We live in a virtual world: Training the trainee using an integrated visual reality simulator curriculum.

Background: Gynaecology trainees struggle to obtain adequate procedural experience. Training programs integrating virtual reality simulators (VRS) have been suggested as a solution.

Aims: The study aimed to assess if a VRS training program (LapSim , Surgical Sciences, Göteborg, 2017) improved live operating performance at six months for novice and experienced trainees.

Preoperative Imaging in Patients with Deep Infiltrating Endometriosis: An Important Aid in Predicting Depth of Infiltration in Rectosigmoid Disease.

Study Objective: To determine the diagnostic accuracy of specialist-performed transvaginal ultrasound (TVUS) and pelvic magnetic resonance imaging (MRI) modalities in predicting depth of deep infiltrating endometriosis (DIE) of the rectosigmoid by comparison with histologic specimens obtained at surgery.

Design: A retrospective analysis, which met the Standards for Reporting of Diagnostic Accuracy Studies (2015) guidelines for a diagnostic accuracy study.

Setting: Tertiary teaching hospital.

The myometrial-cervical ratio (MCR): Assessing the diagnostic accuracy of a novel ultrasound measurement in the diagnosis of adenomyosis.

Background: Adenomyosis is histologically defined by the presence of endometrial glands and stroma in the myometrium. To date, there are no standardised ultrasound findings that reliably predict histological adenomyosis.

Aims: This study aimed to determine the diagnostic accuracy of a novel sonographic measurement for adenomyosis, the myometrial-cervical ratio (MCR), when compared with histopathological diagnosis.

Badger territoriality maintained despite disturbance of major road construction.

Road ecology has traditionally focused on the impact of in-situ and functional roads on wildlife. However, road construction also poses a major, yet understudied, threat and the implications for key aspects of animal behaviour are unknown. Badgers (Meles meles) have been implicated in the transmission of tuberculosis to cattle.

Extra Territorial Excursions by European badgers are not limited by age, sex or season.

European badgers (Meles meles) in medium and high density populations show strong territorial behaviour. Territories in these populations are contiguous, well-marked and often unchanging over many years. However, badgers do not always stay within their territorial boundaries.

Dispersal patterns in a medium-density Irish badger population: Implications for understanding the dynamics of tuberculosis transmission.

European badgers () are group-living mustelids implicated in the spread of bovine tuberculosis (TB) to cattle and act as a wildlife reservoir for the disease. In badgers, only a minority of individuals disperse from their natal social group. However, dispersal may be extremely important for the spread of TB, as dispersers could act as hubs for disease transmission.

Deep infiltrating endometriosis: Can magnetic resonance imaging anticipate the need for colorectal surgeon intervention?

Objective: To identify magnetic resonance imaging (MRI) features associated with colorectal surgical bowel resection for treatment of deep infiltrating endometriosis (DIE).

Materials And Methods: 122 preoperative pelvic MRIs in women with laparoscopically-proven DIE and subsequent surgery (2006-2015) were identified, and retrospective cohort analysis performed. MRIs were reviewed independently by two radiologists blinded to surgical/histopathological outcomes.

The Role of the Mirena Intrauterine Device in the Management of Endometrial Polyps: A Pilot Study.

Study Objective: To study the hypothesis that the levonorgestrel intrauterine device (LNG-IUD) can have a role in the treatment of endometrial polyps confirmed at outpatient hysteroscopy in premenopausal women.

Design: Canadian Task Force classification level II1 (a controlled trial that is not randomised).

Setting: Outpatient hysteroscopy.

Multicentre retrospective study to assess diagnostic accuracy of ultrasound for superficial endometriosis-Are we any closer?

Background: To establish whether the ultrasound findings of minimal endometriosis are confirmed at laparoscopy and that a correlation can be established as to the anatomical sites in this mild form of the disease.

Aims: Patients with pain and suspicion of endometriosis had an ultrasound scan by a sonologist with expertise in endometriosis as part of their pre-operative workup.

Measurements And Main Results: The clinical histories of 53 patients who had laparoscopy to investigate pelvic pain were reviewed.

The characteristics of women recommended a laparoscopy for chronic pelvic pain at a tertiary institution.

Background: Clinician and patient factors impact on the management of chronic pelvic pain (CPP) with medical, surgical or combined approaches possible, although none have proven superior.

Aims: To understand the characteristics of women offered laparoscopic pelvic surgery for CPP.

Materials And Methods: We performed an observational study of women referred with CPP.

Chronic pelvic pain - pain catastrophizing, pelvic pain and quality of life.

Background and aims Chronic pelvic pain (CPP) impacts significantly on the lives of women. Negative coping responses such as pain catastrophizing are thought to be significant in predicting both pain severity and outcome. The combined effect of the individual's response to pain and its severity on their quality of life (QoL) has not been well studied in women with CPP.

Can Narrowband Imaging Improve the Laparoscopic Identification of Superficial Endometriosis? A Prospective Cohort Trial.

Study Objective: To assess the usefulness of narrowband imaging (NBI) to detect additional areas of endometriosis not identified by standard white light in patients undergoing laparoscopy for the investigation of pelvic pain.

Design: A prospective cohort trial (Canadian Task Force classification II). Evidence obtained from a well-designed cohort study.

Super-ranging. A new ranging strategy in European badgers.

We monitored the ranging of a wild European badger (Meles meles) population over 7 years using GPS tracking collars. Badger range sizes varied seasonally and reached their maximum in June, July and August. We analysed the summer ranging behaviour, using 83 home range estimates from 48 individuals over 6974 collar-nights.

Is outpatient hysteroscopy the new gold standard? Results from an 11 year prospective observational study.

Background: In Australia, gynaecologists continue to investigate women with abnormal bleeding and suspected intrauterine pathology with inpatient hysteroscopy despite some evidence in the literature that that there is no difference in safety and outcome when compared to an outpatient procedure.

Aims: This prospective study assessed the safety, effectiveness and acceptability of outpatient hysteroscopy over 11 years at a tertiary hospital in Australia. Resource savings were then calculated.

Are endometrial nerve fibres unique to endometriosis? A prospective case-control study of endometrial biopsy as a diagnostic test for endometriosis in women with pelvic pain.

Study Question: Can the presence of endometrial nerve fibres be used as a diagnostic test for endometriosis in women with pelvic pain?

Summary Answer: Endometrial fine nerve fibres were seen in the endometrium of women both with and without endometriosis, making their detection a poor diagnostic tool for endometriosis.

What Is Known Already: Laparoscopy and biopsy are currently the gold standard for making a diagnosis of endometriosis. It has been reported that small density nerve fibres in the functional layer of the endometrium are unique to women with endometriosis and hence nerve fibre detection could function as a less invasive diagnostic test of endometriosis.

Endometriosis: Does the menstrual cycle affect magnetic resonance (MR) imaging evaluation?

Purpose: To determine if the menstrual cycle affects MR interpretation in patients with pelvic endometriosis.

Materials And Methods: Thirty-one patients with either laparoscopically proven endometriosis, or a high clinical suspicion of deep infiltrative endometriosis, were prospectively recruited from May 2008 to October 2009 and January to June 2012. Two pelvic MR scans were performed for pre-operative planning; during menses and the other mid-cycle.

The effect of patient body mass index on surgical difficulty in gynaecological laparoscopy.

Introduction: Over the past three decades, rates of overweight and obesity internationally have risen to epidemic proportions. There are currently no published prospective studies examining the effect of obesity on gynaecologic laparoscopy for benign indications within a population with obesity rates comparable to Australian women.

Aims: To assess and quantify whether increasing patient body mass index negatively impacted upon the ability to successfully complete planned laparoscopic surgery.

Can anyone screen for deep infiltrating endometriosis with transvaginal ultrasound?

Background: Surgical treatment of deep infiltrating endometriosis (DIE) is complex, and preoperative diagnosis benefits both surgeon and patient. Studies in expert centres have reported high accuracy for transvaginal ultrasound (TVUS) diagnosis of DIE. External validation of these findings has been limited, and no information is available on how quickly these skills can be acquired.

Use of a multimedia module to aid the informed consent process in patients undergoing gynecologic laparoscopy for pelvic pain: randomized controlled trial.

Study Objective: To determine whether providing additional information to the standard consent process, in the form of a multimedia module (MM), improves patient knowledge about operative laparoscopy without increasing anxiety.

Design: Randomized controlled trial (Canadian Task Force classification I).

Setting: Two outpatient gynecologic clinics, one in a private hospital and the other in a public teaching hospital.

Ultrasound-guided hysteroscopy to remove a levonorgestrel intrauterine system in early pregnancy.

Background: Correctly placed levonorgestrel-releasing intrauterine systems (LNG-IUSs) are rarely associated with intrauterine pregnancy when pregnancy occurs. LNG-IUS retrieval, termination of pregnancy and conservative management if retracted strings prevent ready removal are the usual clinical options given to women. The conservative course raises concerns about teratogenesis related to high local progestin exposure for the developing fetus.

Outpatient hysteroscopy: factors influencing post-procedure acceptability in patients attending a tertiary referral centre.

Background: Ambulatory hysteroscopy is a safe, reliable and cost-effective alternative to hysteroscopy under a general anaesthetic for the diagnosis of abnormal uterine bleeding.

Aim: The objective of this study was to assess which factors influenced patients' willingness to attend for future outpatient hysteroscopy. The outpatient hysteroscopy service commenced at the Mercy Hospital for Women in 2000.

The effect of heated humidified carbon dioxide on postoperative pain, core temperature, and recovery times in patients having laparoscopic surgery: a randomized controlled trial.

Study Objective: To determine whether use of heated humidified carbon dioxide as insufflation gas during gynecologic laparoscopy reduced postoperative pain and hypothermia.

Design: A randomized controlled trial (Canadian Task Force classification 1).

Setting: A tertiary referral hospital.

Surgical adhesions: a timely update, a great challenge for the future.

Damage to the peritoneum during abdominal surgery triggers a cascade of events aimed at repairing the damage. As part of this process, fibrin is deposited, which is the precursor to the formation of an adhesion between 2 damaged peritoneal surfaces. This can have a significant impact on morbidity and even mortality as well as large cost implications.