Colon carcinoma presenting as ovarian metastasis.

An adnexal mass is a common gynecological finding. Most adnexal masses are benign neoplasms, especially in premenopausal women. Yet, here we report a premenopausal woman with an adnexal mass that turned out to be an ovarian metastasis from colon cancer.

Value of an objective assessment tool in the operating room.

Background: Concerns about the achievement of surgical proficiency during residency are increasing. To objectify surgical skills, the Objective Structured Assessment of Technical Skills (OSATS) was developed and proven valid, feasible and reliable for use in laboratory settings. This study aimed to evaluate the value of this tool for intraoperative use.

Are minimally invasive procedures harder to acquire than conventional surgical procedures?

Background: It is frequently suggested that minimally invasive surgery (MIS) is harder to acquire than conventional surgery. To test this hypothesis, residents' learning curves of both surgical skills are compared.

Methods: Residents had to be assessed using a general global rating scale of the OSATS (Objective Structured Assessment of Technical Skills) for every procedure they performed as primary surgeon during a 3-month clinical rotation in gynecological surgery.

Skills training in minimally invasive surgery in Dutch obstetrics and gynecology residency curriculum.

The complexity of acquiring minimally invasive surgical (MIS) skills, combined with smaller case volumes for residents have pushed the development of skills training facilities on simulators outside the operating room (OR). Medico-legal and financial constraints have stimulated this development even more. However, the implementation of simulator training into a residency curriculum is shown to be troublesome.

Preoperative predictors of postsurgical adhesion formation and the Prevention of Adhesions with Plasminogen Activator (PAPA-study): results of a clinical pilot study.

Objective: To identify predictors of postsurgical adhesion formation in peritoneal fluid and plasma, and assess efficacy and safety of reteplase (recombinant plasminogen activator [r-PA]).

Design: Prospective randomized study.

Setting: University Medical Center.

Teach the teachers: an observational study on mentor traineeship in gynecological laparoscopic surgery.

Background: To evaluate the effect of a mentor traineeship in laparoscopic surgery in a teaching hospital.

Method: This observational study was performed between January 1997 and December 2004 at Bronovo Hospital, The Hague, The Netherlands. Since January 2001, an advanced endoscopic gynecologist has mentored a trainee in laparoscopic surgery.

Implementation of hysteroscopic surgery in The Netherlands.

Objective: This study was conducted to assess the degree of diffusion of hysteroscopic surgery in gynaecological practice in The Netherlands in order to guide further implementation. The diffusion was objectified by defining the percentage of hospitals performing hysteroscopic procedures and the number of different procedures performed per gynaecologist.

Study Design: In 2003 all Departments of Gynaecology (n=102) in The Netherlands were sent a questionnaire.

Operative laparoscopy in The Netherlands: Diffusion and acceptance.

Objective: To evaluate and update the current status of the implementation of operative laparoscopy in gynaecology in The Netherlands by assessing diffusion and acceptance of each specific procedure per hospital.

Study Design: In 2003 a questionnaire was sent to all hospitals (n = 102), which addressed the total number and type of laparoscopic procedures performed in 2002 stratified by level of difficulty (level 1: diagnostic laparoscopy, sterilization, tubal patency tests; level 2: adhesiolysis, ectopic pregnancy (EP), laparoscopic treatment of endometriosis, cystectomy, oophorectomy, LAVH, tubal surgery for infertility; level 3: myomectomy, total laparoscopic hysterectomy (TLH) and sacropexy). Data were compared to previously published data of 1994.

Hysteroscopic surgery: Perspectives on skills training.

Study Objective: To assess the current exposure to hysteroscopy in gynecologic residency and daily practice in The Netherlands.

Design: Survey (Canadian Task Force Classification III).

Subject: Postgraduate year 5 and 6 residents in Obstetrics and Gynecology and gynecologists who finished residency within 1998-2003 in The Netherlands.

Complications of laparoscopy: an inquiry about closed- versus open-entry technique.

Objective: The purpose of this study was to determine the amount of complications and the incidence of open- versus closed-entry (either by Veress needle or first trocar) technique in gynecologic laparoscopy in The Netherlands.

Study Design: Questionnaire analysis of members of the Dutch Society for Gynaecological Endoscopy and Minimal Invasive Surgery was combined with a Medline literature search. Data related to complications on entry from January 1,1997, through December 31, 2001, were collected by questionnaire and were separated into group I (Veress needle or first trocar) and group II (open-entry technique).