[Interest of multidisciplinary consultation meetings dedicated to endometriosis: From a series of 682 patients].

Objective: We decided to conduct a study based on these multidisciplinary team (MDT) in order to investigate their impact at the University Hospitals of Strasbourg and look for ways to improve this MDT.

Methods: This is a retrospective study of the 682 patients presented to endometriosis MDT from its inception in March 2017 to December 2020.

Results: The MDT decision was different from that initially proposed by the patient's referent for 406 patients (60%).

Urological procedures performed by gynecologists: Activity profile in a gynecological surgery department, 10-year observation cohort.

Introduction: The proximity of the urinary tract to the female genital tract explains its possible involvement in pelvic gynaecological cancer or deep endometriosis. Surgical treatment is aimed at improving overall survival and recurrence-free survival of patients, as well as restoring normal anatomy and functional integrity depending on the pathology. These operations are accompanied by significant post-operative complications.

Bilateral posterior Richter sacrospinous fixation with native tissue: Anatomical and functional results and quality of life assessment over 10 years.

Introduction: Pelvic organ prolapse (POP) is a common condition that affects 50% of women who have given birth in their lifetime. With stop of vaginal mesh sale in 2019, the sacrospinous fixation technique according to Richter with native tissue has seen its incidence tripled in 15 years. Classically, sacrospinous fixation according to Richter is performed unilaterally, however its unilateral or bilateral character is controversial.

Deep infiltrating endometriosis: Laparoscopic nerve-sparing surgery and use of neutral argon plasma.

Objective: To present a minimally approach to the management of deep pelvic endometriosis by nerve-sparing surgery and use of neutral argon plasma for extensive endometriotic lesions.

Design: This is a clinical case video of a 29 years-old patient, affected by deep pelvic endometriosis with primary dysmenorrhea, deep dyspareunia, chronic pelvic pain and dyschezia. Pelvic MRI shows a right ovarian endometrioma measuring 5 cm, a thickening of the right uterosacral ligament and a uterine torus nodule.

Vaginal and laparoscopic sub-urethral sling explantation.

Introduction And Hypothesis: The objective was to describe the different laparoscopic and vaginal steps of sub-urethral infected mesh explantation as well as an unexpected and unusual complication: a sub-mucosal calcification on the sub-urethral segment of the sling that was not infiltrating the urethra.

Methods: This was carried out at our University Teaching Hospital of Strasbourg.

Results: We show the complete removal of an infected retropubic sling in a patient who had already undergone three previous surgeries without resolution of symptoms.

Preliminary observational study of the implementation of hyperthermic intraperitoneal chemotherapy in ovarian cancer in the gynecological surgery department at the University Hospital of Strasbourg.

Objective: According to French guidelines, hyperthermic intraperitoneal chemotherapy (HIPEC) can be performed for Federation of Gynecology and Obstetrics stage III primary epithelial ovarian, tubal, and peritoneal cancers that are initially unresectable after 3 or 4 cycles of intravenous chemotherapy. The main objective of this preliminary study was to analyze the components necessary for the establishment of HIPEC in an expert gynecological oncological surgery center. The secondary objective was to compare HIPEC using conventional laparotomy and laparoscopic approaches.

Feasibility and clinical value of virtual reality for deep infiltrating pelvic endometriosis: A case report.

Deep infiltrating pelvic endometriosis and its surgical management is associated with a risk of major postoperative complications. Magnetic Resonance Imaging (MRI) is recommended preoperatively in order to obtain the most precise mapping of the extent of endometriotic lesions. The aim of this work was to assess the feasibility and clinical interest of 3D modeling by surface rendering as a preoperative planning tool in a patient with deep infiltrating pelvic endometriosis.

Laparoscopic En Bloc Pelvic Resection with Rectosigmoid Resection and Anastomosis for Stage IIB Ovarian Cancer: Hudson's Procedure Revisited.

Study Objective: To demonstrate a systematic approach to the laparoscopic en bloc pelvic resection with rectosigmoid resection and anastomosis as part of ovarian cancer treatment in a tertiary gynecologic surgery referral center.

Design: This video illustrates an en bloc pelvic resection performed par laparoscopy in 10 steps.

Setting: A 56-year-old patient with an advanced high-grade serous ovarian cancer extending into the rectum was amenable to primary debulking surgery in accordance with the French guidelines [1].

Nerve Anatomy Around Lumbo-aortic Lymphadenectomy by Retroperitoneal Approach.

Study Objective: To describe the anatomy of the nerves during a laparoscopic retroperitoneal para-aortic lymphadenectomy with prioritization of their preservation.

Design: Demonstration of a nerve-preserving para-aortic lymphadenectomy.

Setting: A 65-year-old woman with no significant medical history underwent diagnostic laparoscopy for evaluation of a right ovarian mass.

Basics of immunotherapy for epithelial ovarian cancer.

Epithelial ovarian cancer (EOC) is the most lethal of all gynecological cancers. Despite excellent responses to standard treatment in approximately 70% of patients, most of them will relapse within 5 years of initial treatment and many of them will develop chemotherapy-resistant disease. It is then important to find other means of treatment for these patients such as immunotherapy or targeted therapy.

Bowel resection performed by gynecologists - Outcomes and learning curves. Activity profile in a Gynecology Department: 7-year observational cohort.

Objective: Bowel resection is frequently used when performing oncological surgery to obtain complete cytoreduction or to remove endometriosis in case of intestinal invasion. Acquiring the surgical skills to perform this kind of procedure is crucial to offer to our patients an optimal management. The aim of this study is to describe a 7-years surgical experience in bowel resections of a gynecologic surgeon and to determine his learning curves.

Adherence to European ovarian cancer guidelines and impact on survival: a French multicenter study (FRANCOGYN).

Objective: The primary objective of the study was to validate the European Society for Medical Oncology (ESMO)-European Society of Gynecologic Oncology (ESGO) ovarian cancer guideline as a method of assessing quality of care, and to identify patient characteristics predictive of non-adherence to European guideline care. The secondary objectives were to analyze the evolution of practices over the years and to evaluate heterogeneity between centers.

Methods: This retrospective multicenter cohort study of invasive epithelial ovarian cancer reported to the FRANCOGYN database included data from 12 French centers between January 2000 and February 2017.

Status of Surgical Management of Borderline Ovarian Tumors in France: are Recommendations Being Followed? Multicentric French Study by the FRANCOGYN Group.

Background: Borderline ovarian tumors (BOTs) are tumors with a favorable prognosis but whose management by consensus is essential to limit the risk of invasive recurrence. This study aimed to conduct an inventory of surgical practices for BOT in France and to evaluate the conformity of the treatment according to the current French guidelines.

Methods: This retrospective, multicenter cohort study included nine referral centers of France between January 2001 and December 2018.

Relevance of Laparoscopic Surgery for Ovarian Cancer in Well-selected Patients: A Propensity-matched Comparison With Laparotomy.

Background/aim: This study aimed to evaluate the relevance of laparoscopy in comparison with laparotomy in the management of ovarian cancer in well-selected patients.

Patients And Methods: Data of consecutive ovarian cancer patients treated by laparoscopy were matched 1:1 to a cohort of patients operated by laparotomy using a propensity score matching. The inclusion criteria included patients who underwent a complete staging procedure in the early stages and optimal upfront or interval debulking surgery for advanced ovarian cancer.

Diagnostic Accuracy and Clinical Impact of Sentinel Lymph Node Sampling in Endometrial Cancer at High Risk of Recurrence: A Meta-Analysis.

Purpose: To assess the value of sentinel lymph node (SLN) sampling in high risk endometrial cancer according to the ESMO-ESGO-ESTRO classification.

Methods: We performed a comprehensive search on PubMed for clinical trials evaluating SLN sampling in patients with high risk endometrial cancer: stage I endometrioid, grade 3, with at least 50% myometrial invasion, regardless of lymphovascular space invasion status; or stage II; or node-negative stage III endometrioid, no residual disease; or non-endometrioid (serous or clear cell or undifferentiated carcinoma, or carcinosarcoma). All patients underwent SLN sampling followed by pelvic with or without para-aortic lymphadenectomy.

F-FDG PET/CT Imaging of Peritoneal Fibrosis Mimicking Persistent Metastatic Ovarian Carcinoma.

A 65-year-old woman was addressed for clinical and biological suspicion of ovarian cancer relapse. F-FDG PET/CT revealed massive peritoneal carcinomatosis. Post-chemotherapy PET/CT showed complete metabolic response in initial localizations albeit three new F-FDG uptakes appeared in the mesentery and in the retro-hepatic space.

Three and Five-Year Mortality in Ovarian Cancer after Minimally Invasive Compared to Open Surgery: A Systematic Review and Meta-Analysis.

As regards ovarian cancer, the use of minimally invasive surgery has steadily increased over the years. Reluctance persists, however, about its oncological outcomes. The main objective of this meta-analysis was to compare the three and five-year mortality of patients operated by minimally invasive surgery (MIS) for ovarian cancer to those operated by conventional open surgery (OPS), as well as their respective perioperative outcomes.

Impact of Lymphadenectomy on Survival of Patients with Serous Advanced Ovarian Cancer After Neoadjuvant Chemotherapy: A French National Multicenter Study (FRANCOGYN).

Background: The population of interest to this study comprised individuals with advanced-stage ovarian carcinoma who were exposed to neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS). Those who had not received systematic lymphadenectomy (SL; Group 1) were compared to those who had received SL (Group 2). Outcome measures included progression-free survival (PFS), overall survival (OS), and surgical complications.

Randomized Study Comparing a Reusable Morcellator with a Resectoscope in the Hysteroscopic Treatment of Uterine Polyps: The RESMO Study.

Study Objective: To compare a reusable hysteroscopic morcellator and standard resectoscopes in the hysteroscopic management of uterine polyps.

Design: Single-center randomized prospective single-blind trial (resectoscope-morcellator study).

Setting: Centre Médico-chirurgical Obstétrique teaching hospital, Strasbourg University Hospitals, France.

Frozen Pelvis Surgical Strategy in 10 Steps.

Study Objective: To describe a 10-step strategy to treat severe endometriosis with a frozen pelvis by laparoscopy.

Design: Educational video.

Setting: University Hospital of Strasbourg, France.

Impact of neoadjuvant chemotherapy cycles on survival of patients with advanced ovarian cancer: A French national multicenter study (FRANCOGYN).

Objective: The purpose of this study was to compare two groups of patients presenting advanced ovarian carcinoma benefiting from neoadjuvant chemotherapy (NAC) followed by cytoreductive surgery: after 3-4 cycles (group 1) or ≥ 5 cycles (group 2), regarding overall survival (OS) and progression-free survival (PFS), complications related to surgery as well as the extent of cytoreduction were assessed.

Study Design: We conducted a retrospective, multicenter cohort study in nine referral centers of France, reviewing the charts of all patients who underwent NAC between January 2000 and June 2017. We performed an OS analysis using multivariate Cox regression models adjusted for potential confounders.

Sacrospinofixation of Richter in 8 Points: Original Contribution of the Laparoscopic Column in the Visualization of the Sacrospinous Ligaments.

Study Objective: Although the standard technique is currently based on laparoscopic promontofixation, the standard vaginal technique for the treatment of uterine prolapse is sacrospinofixation according to Richter [1-3]. Described by Kurt Richter in 1968, this intervention corrects the middle floor and consists of fixing the vaginal dome (after hysterectomy or not) on the sacrospinous ligament(s) [4,5]. The technique includes a wide dissection of the pararectal fossa using several Breisky valves to grip the sacrospinous ligament under strict visual control.