Perioperative Efficiency of Sugammadex Following Laparoscopic Cholecystectomy in Clinical Practice.

Studies have proposed that the routine use of the modified gamma-cyclodextrin, sugammadex, could provide perioperative time savings. However, these investigations have been limited to small group analyses. The purpose of this study was to test the effectiveness of sugammadex on perioperative times when compared to neostigmine under general clinical practice conditions following rocuronium-induced neuromuscular blockade for laparoscopic cholecystectomy.

Novel Catheter Multiscope: A Feasibility Study.

Unlabelled: Open Challenges: Continuous monitoring of fundamental cardiovascular hemodynamic parameters is essential to accomplish critical care diagnostics. Today's standard of care measures these critical parameters using multiple monitoring technologies. These state-of-the-art technologies require expensive instrumentation and complex infrastructure.

Psychological maltreatment: An international challenge to children's safety and well being.

Background: Child psychological maltreatment (PM), also known as emotional abuse and neglect, mental violence, and emotional maltreatment, is the least recognized and addressed of the four major forms of child maltreatment.

Objectives: This article provides an 1) the history of PM and its relationship to children's rights, 2) an overview of the current state of knowledge, 3) implications of diversity for the topic of PM, 4) an example of a topic-relevant intervention, and 5) a vision for further progress in addressing this form of child maltreatment.

Participants And Settings: NA.

Cost-effectiveness of a preoperative pelvic MRI in pelvic organ prolapse surgery.

Objective: To investigate the cost-effectiveness of preoperative pelvic magnetic resonance imaging (MRI) in identifying women at high risk of surgical failure following apical repair for pelvic organ prolapse (POP).

Methods: A decision tree (TreeAgePro Healthcare software) was designed to compare outcomes and costs of screening with a pelvic MRI versus no screening. For the strategy with MRI, expected surgical outcomes were based on a calculated value of the estimated levator ani subtended volume (eLASV) from previously published work.

The Association Between Hospital Surgical Volume and the Uptake of Minimally Invasive Surgical Approach and Outpatient Setting for Hysterectomy.

Background: There are large variations in the use of minimally invasive surgery (MIS), and outpatient hysterectomy (OP) among Medicare patients according to hospital surgical volume and geographical distribution.

Objective: To explore the changing trend in OP and MIS hysterectomy in the United States.

Study Design: We used all Medicare fee-for-service claims data for 2012 and 2014 to determine the incidence of OP and MIS hysterectomy according to hospital surgical volume and geographical distribution.

Automated contour tracking and trajectory classification of pelvic organs on dynamic MRI.

A method is presented to automatically track and segment pelvic organs on dynamic magnetic resonance imaging (MRI) followed by multiple-object trajectory classification to improve understanding of pelvic organ prolapse (POP). POP is a major health problem in women where pelvic floor organs fall from their normal position and bulge into the vagina. Dynamic MRI is presently used to analyze the organs' movements, providing complementary support for clinical examination.

A Simplified Novel Approach for Total Laparoendoscopic Single-Site (LESS) Hysterectomy.

Total laparoendoscopic single-site (LESS) hysterectomy is a technically challenging minimally-invasive gynecologic procedure. Multiple technological innovations assist surgeons to overcome the challenges that are usually encountered during this advanced approach. Simplifying the steps of this advanced surgery is an invaluable addition in overcoming associated challenges with this procedure.

A novel acoustic catheter stethoscope based acquisition and signal processing framework to extract multiple bio signals.

In this study, a novel acoustic stethoscope based on an intravenous catheter was introduced to measure vascular pressures from a Yorkshire pig. Our hypothesis is that by means of this single device (measurement system) and by applying signal analysis and processing framework, multiple vital bio signals can be extracted. In contrast, current conventional state-of-the-art technologies use multiple devices to provide the same information.

Demonstration of a box-stitch technique for laparoscopic uterosacral ligament suspension.

Aim: We demonstrate a novel box stitch technique of laparoscopic post-hysterectomy uterosacral ligament suspension for apical prolapse in restorative pelvic reconstructive surgery.

Material And Methods: We present a case of a 58yo female with symptomatic stage III pelvic organ prolapse with a history of a total abdominal hysterectomy 30 years prior. She strongly desired the usage of no synthetic or biologic mesh for her restorative surgical repair.

Evaluation of patient preparedness for surgery: a randomized controlled trial.

Background: Patient preparedness for pelvic reconstructive surgery has important implications for patient satisfaction and the perception of improvement after surgery. The ideal method in which to optimally prepare patients for surgery has not been determined.

Objective: The objective of the study was to evaluate the impact of a preoperative patient education video on patient preparedness prior to sacrocolpopexy as measured by a preoperative preparedness questionnaire.

Automatic vertebra segmentation on dynamic magnetic resonance imaging.

The automatic extraction of the vertebra's shape from dynamic magnetic resonance imaging (MRI) could improve understanding of clinical conditions and their diagnosis. It is hypothesized that the shape of the sacral curve is related to the development of some gynecological conditions such as pelvic organ prolapse (POP). POP is a critical health condition for women and consists of pelvic organs dropping from their normal position.

Automated tracking, segmentation and trajectory classification of pelvic organs on dynamic MRI.

Pelvic organ prolapse is a major health problem in women where pelvic floor organs (bladder, uterus, small bowel, and rectum) fall from their normal position and bulge into the vagina. Dynamic Magnetic Resonance Imaging (DMRI) is presently used to analyze the organs' movements from rest to maximum strain providing complementary support for diagnosis. However, there is currently no automated or quantitative approach to measure the movement of the pelvic organs and their correlation with the severity of prolapse.

Association Between Obesity and Perioperative Morbidity in Open Versus Laparoscopic Sacrocolpopexy.

Objectives: The aim of this study was to compare differences in 30-day perioperative morbidity and mortality for women undergoing open sacrocolpopexy (OSCP) versus laparoscopic sacrocolpopexy (LSCP) across all body mass index (BMI) groups and between patients of ideal versus elevated BMI (includes overweight, obese, and morbidly obese).

Materials And Methods: Data for this retrospective review were obtained from the American College of Surgeons-National Surgical Quality Improvement Project database using current procedural terminology. All women older than 18 years who underwent an OSCP or LSCP from 2005 to 2013 were included.

Trends of Bilateral Salpingectomy During Vaginal Hysterectomy With and Without Laparoscopic Assistance Performed for Benign Indications in the United States.

Study Objective: To estimate the recent temporal trends of concurrent bilateral salpingectomy (BS) during vaginal hysterectomy (total vaginal hysterectomy [TVH] and laparoscopic-assisted vaginal hysterectomy [LAVH]) in the United States.

Design: A cross-sectional analysis was conducted using data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, including all female patients 18 years and older whose inpatient discharge record indicated a TVH or LAVH performed for benign indications between January 1, 1998, and December 31, 2011. Joinpoint regression was used to identify statistically significant changes in overall and subgroup temporal trends of TVH and LAVH as well as concomitant BS during the 14-year study period (Canadian Task Force Classification II).

Barbed Sutures in Minimally Invasive Gynecologic Surgery.

The introduction of knotless barbed suture into the surgical market has decreased the challenges of laparoscopic suturing. Since its introduction, barbed suture has gained popularity in the field of minimally invasive gynecologic surgery and is now commonly used to close the vaginal cuff in total laparoscopic hysterectomy, to re-approximate the myometrium after laparoscopic myomectomy, and to shorten the procedure time during a laparoscopic sacrocolpopexy. Barbed sutures facilitate rapid and consistent wound closure, allowing for equal distribution of tissue tension across the suture line, and thereby providing a more secure wound closure.

Comparing Single and Dual Console Systems in the Robotic Surgical Training of Graduating OB/GYN Residents in the United States.

Objective. To assess the impact of a single versus dual console robotic system on the perceptions of program directors (PD) and residents (RES) towards robotic surgical training among graduating obstetrics and gynecology residents. Design.

Association between Fellowship Training, Surgical Volume, and Laparoscopic Suturing Techniques among Members of the American Association of Gynecologic Laparoscopists.

Study Objective. To compare surgical volume and techniques including laparoscopic suturing among members of the American Association of Gynecologic Laparoscopists (AAGL) according to fellowship training status. Design.

Does Laparoscopic Hysterectomy Increase the Risk of Vaginal Cuff Dehiscence? An Analysis of Outcomes from Multiple Academic Centers and a Review of the Literature.

Vaginal cuff dehiscence represents a serious, but infrequent complication after hysterectomy, with a reported increased incidence following a laparoscopic approach. Various risk factors have been proposed including laparoscopically placed suture, surgical experience, use of electrosurgery, surgical indication, and obesity. Technical aspects of the procedure itself have also been questioned such as the variable use of monopolar electrosurgery during colpotomy and the suture type or number of layers chosen to reapproximate the vaginal cuff.

Estimated levator ani subtended volume: a novel assay for predicting surgical failure after uterosacral ligament suspension.

Background: Levator ani muscle complex plays an important role in pelvic support and defects or laxity in this muscle complex contributes to pelvic organ prolapse and recurrence after surgical repair.

Objective: The purpose of this study was to determine whether estimated levator ani subtended volume can predict surgical outcomes for laparoscopic bilateral uterosacral ligament suspension.

Study Design: A retrospective cohort study was performed in patients who underwent laparoscopic uterosacral ligament suspension from 2010-2012.

National trends of adnexal surgeries at the time of hysterectomy for benign indication, United States, 1998-2011.

Objective: We sought to investigate the most recent national trends of bilateral salpingectomy (BS) and bilateral salpingo-oophorectomy (BSO) at the time of hysterectomy performed for benign indications.

Study Design: We conducted a national cross-sectional analysis of all inpatient discharges for women aged ≥18 years who underwent a hysterectomy for benign indications from 1998 through 2011 using the largest publicly available all-payer inpatient database in the United States. We scanned International Classification of Diseases, Ninth Revision codes for an indication of specific bilateral adnexal surgeries, including BSO and BS.

Association between obesity and the trends of routes of hysterectomy performed for benign indications.

Objective: To estimate the association between obesity and the recent trends of routes chosen for hysterectomy performed for benign indications in the United States.

Materials And Methods: Using the American College of Surgeons-National Surgical Quality Improvement Project's database, patients who underwent hysterectomy for benign indications from 2005 to 2011 were identified by International Classification of Diseases, 9th Revision codes and were categorized into total abdominal hysterectomy (TAH), total vaginal hysterectomy (TVH), laparoscopically assisted vaginal hysterectomy (LAVH), and total laparoscopic hysterectomy (TLH). The patients were divided into four subgroups according to body mass index (BMI) (less than 25, 25-29.

Automated Localization of Multiple Pelvic Bone Structures on MRI.

In this paper, we present a fully automated localization method for multiple pelvic bone structures on magnetic resonance images (MRI). Pelvic bone structures are at present identified manually on MRI to locate reference points for measurement and evaluation of pelvic organ prolapse (POP). Given that this is a time-consuming and subjective procedure, there is a need to localize pelvic bone structures automatically.

Total laparoscopic hysterectomy in the obese patient.

Obesity is a challenging health problem that affects surgical decision-making. Obesity has also been associated with an increase in the perioperative complication rate in open abdominal hysterectomy and can increase the level of difficulty in performing a vaginal hysterectomy. Total laparoscopic hysterectomy (TLH) is a route that can offer advantages in obese patients including smaller incisions that are less likely to become infected as well as less post-operative pain and good visualization.