Predicting major complications in patients undergoing laparoscopic and open hysterectomy for benign indications.

Background: Hysterectomy, the most common gynecological operation, requires surgeons to counsel women about their operative risks. We aimed to develop and validate multivariable logistic regression models to predict major complications of laparoscopic or abdominal hysterectomy for benign conditions.

Methods: We obtained routinely collected health administrative data from the English National Health Service (NHS) from 2011 to 2018.

Iatrogenic bladder and ureteral injuries following gynecological and obstetric surgery.

Key Message: Ureteral injuries are often associated with complications and risk of fistula especially in case of malignancy. Length of catheterization should be reconsidered according to the injury.

Purpose: Iatrogenic urinary tract injuries are potential complications of gynecologic and obstetric surgery.

The Effect of Patient Positioning on Ureteral Efflux During Intraoperative Cystoscopy: A Randomized Controlled Trial.

Study Objective: To identify the relationship between patient position during surgery and time to confirmation of ureteral patency on cystoscopy.

Design: Randomized controlled trial.

Setting: Academic tertiary care medical center.

Is endourological intervention a suitable treatment option in the management of iatrogenic thermal ureteral injury? A contemporary case series.

Background: Iatrogenic ureteral injury (IUI) is relatively rare, however, can cause sepsis, kidney failure, and death. Most cases of IUI are not recognized until the patient presents with symptoms following pelvic surgery or radiotherapy. Recently, minimally invasive approaches have been used more frequently in the treatment of IUI.

Does the experience of the first assistant affect organ injuries in laparoscopic hysterectomy for benign diseases?

Purpose: This study sought to explore whether the experience level of the first assistant surgeon influences perioperative organ injuries (ureteral, bladder, and intestinal injuries) in patients undergoing total laparoscopic hysterectomy (TLH) for benign diseases. We defined an experienced surgeon as a surgeon certified by the Skill Qualification Committee of the Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy or a surgeon with equivalent surgical skills.

Methods: We reviewed our surgical registry database of TLH for benign indications between 2014 and 2020 and only selected cases performed by an experienced primary surgeon.

Implementation of a policy of universal cystoscopy at the time of hysterectomy for benign indications: A retrospective comparative study.

Background: Lower urinary tract injury (LUTI) is a serious complication of major gynaecologic surgery. Although intra-operative cystoscopy can facilitate timely diagnosis and treatment of LUTI, the optimal approach to cystoscopy at the time of benign hysterectomy remains debatable.

Aims: To assess whether implementation of a policy of universal cystoscopy at the time of benign hysterectomy was associated with a difference in intra-operative detection and rates of LUTI.

Ureteric injury after laparoscopic hysterectomy: a report of 3 cases and brief literature review.

Objectives: The application of minimally invasive laparoscopic techniques in gynecologic surgery gained popularity due to quicker recovery, shorter hospital stays as well as lower risk of complications. Ureteric injuries at laparoscopic hysterectomies are incidental and occur in less than 1% of cases. They can be identified intra-operatively but most of them are undetected.

Robotic vaginal natural orifice transluminal endoscopic myomectomy.

Objective: To describe a novel, minimally invasive technique for performing myomectomy, a fertility-sparing procedure.

Design: This technique was developed based on similar techniques for other surgeries that showed a benefit. Liu et al.

Very Low Rates of Ureteral Injury in Laparoscopic Hysterectomy Performed by Fellowship-trained Minimally Invasive Gynecologic Surgeons.

Study Objective: The objective of this case series is to evaluate the rates of ureteral injury at the time of laparoscopic hysterectomy among high-volume fellowship-trained surgeons.

Design: A retrospective chart review was performed, evaluating laparoscopic hysterectomy cases between 2009 and 2019 performed exclusively by fellowship-trained surgeons.

Setting: Division of Minimally Invasive Gynecologic Surgery (MIGS) at the Brigham and Women's Hospital and Brigham and Women's Faulkner Hospital, a Harvard Medical School teaching hospital in Boston.

Cystoscopic-guided Robotic Resection of Bladder Trigone Endometriosis Nodule with Ureteral Preservation.

Study Objective: To demonstrate tips and tricks for the successful execution of robotic-assisted resection of a large bladder trigone endometriosis nodule while preserving the ureters.

Design: Stepwise demonstration with narrated video footage.

Setting: An academic tertiary care hospital.

Sacrocolpopexy Techniques for the Savvy Surgeon.

Laparoscopic sacrocolpopexy (LSCP) can be challenging even for the experienced surgeon. Knowledge and adequate visualization of the sacral and pelvic anatomy is paramount to prevent potentially catastrophic intra-operative hemorrhage, nerve or ureteral injury, and to facilitate presacral dissection. We highlight several techniques to maximize surgical efficiency, optimize visualization of the sacral anatomy during presacral dissection, as well as a method to facilitate peritoneal closure over the mesh during LSCP.

Ureteric Injuries Following Obstetrics and Gynaecologic Surgeries: A Single-Center Experience.

Background: Ureteric injuries are not uncommon in obstetric and gynaecologic surgeries. Some specific procedures predispose to these injuries. Recognition is often delayed.

Complications of ovarian cancer surgery in Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta: A cross-sectional study.

Background: Ovarian cancer remains as one of the deadliest gynecologic problems globally. Often appears in advanced state, its surgery proves to be a challenge for clinicians. This study aim to present complications surrounding ovarian cancer surgery.

Uretero-vaginal fistulas - clinical presentation, treatment and literature overview.

A uretero-vaginal fistula (UVF) describes an abnormal connection between the ureter and vagina causing urinary incontinence, frequent infection, and discomfort. Although UVF might be diagnosed after vaginal delivery, infertility treatment or pelvic radiation therapy, gynecological operations, especially total abdominal hysterectomy, remain the leading cause of ureteral injury and formation of UVF. Traditional ureteroneocystostomy was usually the treatment of choice in patients with UVF.

Robotic-assisted Laparoscopic Ureterolysis for Deep Infiltrating Endometriosis using Indocyanine Green Under Near-Infrared Fluorescence.

Study Objective: To demonstrate safe identification of ureters in patients with deep infiltrating endometriosis or severe adhesive disease using indocyanine green (ICG) under near-infrared fluorescence (NIRF) on the robotic platform.

Design: Stepwise demonstration using narrated video footage.

Setting: An academic tertiary care hospital.

Comment on renal autotransplantation: A final option to preserve the kidney after an iatrogenic ureteral injury.

To the Editor, Autologous Renal Transplantation (ART) since firstly described in 1963 by Hardy, has been used in various cases. There are various reasons for the transplantation such as iatrogenic ureteral damage, chronic kidney pain, unresectable renal tumors or renovascular diseases. Indications concerning the suitable patients for this kind of procedure are gradually increasing.

Laparoscopic Resection of a High Grade Serous Ovarian Cancer that Recurred at the Vaginal Stump with Extensive Pelvic Adhesions after Complete Surgical Staging.

Study Objective: To show laparoscopic resection of a high grade serous ovarian cancer that recurred at the vaginal stump with extensive pelvic adhesions after complete surgical staging.

Design: Stepwise demonstration of the procedure with narrated video footage.

Setting: University hospital.

Ureteric injuries during hysterectomy-A Norwegian retrospective study of occurrence and claims for compensation over an 11-year period.

Introduction: Ureteric injury is a rare but serious, iatrogenic complication of hysterectomy. The risk depends on indication for surgery, predisposing risk factors, and peroperative conditions. Our aims were to evaluate and learn from compensation claims to The Norwegian System of Patient Injury Compensation (NPE) for ureteric injury occurring during hysterectomies to predict risk factors, time of identification, symptoms, and consequences, and to relate these cases to injuries registered in The Norwegian Patient Registry.

Real-time intraoperative ureter visualization with a novel Near-Infrared Ray Catheter during laparoscopic hysterectomy for gynecological cancer.

Ureteral injuries are well-known complications of gynecologic surgery, with a higher prevalence in laparoscopic surgery than in laparotomy [1]. The use of near-infrared fluorescent imaging navigation is currently being considered a novel method to identify the ureters intraoperatively and prevent ureteral injuries [2]. The Near-Infrared Ray Catheter (NIRC) fluorescent ureteral catheter is a newly developed device, containing a fluorescent resin that can be recognized by near-infrared irradiation.

Laparoscopic ureteral reimplantation applying the modified psoas hitch and Lich-Gregoir onlay technique: a 10-step surgical video.

Introduction And Hypothesis: Describe the surgical technique of laparoscopic ureterovesical reimplantation applying the modified psoas hitch with Lich-Gregoire onlay technique to manage a distal ureteral fistula after a hysterectomy for a gynecologic malignancy.

Materials And Methods: This video illustrates the surgical technique of laparoscopic ureteral reimplantation applying the modified psoas hitch with Lich-Gregoire onlay technique in a ten-step surgical video.

Results: Step 1: closure of the caudal ureter.

The urological complications of vaginal birth after cesarean (VBAC) - a literature review.

The appearance of urological complications is a major problem in obstetrics and gynecologic surgery; the bladder is the most common damaged organ. Due to a continuous increase in the rate of cesareans, the incidence of urologic complications will be potentially higher. We reviewed the most important risk factors for urinary tract injury and analyzed the strategies necessary to avoid these situations during vaginal birth after cesarean (VBAC).

A Review on the Etiology, Prevention, and Management of Ureteral Injuries During Obstetric and Gynecologic Surgeries.

Iatrogenic ureteral injuries are a rare but serious complication of some gynecological and obstetric procedures with both high morbidity and legal implications. The incidence varies widely depending on the type and extent of the surgeries with about 70% unrecognized intraoperatively. When recognized intraoperatively and promptly managed, the prognosis is good.

Ureteric Injuries after Hysterectomy in a Tertiary Care Center of Nepal: A Descriptive Cross-sectional Study.

Introduction: Pelvic surgery is the most common cause of iatrogenic ureteral injury. The incidence of ureteric injuries varies between skilled and inexperienced surgeons. The study aims to determine the prevalence of ureteric injuries sustained during hysterectomy in a tertiary care center of Nepal.