Immunohistochemical Evaluation of Potential Biomarkers for Targeted Intraoperative Fluorescence Imaging in Endometriosis: Towards Optimizing Surgical Treatment.

Surgical intervention for endometriosis is an important treatment modality, yet incomplete resection resulting from poor visibility of affected tissue and consequently recurrence of disease remains a prevalent challenge. Intra-operative visualization of endometriosis, enabling fluorescence-guided surgery (FGS), could help to optimize surgical treatment. A biomarker, upregulated in endometriosis compared to adjacent tissue, is required to use as a target for FGS.

The (cost-) effectiveness Of Surgical excision of Colorectal endometriosis compared to ART treatment trAjectory (TOSCA study) - a study protocol.

Currently, the optimal treatment to increase the chance of pregnancy and live birth in patients with colorectal endometriosis and subfertility is unknown. Evidence suggests that that both surgery and in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) are effective in improving live birth rate (LBR) among these women. However, the available evidence is of low quality, reports highly heterogeneous results, lacks direct comparison between both treatment options and does not assess whether a combination strategy results in a higher LBR compared to IVF/ICSI-only treatment.

Histological analysis of (antral) follicle density in ovarian cortex tissue attached to stripped endometriomas.

Purpose: When resecting endometriomas with the stripping technique, in the majority of cases, a thin line of adjacent ovarian cortex is attached to the endometrioma. In this study, we performed histological analysis to determine (antral) follicle density in the ovarian cortex tissue attached to stripped endometriomas and assessed patient- and surgical characteristics that could affect this.

Methods: Histological slides of previously removed endometriomas were assessed.

Evaluation of the effect of previous endometriosis surgery on clinical and surgical outcomes of subsequent endometriosis surgery.

Purpose: Patients often undergo repeat surgery for endometriosis, due to recurrent or residual disease. Previous surgery is often considered a risk factor for worse surgical outcome. However, data are scarce concerning the influence of subsequent endometriosis surgery.

Biomarker identification for endometriosis as a target for real-time intraoperative fluorescent imaging: A new approach using transcriptomic analysis to broaden the search for potential biomarkers.

Intra-operative fluorescent imaging of endometriosis could help to optimize surgical treatment. Potential biomarkers to use as target for endometriosis-binding fluorescent probes were identified using a new five-phase transcriptomics-based approach to broaden the search for biomarkers. Using publicly available datasets, a differentially expressed gene (DEG) analysis was performed for endometriosis versus surgically relevant surrounding tissue (peritoneum, bladder, sigmoid, rectum, transverse colon, small intestine, vagina, and fallopian tubes) for which data was available.

Bowel preparation in MRI for detection of endometriosis: Comparison of the effect of an enema, no additional medication and intravenous butylscopolamine on image quality.

Purpose: To compare the effect of three different patient preparation strategies for reducing bowel motion on image quality in pelvic MRI.

Methods: Retrospective study in which 95 consecutive patients undergoing pelvic MRI were subdivided based on preparation type for reduction of bowel motion: group 1 (N = 31) fasted 4 h and applied an enema (Bisacodyl 10 mg); group 2 (N = 32) received no medication; group 3 (N = 32) received intravenous butylscopolamine (Buscopan® 50 mg). Image quality was reviewed by visual assessment of delineation (3-point-scale) of pelvic structures: uterus, adnexa, bladder, rectum, sigmoid, uterosacral ligaments, round ligaments and small bowel.

Measuring surgical safety during minimally invasive surgical procedures: a validation study.

Background: During the implementation of new interventions (i.e., surgical devices and technologies) in the operating room, surgical safety might be compromised.

WITHDRAWN: A dynamic quality assessment tool for laparoscopic hysterectomy to measure surgical outcomes.

The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.

A dynamic quality assessment tool for laparoscopic hysterectomy to measure surgical outcomes.

Background: The current health care system has an urgent need for tools to measure quality. A wide range of quality indicators have been developed in an attempt to differentiate between high-quality and low-quality health care processes. However, one of the main issues of currently used indicators is the lack of case-mix correction and improvement possibilities.

Surgical flow disturbances in dedicated minimally invasive surgery suites: an observational study to assess its supposed superiority over conventional suites.

Background: Minimally invasive surgery (MIS) is frequently compromised by surgical flow disturbances due to technology- and equipment-related failures. Compared with MIS in a conventional cart-based OR, performing MIS in a dedicated integrated operating room (OR) is supposed to be beneficial to patient safety. The aim of this study was to compare a conventional OR with an integrated OR with regard to the incidence and effect of equipment-related surgical flow disturbances during an advanced laparoscopic gynecological procedure [laparoscopic hysterectomy (LH)].

Hysterectomy in very obese and morbidly obese patients: a systematic review with cumulative analysis of comparative studies.

Purpose: Some studies suggest that also regarding the patient with a body mass index (BMI) ≥35 kg/m(2) the minimally invasive approach to hysterectomy is superior. However, current practice and research on the preference of gynaecologists still show that the rate of abdominal hysterectomy (AH) increases as the BMI increases. A systematic review with cumulative analysis of comparative studies was performed to evaluate the outcomes of AH, laparoscopic hysterectomy (LH) and vaginal hysterectomy (VH) in very obese and morbidly obese patients (BMI ≥35 kg/m(2)).

Learning from visual force feedback in box trainers: tissue manipulation in laparoscopic surgery.

Background: Currently, task time and errors are often used as performance parameters in laparoscopic training. Training with the focus on task time improvement alone results in fast, but possibly less controlled, instrument movements and therefore suboptimal tissue handling skills.

Methods: Twenty-five medical students were randomly assigned in two groups.

Visual force feedback improves knot-tying security.

Background: Residents in surgical specialties suture multiple wounds in their daily routine and are expected to be able to perform simple sutures without supervision of experienced surgeons. To learn basic suture skills such as needle insertion and knot tying, applying an appropriate magnitude of force in the desired direction is essential. To investigate if training with real-time visual force feedback improves the suture skills of novices, a study was conducted using a training platform that measures all forces exerted on a skin pad, i.

An alternative approach for removal of placental remnants: hysteroscopic morcellation.

Study Objective: To evaluate our initial experience with hysteroscopic morcellation for removal of placental remnants.

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

Setting: University hospital and 2 teaching hospitals.

Achieving consensus on the definition of conversion to laparotomy: a Delphi study among general surgeons, gynecologists, and urologists.

Background: In laparoscopic surgery, conversion to laparotomy is associated with worse clinical outcomes, especially if the conversion is due to a complication. Although apparently important, no commonly used definition of conversion exists. The aim of this study was to achieve multidisciplinary consensus on a uniform definition of conversion.

Clinical relevance of conversion rate and its evaluation in laparoscopic hysterectomy.

Study Objectives: To estimate the current conversion rate in laparoscopic hysterectomy (LH); to estimate the influence of patient, procedure, and performer characteristics on conversion; and to hypothesize the extent to which conversion rate can act as a means of evaluation in LH.

Design: Prospective cohort study (Canadian Task Force classification II-2).

Setting: The study included 79 gynecologists representing 42 hospitals throughout the Netherlands.

Predictors of successful surgical outcome in laparoscopic hysterectomy.

Objective: To estimate, after correction for patient factors, to what extent blood loss, operative time, and adverse events are decisive factors for the successful outcome of laparoscopic hysterectomy. A secondary objective was to estimate to what extent a successful outcome can be predicted from surgical experience or other measures of surgical skill.

Methods: A nationwide multivariate 1-year cohort analysis was conducted with gynecologists who perform laparoscopic hysterectomy.

[Safe introduction of laparoscopic hysterectomy using a mentor].

Objective: Evaluation of the introduction of laparoscopic hysterectomy in a teaching hospital by means of a structured mentor-traineeship.

Design: Retrospective, with prospectively designed database.

Methods: By means of a mentor-traineeship the technique of laparoscopic hysterectomy was introduced to two gynaecologists in a teaching hospital.