Pregnancy after laparoscopic hysteropexy: Is there a prolapse recurrence?

Laparoscopic hysteropexy is a surgery of choice for woman with pelvic organ prolapse wishing to retain fertility. There are few cases of pregnancies after this surgery as standard practice recommends to fulfil their family project before undergoing laparoscopic prolapse surgery. Our operative technique involves the use of 2 polypropylene meshes, one placed anteriorly and one posteriorly, they are attached to the cervix and together through the cervix.

The impact of laparoscopic gynecological surgery training on the technicity index of a developing country center.

Purpose: To compare laparoscopic gynecological surgery training between a developed country's reference center (host center) and a public reference service in a developing country (home center), and use the technicity index (TI) to compare outcomes and to determine the impact of laparoscopic gynecological surgery fellowship training on the home center's TI.

Methods: The impact of training on the home center was assessed by comparing surgical performance before and after training. TI was assessed in 2017 in the host center, and before and after training in the home center.

Effects of Low Intraperitoneal Pressure on Quality of Postoperative Recovery after Laparoscopic Surgery for Genital Prolapse in Elderly Patients Aged 75 Years or Older.

Study Objective: Previous clinical trials for laparoscopic surgery have included few elderly patients aged ≥75 years. We aimed to evaluate the quality of postoperative recovery after laparoscopic surgery using low intraperitoneal pressure (IPP) (6 mm Hg) and warmed, humidified carbon dioxide gas for genital prolapse in elderly patients aged ≥75 years.

Design: Prospective consecutive case series.

Laparoscopic TOT-like Burch Colposuspension: Back to the Future?

Objective: To demonstrate a modification of the classic Burch procedure, called "laparoscopic transobturator tape (TOT)-like Burch colposuspension." The technique does not involve any type of prosthesis placement, and it is an alternative for patients with stress urinary incontinence in a future without meshes. Describing and standardizing the procedure in different steps makes the surgery reproducible for gynecologists and safe for the patients.

Which Knots Are Recommended in Laparoscopic Surgery and How to Avoid Insecure Knots.

Study Objective: To investigate why security of identical knot sequences is variable and how to avoid occasionally insecure knots.

Design: A factorial design was used to assess factors affecting the security of half knot (H) and half-hitch (S) knot combinations. The effect of tying forces and the risk factors to transform H knots into S knots were investigated.

Minilaparoscopic Total Hysterectomy in Current Practice Feasibility and Benefits: A Unicentric, Randomized Controlled Trial.

Study Objective: To investigate whether mini-instrumentation may be used for hysterectomy (HT) by all surgeons (assistants and seniors) without increasing the operative time or altering surgeon working conditions.

Design: A unicenter, randomized controlled, single blind, parallel, noninferiority trial comparing 2 surgical techniques.

Setting: A tertiary referral center.

Laparoscopic Myomectomy in 10 Steps.

Study Objective: Laparoscopic myomectomy has the advantages of a minimally invasive approach for the surgical treatment of myomas. The standardization and description of the technique are the main objectives of this video. We described laparoscopic myomectomy in 10 steps, which could help make this procedure easier and safer [1].

Laparoscopic Ureteroneocystostomy with a Vesicopsoas Hitch in 10 Steps.

Study Objective: Laparoscopic ureteroneocystostomy with a vesicopsoas hitch has the advantages of a minimally invasive approach. The standardization and description of the technique are the main objectives of this video. We described this procedure in 10 steps, which could help to understand and perform this procedure.

Laparoscopic Promontofixation in 10 Steps.

Study Objective: Laparoscopic promontofixation has all the advantages of a minimally invasive approach for the treatment of urogenital prolapse. The standardization and description of the technique was the main objective of this video. We describe the complete procedure in 10 steps, which could help to understand and perform this procedure simply, easily, and safely.

Effects of low intraperitoneal pressure and a warmed, humidified carbon dioxide gas in laparoscopic surgery: a randomized clinical trial.

Laparoscopic surgery technology continues to advance. However, much less attention has been focused on how alteration of the laparoscopic surgical environment might improve clinical outcomes. We conducted a randomized, 2 × 2 factorial trial to evaluate whether low intraperitoneal pressure (IPP) (8 mmHg) and/or warmed, humidified CO (WH) gas are better for minimizing the adverse impact of a CO pneumoperitoneum on the peritoneal environment during laparoscopic surgery and for improving clinical outcomes compared to the standard IPP (12 mmHg) and/or cool and dry CO (CD) gas.

Transrectal Mesh Erosion Requiring Bowel Resection.

Study Objective: To report a case of a transrectal mesh erosion as complication of laparoscopic promontofixation with mesh repair, necessitating bowel resection and subsequent surgical interventions.

Introduction: Sacrocolpopexy has become a standard procedure for vaginal vault prolapse [1], and the laparoscopic approach has gained popularity owing to more rapid recovery and less morbidity [2,3]. Mesh erosion is a well-known complication of surgical treatment for prolapse as reported in several negative evaluations, including a report from the US Food and Drug Administration in 2011 [4].

Sampling in Atypical Endometrial Hyperplasia: Which Method Results in the Lowest Underestimation of Endometrial Cancer? A Systematic Review and Meta-analysis.

Our objective was to identify the most accurate method of endometrial sampling for the diagnosis of complex atypical hyperplasia (CAH), and the related risk of underestimation of endometrial cancer. We conducted a systematic literature search in PubMed and EMBASE (January 1999-September 2013) to identify all registered articles on this subject. Studies were selected with a 2-step method.

Laparoscopic-assisted Retropubic Midurethral Sling Placement: A Technique to Avoid Major Complications.

Study Objective: To describe a technique for the safe placement of retropubic midurethral slings in patients undergoing concomitant laparoscopic surgery in order to avoid major complications associated with this procedure such as bladder perforation and retropubic hematomas.

Design: Step-by-step video demonstration of the technique.

Setting: A university tertiary care hospital.

Are gynecologists sufficiently trained and educated on electro surgery and basic laparoscopic setting?

Background: Basic knowledge of electrosurgery and patient's safety during laparoscopic setup are fundamental, as laparoscopic surgical skills do. The aim of this prospective case-control study was to assess the improvement of such knowledge and skills among gynecologists.

Methods: Gynecologists attending a training course on laparoscopy at the Centre International de Chirurgie Endoscopique (CICE), Clermont Ferrand (France) (December 2013-March 2014) were asked to answer a questionnaire about their own clinical activity and basic surgical knowledge and skills at the beginning and end of the course.

What to Do With Recurrent Prolapse After Vaginal Mesh Failure?

Study Objective: To show that in selected cases laparoscopic sacrocolpopexy can be used for the treatment of recurrent pelvic organ prolapse after vaginal mesh surgery.

Methods: Step-by-step examination of the technique using an educative video. Institutional review board approval was obtained.

Laparoscopic Ureteroneocystostomy: Be Prepared!

Study Objective: To assess the outcomes and complications of laparoscopic ureteroneocystotomy in gynecologic surgery.

Design: We retrospectively reviewed all medical records of patients who underwent ureteroneocystostomy between April 2008 and May 2012.

Design Classification: Retrospective case series study.

Laparoscopy-like operative vaginoscopy: a new approach to manage mesh erosions.

Study Objective: Mesh erosion through the vagina is the most common complication of synthetic mesh used for pelvic organ prolapse repair. However, conventional transvaginal mesh excision has many technical limitations. We aimed at creating and describing a new surgical technique for transvaginal removal of exposed mesh that would enable better exposition and access, thus facilitating optimal treatment.

Targeting the Wnt/β-catenin pathway in endometriosis: a potentially effective approach for treatment and prevention.

Endometriosis is a chronic, estrogen-dependent disease associated with infertility and pelvic pain. Endometriosis is defined by the presence of extra-uterine endometrial tissue. It affects approximately 10% of reproductive-aged women.

What's the impact of the obesity on the safety of laparoscopic hysterectomy techniques?

Objective: To evaluate the impact of obesity in the safety of laparoscopic hysterectomy.

Study Design: A retrospective study was conducted using a database of 2271 women undergoing laparoscopic hysterectomy for benign diseases between January 1995 and December 2008 at the Centre Hospitalier Universitaire Estaing (Clermont-Ferrand, France). Patients were divided into two groups according to the body mass index: <30 kg/m(2) (n=2088) and ≥ 30 kg/m(2) (n=183).