Predictive Factors for Morcellation during Total Laparoscopic Hysterectomy: A Cohort Study.

Objectives: Our objective was to identify predictors of morcellation during a total laparoscopic hysterectomy (TLH).

Methods: A retrospective cohort study (Canadian Task Force classification II-2) taking place in a university hospital center in Quebec, Canada. Participants were women undergoing a TLH for a benign gynaecologic pathology from January 1, 2017, to January 31, 2019.

Effect of Postoperative Hormonal Suppression on Fertility in Patients With Endometriosis After Conservative Surgery: A Systematic Review and Meta-analysis.

Objective: To evaluate the effect of hormonal suppression on fertility when administered to infertile patients or patient wishing to conceive after surgery for endometriosis.

Data Sources: A systematic search of MEDLINE, EMBASE, CENTRAL and ClinicalTrials.gov was performed by two independent reviewers from the databases' inception until December 2020.

Technicity in Canada: A Nationwide Whole-Population Analysis of Temporal Trends and Variation in Minimally Invasive Hysterectomies.

Study Objective: The objective of our study was to provide a contemporary description of hysterectomy practice and temporal trends in Canada.

Design: A national whole-population retrospective analysis of data from the Canadian Institute for Health Information.

Setting: Canada.

Guideline No. 412: Laparoscopic Entry for Gynaecological Surgery.

Objective: To evaluate the benefits and risks of laparoscopic surgery and provide clinical direction on entry techniques, technologies, and their associated complications in gynaecological surgery.

Target Population: All patients, including pregnant women and women with obesity, undergoing laparoscopic surgery for various gynaecological indications.

Options: The laparoscopic entry techniques and technologies reviewed in formulating this guideline included the closed (Veress needle-pneumoperitoneum-trocar) technique, direct trocar insertion, open (Hasson) technique, visual entry systems, and disposable shielded and radially expanding trocars.

Minimally Invasive Hysterectomy Rates in Québec: Trends Over the Last Decade and Predictors of Technicity.

Objective: To assess trends and predictors of a high technicity index for hysterectomies performed in the province of Québec.

Methods: We conducted a retrospective study using the ADAM database to determine the annual number hysterectomies performed for a suspected benign condition and the surgical approach used across 81 hospitals in the province of Québec from 2007 to 2017. We calculated the technicity index for each hospital and analyzed trends in surgical approach using the Cochran-Armitage test.

Morcellation During Total Laparoscopic Hysterectomies: Implications of the Use of a Contained Bag System.

Objective: This study sought to report the feasibility and clinical implications of in-bag morcellation for total laparoscopic hysterectomy (TLH).

Methods: Women who required uterine morcellation during TLH from January 2017 to December 2018 (at the Centre Hospitalier Universitaire de Québec - CHUL, Québec, QC) were included. Women with a preoperative suspicion of malignancy were excluded (Canadian Task Force classification II-2).

Contained Morcellation of Very Large Uterus.

A 38-year-old woman was referred to our centre for symptomatic leiomyoma. The patient had a large uterus, heavy menstrual bleeding, and compressive symptoms refractory to medical treatments. The patient was then scheduled for total laparoscopic hysterectomy with contained morcellation.

Endometrial ablation or resection versus levonorgestrel intra-uterine system for the treatment of women with heavy menstrual bleeding and a normal uterine cavity: a systematic review with meta-analysis.

Background: Endometrial ablation/resection and the levonorgestrel intra-uterine system (LNG-IUS) are well-established treatment options for heavy menstrual bleeding to avoid more invasive alternatives, such as hysterectomy.

Objective: The aim was to compare the efficacy and safety of endometrial ablation or resection with the LNG-IUS in the treatment of premenopausal women with heavy menstrual bleeding and to investigate sources of heterogeneity between studies.

Search Methods: We searched the databases MEDLINE, EMBASE, CENTRAL, Web of Science, Biosis and Google Scholar as well as citations and reference lists published up to August 2019.

Sodium Fluorescein for Ureteral Jet Detection: A Prospective Observational Study.

Background And Objectives: Laparoscopic hysterectomy poses the risk of lower urinary tract injury, and intraoperative recognition of urinary tract injury is often difficult. We sought to evaluate sodium fluorescein coloration of ureteral jets during cystoscopy after laparoscopic hysterectomy and to evaluate surgeons' satisfaction with this method of injury detection.

Methods: This was an observational study, in which data were collected prospectively.

Pyomyoma After Uterine Artery Embolization: Laparotomy Avoided by In-Bag Morcellation.

We report a case of a pyomyoma in which in-bag morcellation allowed for a total laparoscopic hysterectomy instead of laparotomy, which has been recognized as the standard of care to avoid the spread of infection from morcellation. A 45-year-old multiparous woman presented with sepsis, pelvic pain, and leukocytosis at 1 month after undergoing uterine artery embolization for symptomatic uterine leiomyoma. Pelvic computed tomography scan revealed a 9-cm suspected pyomyoma.

No. 193-Laparoscopic Entry: A Review of Techniques, Technologies, and Complications.

Objective: To provide clinical direction, based on the best evidence available, on laparoscopic entry techniques and technologies and their associated complications.

Options: The laparoscopic entry techniques and technologies reviewed in formulating this guideline include the classic pneumoperitoneum (Veress/trocar), the open (Hasson), the direct trocar insertion, the use of disposable shielded trocars, radially expanding trocars, and visual entry systems.

Outcomes: Implementation of this guideline should optimize the decision-making process in choosing a particular technique to enter the abdomen during laparoscopy.

Imaging for Polyps and Leiomyomas in Women With Abnormal Uterine Bleeding: A Systematic Review.

Objective: To evaluate the accuracy of saline infusion sonohysterography in comparison with transvaginal ultrasonography for diagnosing polyps and submucosal leiomyomas in women with abnormal uterine bleeding.

Data Sources: We searched the databases MEDLINE, EMBASE, CENTRAL, and ClinicalTrials.gov as well as citations and reference lists to the end of November 2015.

Low vs Standard Pressures in Gynecologic Laparoscopy: a Systematic Review.

Background: The optimal intraperitoneal pressure during laparoscopy is not known. Recent literature found benefits of using lower pressures, but the safety of doing abdominal surgery with low peritoneal pressures needs to be assessed. This systematic review compares low with standard pneumoperitoneum during gynecologic laparoscopy.

Burden of symptomatic uterine fibroids in Canadian women: a cohort study.

Objective: Due to variability in size, number, and location of uterine fibroids (UFs), symptoms can range widely among women. We sought to characterize burden of illness and quality of life (QoL) among women with symptomatic UFs.

Research Design And Methods: An online survey queried the gynecologic health and menstrual cycle of Canadian women aged 20 to 49.