The Asian Society of Endometriosis and Adenomyosis guidelines for managing adenomyosis.

This is the first guidelines for adenomyosis from the Asian Society of Endometriosis and Adenomyosis.

Clinical Diagnosis and Early Medical Management for Endometriosis: Consensus from Asian Expert Group.

This work provides consensus guidance regarding clinical diagnosis and early medical management of endometriosis within Asia. Clinicians with expertise in endometriosis critically evaluated available evidence on clinical diagnosis and early medical management and their applicability to current clinical practices. Clinical diagnosis should focus on symptom recognition, which can be presumed to be endometriosis without laparoscopic confirmation.

Venous Thromboembolism and Adenomyosis: A Retrospective Review.

Objectives: The objective of the study was to evaluate the incidence of venous thromboembolism (VTE) in patients who have been admitted for adenomyosis at our institute and describe their clinical characteristics and management.

Materials And Methods: A retrospective review of the medical records of all patients who were admitted to the gynecology ward between January 2015 and August 2016 was conducted, and all patients who had adenomyosis were included in this study. Clinical details that were evaluated included age, parity, body mass index, significant comorbidities, size of the uterus on physical examination, the size of the adenomyoma (if present) on pelvic ultrasonography, initial hemoglobin, and hematocrit on admission, whether blood transfusion was required, acute and long-term treatment and whether or not there were any associated VTE and treatment given.

Tubo-Ovarian Abscesses: Epidemiology and Predictors for Failed Response to Medical Management in an Asian Population.

Pelvic inflammatory disease (PID) complicated by tubo-ovarian abscesses (TOA) has long-term sequelae in women of reproductive age. Consensus on the optimal treatment of TOA remains lacking. Most clinicians utilize antibiotics as a first-line conservative approach, failing which invasive intervention is adopted.

The clinical profile of young and adolescent women with laparoscopically diagnosed endometriosis in a Singapore tertiary hospital.

Objective: Endometriosis has been increasingly recognized as the cause of severe dysmenorrhea among younger women including adolescents, often with significant delay from time of presentation to diagnosis. Data on the South East Asian women is scarce. This study aims to describe the disease pattern in a group of young Asian women with histological diagnosis of endometriosis in our center.

Laparoscopic Anterior Resection with Transvaginal Specimen Extraction (TVSE) for Colorectal Cancer and Concomitant Total Hysterectomy and Bilateral Salpingo-Oophrectomy (THBSO): A Technical Description.

Background: Natural orifice specimen extraction (NOSE) has evolved to circumvent the need for a specimen extraction site. Transvaginal specimen extraction (TVSE) for colorectal disease has been shown to be safe and feasible in selected cases.1 2 We describe our technique of TVSE in a case of laparoscopic ultra-low anterior resection (ULAR) with defunctioning ileostomy (DI) with a concomitant total hysterectomy and bilateral salpingo-oophrectomy (THBSO).

First ever case of spontaneous triplet cornual pregnancy: management of laparoscopic cornual resection with modified endoloop method.

A 23-year-old woman, gravida 2 para 0, presented at 8 weeks gestation with a spontaneously conceived triplet cornual ectopic pregnancy. She was at high risk of ectopic pregnancy as she had been previously treated for pelvic inflammatory disease and had also undergone laparoscopic salpingostomy for right-sided ectopic pregnancy. She was clinically stable and her abdomen was soft and non-tender.

Use of narrowband imaging for the detection of endometriosis.

Study Objective: To show a new technique using narrowband imaging for the detection of endometriosis.

Design: A step-by-step illustration of the difference in visualization of endometriosis using a visible light spectrum laparoscope compared with a narrowband imaging light source.

Setting: Radical excision of endometriosis is considered the best treatment to control the disease extent and symptoms of endometriosis.

Minilaparoscopic hysterectomy made easy: first report on alternative instrumentation and new integrated energy platform.

Minilaparoscopy is an attractive approach for hysterectomy due to advantages such as reduced morbidities and enhanced cosmesis. However, it has not been popularized due to the lack of suitable instruments and high technical demand. We aim to highlight the first case of minilaparoscopic hysterectomy reported in Asia and the use of a new integrated energy platform, Thunderbeat.

Single incision laparoscopic surgery for a large endometriotic cyst.

We describe a technique for the treatment of large benign ovarian cysts by single port laparoscopic surgery via the umbilical approach. X-cone single port system (Karl Storz) was employed in this surgery. Prebent atraumatic grasping forceps were used in conjunction with the straight laparoscopic instruments.

Single-port endo-laparoscopic surgery in combined abdominal procedures.

Single-port endo-laparoscopic surgery has gained support in the surgical community because it is perceived to offer a better postoperative outcome as it requires only a single incision. We write this prospective observational study to ascertain the feasibility and safety of this technique in patients otherwise requiring two operations. Five patients who underwent double procedures with a single-port device were reviewed: Case 1, a transabdominal preperitoneal hernia repair and gastric wedge resection; Case 2, cholecystectomy and diaphragmatic hernia repair; Case 3, oophorectomy and incisional hernia repair; Case 4, anterior resection of the rectum and hepatic segmentectomy; and Case 5, left adrenalectomy and cholecystectomy.

Get "real" with hysteroscopy using the pig bladder: a "uterine" model for hysteroscopy training.

Introduction: This study aimed to develop a realistic and lifelike uterine model for the training of hysteroscopy skills.

Materials And Methods: A lifelike "uterine" model was constructed using female pig bladder. The pig bladder was enclosed within a malleable mould, with both ureters blocked by pins.

Laparoendoscopic Single-Site Surgery (LESS) for a Large Ovarian Tumour: First Clinical Case Report.

Objective. To report the feasibility of removing a 10 cm ovarian fibroma via a laparoendoscopic single-site trocar through trans-umbilical access. Design.

Gynaecologic robot-assisted cancer and endoscopic surgery (GRACES) in a tertiary referral centre.

Introduction: Robotic-assisted gynaecologic surgery is gaining popularity and it offers the advantages of laparoscopic surgery whilst overcoming the limitations of operative dexterity. We describe our experience with the fi rst 40 cases operated under the GRACES (Gynaecologic Robot- Assisted Cancer and Endoscopic Surgery) programme at the Department of Obstetrics & Gynecology, National University Hospital, Singapore.

Materials And Methods: A review was performed for the fi rst 40 women who had undergone robotic surgery, analysing patient characteristics, surgical timings and surgery-related complications.

An unexpected presentation of endometriosis--a "parasitic" cyst of the bowel in a menopausal woman on hormone therapy.

Introduction: This report describes a "parasitic" endometriotic cyst of the small bowel.

Clinical Picture: A menopausal woman with a pelvic mass presenting years after commencing hormone therapy.

Treatment: We performed laparoscopic excision of a cystic tumour attached to the small bowel with a solitary vascular pedicle.