250 g (n = 720) and 250 g or more (n = 263).

Cystosufflation to prevent bladder injury.

Study Objective: This brief report will share information about the use and safety of inflating the bladder with carbon dioxide to delineate the margins during laparoscopic dissections near the bladder in patients who have scarring, adhesions, or challenging anatomy.

Design: A retrospective chart review of patients undergoing total or radical laparoscopic hysterectomy, or support procedures from September 5, 1996, through October 30, 2008, was conducted. Canadian Task Force level III.

257 incidental appendectomies during total laparoscopic hysterectomy.

Objective: This retrospective observational report analyzes the demographics, blood loss, length of surgical duration, number of days in the hospital, and complications for 821 consecutive patients undergoing total laparoscopic hysterectomy over a 11-year period stratified by incidental appendectomy.

Methods: A retrospective chart abstraction was performed. ANOVA and chi-square tests were performed with significance preset at P<0.

Total laparoscopic hysterectomy for female-to-male transsexuals.

Objective: To compare the results of laparoscopic hysterectomy, salpingo-oophorectomy, and incidental appendectomy for female-to-male transsexuals with those of female patients.

Methods: Retrospective chart abstraction of all patients undergoing total laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and appendectomy since September 1996. Significance from analysis of covariance or chi2 was set at .

Total laparoscopic hysterectomy: technique and complications of 830 cases.

Objective: This study analyses the technique and complications from total laparoscopic hysterectomy.

Methods: Retrospective chart abstraction was performed on 830 consecutive patients operated on between 1996 and 2006. Demographic and surgical data were analyzed by ANOVA, chi-square, and Spearman and Pearson correlation techniques were used with significance set at P<0.

Total laparoscopic hysterectomy with and without lymph node dissection for uterine neoplasia.

Study Objective: To compare surgical outcomes of patients with uterine neoplasia undergoing total laparoscopic hysterectomy only (TLH) with those having TLH and lymph node dissection (TLHND) from September 5, 1996 through January 13, 2007.

Design: Retrospective chart analysis (Canadian Task Force classification II-2).

Setting: Three tertiary surgical centers in California.

Cystoscopy with a 5-mm laparoscope and suction irrigator.

To investigate the hypothesis that cystoscopy using a 5-mm suction irrigator and video laparoscope is safe and useful during total laparoscopic hysterectomy (TLH), a retrospective analysis of patients undergoing total or radical laparoscopic hysterectomy over a 10-year period was conducted. Of 744 patients having simple or radical laparoscopic hysterectomy for either benign or malignant indications, 344 had cystoscopy using a 5-mm laparoscope after inflating the bladder with a 5-mm saline suction irrigator. Procedures in which cystoscopy was used took 13 minutes longer (mean: 141 vs 128, p = .

Total laparoscopic hysterectomy for uterine pathology: impact of body mass index on outcomes.

Objective: We sought to analyze surgical results of women with uterine cancers having TLH+/-staging, stratifying data by body mass index (BMI).

Methods: This is a retrospective analysis of data from 9 years, using Pearson and Spearman correlations, ANOVA and Fisher's Exact Test with significance at P<0.05, stratifying by BMI (kg/m2): underweight (<18.

Health policy considerations for our sexual minority patients.

Homosexuality and transsexuality are still widely viewed by lay individuals as morally negative and deserving of legal proscription. Peer-reviewed data confirm that experiences of legal discrimination are associated with stress-related health problems, reduced utilization of health care, and financial and legal challenges for individuals and families, especially those with children. In the last 3 years, the American Psychiatric Association, American Psychological Association, and American Psychoanalytic Association have each reviewed the research on sexual orientation and identity, and each has confirmed that sexual orientation and gender identity do not correlate with mental illness or immorality.

Total laparoscopic hysterectomy versus total abdominal hysterectomy: cohort review of patients with uterine neoplasia.

Objective: Retrospective analysis of surgico-pathologic data comparing total laparoscopic hysterectomy (TLH) with total abdominal hysterectomy (TAH) patients with uterine neoplasia.

Methods: We conducted a chart abstraction of all patients undergoing hysterectomy for uterine neoplasia from September 1996 to November 2004. Patients were assigned to undergo the abdominal or laparoscopic approach based on established clinical safety criteria.

Embryo cryopreservation after diagnosis of stage IIB endometrial cancer and subsequent pregnancy in a gestational carrier.

Objective: To describe a case of embryo cryopreservation before hysterectomy and bilateral salpingo-oophorectomy for endometrial cancer.

Design: Case report.

Setting: University and community service.

Total laparoscopic hysterectomy for oncological indications with outcomes stratified by age.

Objective: We hypothesize that there is no difference in surgical outcomes of patients undergoing total laparoscopic hysterectomy (TLH) for various oncological indications when stratified by age categories.

Methods: Data were analyzed by ANOVA and chi-square test with significance of P < 0.05, stratified by age (young: <50 years, middle: 50-64, senior age 65+).

Advocacy for women's health should include lesbian health.

Although research confirms that homosexuality is a normal expression of human sexuality, established scientific studies are often not reflected in laws and judicial opinions for lesbians with regard to employment, taxation, pensions, disability, healthcare, immigration, military service, marriage, custody, and adoption. The expression of homosexual attraction or behavior is sometimes met by disdain or violence. Psychological and epidemiological research confirms that the public discriminatory attitudes and second-class legal status cause physical, emotional, and financial harm to lesbians, their families, and their children.

Selective incorporation of total laparoscopic hysterectomy for adnexal pathology and body mass index.

Objectives: We studied patients undergoing adnexectomy with total laparoscopic hysterectomy (TLH) for ovarian pathology, over a 6-year period.

Methods: Chart abstraction, analyzed by ANOVA, Fisher's Exact Test with significance at P < 0.05, stratifying by body mass index (BMI, kg/m(2): ideal < 25; overweight 25-29.

Total laparoscopic hysterectomy: body mass index and outcomes.

Objective: This retrospective review of patients undergoing total laparoscopic hysterectomy examines whether differences in outcomes exist on the basis of body mass index (BMI).

Methods: All cases of total laparoscopic hysterectomy performed from September 1996 to July 2002 for benign diagnoses, and microinvasive cervical, early endometrial, and occult ovarian carcinoma were reviewed. There were 330 patients analyzed by BMI category (range, 18.