Racial Disparities in Hysterectomy Route for Benign Disease: Examining Trends and Perioperative Complications from 2007 to 2018 Using the NSQIP Database.

Study Objective: To examine national trends among race and ethnicity and route of benign hysterectomy from 2007 to 2018.

Design: This is a retrospective analysis of the prospective National Surgical Quality Improvement Program cohort program.

Setting: This study included data from the National Surgical Quality Improvement Program database including data from the 2014 to 2018 targeted hysterectomy files.

Trends and Perioperative Outcomes across Elective Benign Hysterectomy Procedures from the ACS-NSQIP 2007-2017.

Study Objective: In this study, we describe trends of all 3 routes of hysterectomy, patient demographics, and perioperative morbidity among women undergoing surgery for benign indications between 2007 and 2017. We also sought to compare the rates of extended length of stay (ELOS) and readmission rates among the laparoscopic, abdominal, and transvaginal routes.

Study Design: A retrospective cohort study.

Patterns of narcotic utilization in women undergoing hysterectomy for benign indications.

Objective: To determine whether perioperative narcotic utilization at the time of hysterectomy has decreased since 2012.

Study Design: Retrospective cohort study.

Setting: Academic university hospital.

Malnutrition is Associated with Poor Postoperative Outcomes Following Laparoscopic Hysterectomy.

Background: Malnutrition continues to be pervasive among the general population, with rates as high as 50% of patients undergoing surgical procedures. Data is limited about women undergoing surgery for non-malignant gynecologic indications (generally elective laparoscopic hysterectomies, after failed conservative measures). With the significant increase in benign gynecologic surgery, it is of the upmost importance that surgeons optimize modifiable risk factors for patients undergoing laparoscopic hysterectomy.

Patterns of voiding following laparoscopic hysterectomy.

Objective: Clarify the normal patterns of voiding after minimally invasive hysterectomy. We also aim to identify perioperative factors associated with delayed time to void immediately following hysterectomy.

Design: Retrospective cohort study SELECTION: Women undergoing laparoscopic hysterectomy between September 2012 to October 2018 at a single academic university hospital.

Recommendations for Pregnancy in Rare Inherited Anemias.

Rare inherited anemias are a subset of anemias caused by a genetic defect along one of the several stages of erythropoiesis or in different cellular components that affect red blood cell integrity, and thus its lifespan. Due to their low prevalence, several complications on growth and development, and multi-organ system damage are not yet well defined. Moreover, during the last decade there has been a lack of proper understanding of the impact of rare anemias on maternal and fetal outcomes.

Safety and feasibility of the three-port robot-assisted hysterectomy across uterine weights.

One strategy thought to reduce direct costs associated with robotic surgery is minimizing the number of robotic arms used for a surgery. We aim to demonstrate the safety and feasibility of the three-port robot-assisted hysterectomy across uterine weights. Retrospective cohort study in a tertiary care university hospital of consecutive patients undergoing a three-port robot-assisted hysterectomy for benign indications.

Cost variance across obesity class for women undergoing laparoscopic hysterectomy by high-volume gynecologic surgeons.

Health-care costs are affected by obesity with both the direct and indirect costs of health care increasing as body mass index (BMI) increases. However, one important aspect of obesity that lacks rigorous study is what impact BMI has on direct surgical cost. We performed a retrospective cohort study of women undergoing a laparoscopic hysterectomy at our single academic university center between January 2012 and December 2017.

Perioperative Narcotic Trends in Women Undergoing Minimally Invasive Myomectomy.

Study Objective: Evaluate the perioperative narcotic utilization patterns at the time of myomectomy, specifically as they relate to the opioid epidemic. We also aim to evaluate the differences between conventional laparoscopy and robotic surgery in terms of narcotic utilization.

Design: Retrospective cohort study.

The effect of anemia severity on postoperative morbidity among patients undergoing laparoscopic hysterectomy for benign indications.

Introduction: One-third of non-pregnant women worldwide are anemic. Anemia is a known independent risk factor for postoperative morbidity. Given that the vast majority of hysterectomies are not performed in the emergency setting, we designed this study to evaluate the effect of preoperative anemia on postoperative morbidity following laparoscopic hysterectomy performed for benign indications.

Artificial intelligence and augmented reality in gynecology.

Purpose Of Review: Artificial intelligence and augmented reality have been progressively incorporated into our daily life. Technological advancements have resulted in the permeation of similar systems into medical practice.

Recent Findings: Both artificial intelligence and augmented reality are being increasingly incorporated into the practice of modern medicine to optimize decision making and ultimately improve patient outcomes.

Impact of Diabetes Mellitus on Postoperative Complications Following Laparoscopic Hysterectomy for Benign Indications.

Background: Current research pertaining to minimally invasive gynecologic surgical outcomes in the context of diabetes mellitus (DM) is limited. This study seeks to evaluate the association between DM and postoperative complications following laparoscopic hysterectomy for benign indications.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was utilized.

Differences in Postoperative Morbidity among Obese Patients Undergoing Abdominal Versus Laparoscopic Hysterectomy for Benign Indications.

Study Objective: To analyze the interaction between the route of hysterectomy for benign disease and postoperative morbidity among patients stratified by body mass index (BMI) and to test for a dose-dependent relationship between obesity severity and postoperative morbidity.

Design: A retrospective cohort study.

Patients: Benign hysterectomy cases were abstracted from the American College of Surgeons National Safety and Quality Improvement Program from 2005 to 2016.

Predictors of Overnight Admission After Laparoscopic Myomectomy in a High-Volume Minimally Invasive Gynecologic Surgery Setting.

Study Objective: Our primary goal was to uncover preoperative and intraoperative risk factors that prevented same-day discharge (SDD) after myomectomy in a setting where SDD was the standard of care. Uncovered predictors would serve to enhance patient counseling and medical optimization before surgery.

Design: Single-center retrospective cohort study.

Effect of Perioperative Transfusion on Postoperative Morbidity Following Minimally Invasive Hysterectomy for Benign Indications.

Study Objective: To examine the impact of perioperative allogeneic blood transfusion (ABT) on postoperative infectious wound occurrences, sepsis-related events. and venous thromboembolism.

Design: Retrospective cohort study.

Review of strategies and factors to maximize cost-effectiveness of robotic hysterectomies and myomectomies in benign gynecological disease.

Common benign gynecologic procedures include hysterectomies and myomectomies, with hysterectomy being the most common gynecologic procedure in the United States [1]. While historically performed via laparotomy, the field of gynecologic surgery was revolutionized with the advent of laparoscopic techniques, with the most recent advancement being the introduction of robotic-assisted surgery in 2005. Robotic surgery has all the benefits of laparoscopic surgery such as decreased blood loss, quicker return to activities, and shorter length of hospital stay.

Novel Approach for 2-Port Laparoscopic Hysterectomy.

. To describe a novel technique for a port-reducing laparoscopic hysterectomy. The 2-port laparoscopic hysterectomy (TPH) is performed through two 5-mm ports without the use of any multiport channels.

Impact of Chronic Obstructive Pulmonary Disease on Laparoscopic Hysterectomy Outcome.

Background And Objectives: Limited research exists on the association between chronic obstructive pulmonary disease (COPD) and morbidity and mortality after laparoscopic hysterectomy. The objective of this study is to examine the following: 1) which demographics and comorbidities are most likely to present concurrently in patients with COPD? 2) Are patients with COPD undergoing laparoscopic hysterectomy at increased risk for development of postoperative complications within 30 days?

Methods: Retrospective cohort study using data collected from 2007 to 2016 from the American College of Surgeons National Surgical Quality Improvement Program database. All patients who underwent laparoscopic hysterectomy were identified by Current Procedural Terminology codes and stratified based on COPD status.

Physiological Response to Opioids.

The clinical setting in which women's health physicians practice, whether as generalist, obstetricians and gynecologists, or subspecialists, dictates our frequent clinical interaction with "pain." Opioid-containing medications are frequently prescribed within our specialty as a means of immediate pain relief. Opioid-containing medication causes a deep physiological alteration of several systems resulting in potential harm to acute and chronic opioid users.

Comparison between single-site and multiport robot-assisted myomectomy.

Minimizing the number of port incisions during minimally invasive surgery is associated with improved outcomes and patient satisfaction. We designed this work to study the perioperative outcomes of robotic single-site myomectomy (RSSM) in comparison to robotic multiport myomectomy (RMM) in a certain subset of patients. The design of the study is a multicenter retrospective analysis (Canadian Task Force classification III).

Effect of postoperative partial bladder filling after minimally invasive hysterectomy on postanesthesia care unit discharge and cost: a single-blinded, randomized controlled trial.

Background: Hysterectomy is one of the most common surgical procedures performed each year with substantial related health care costs. This trial studied the effect of postoperative bladder backfilling to submicturition level in the operating room and its effect on early postoperative patient care and related cost.

Objective: The objective of the study was to compare the effect of bladder backfilling on early postoperative patient care and related cost.

Robot-assisted transabdominal cerclage for the prevention of preterm birth: A multicenter experience.

Objective: High-risk pregnancy stratification and the use of Progesterone and prophylactic cerclage based on prior obstetrical outcomes and cervical length screening have been successful in curbing the impact of preterm birth. However, a large number of women will still suffer from preterm delivery even with optimal management. Experts agree that a transabdominal cerclage is the next best option for women who fail a transvaginal cerclage in a prior pregnancy.

Technique for Tissue Containment and Extraction in the Complex Minimally Invasive Myomectomy Setting.

Study Objective: To achieve tissue containment and extraction for numerous and large myomas in the complex minimally invasive difficult myomectomy setting via a surgical tutorial including technical pointers and suggestions DESIGN: A step-by-step explanation of the .surgery using video (instructive video) (Canadian Task Force classification III). Institutional review board approval was not required for this study.

Surgical variance between postconceptional and preconceptional minimally invasive transabdominal cerclage placement.

Recent data show that transabdominal cerclage placement via laparoscopy carries better obstetrical outcomes in comparison to transabdominal cerclage placement via laparotomy. In this surgical tutorial, we review the technique for minimally invasive abdominal cerclage and highlight the surgical differences between preconceptional and conceptional cerclage.