Abstract:
OBJECTIVE:To provide a step-by-step description of our published technique of single-site robot-assisted laparoscopic myomectomy with the goal of promoting its safe adoption. DESIGN:Surgical video tutorial. SETTING:University medical center. PATIENT(S):Ten women undergoing single-site robot-assisted laparoscopic myomectomy between November 2014 and March 2015. INTERVENTION(S):A 2.5-cm vertical incision is made within the umbilicus, through which a multilumen single-site port (da Vinci Single-Site; Intuitive Surgical) is seated. An 8.5-mm 0-degree laparoscope is introduced, and the teleoperator (da Vinci Si Surgical Platform; Intuitive Surgical) is docked, allowing subsequent placement of two curved 5-mm instrument cannulae. Two wristed, semirigid needle drivers are loaded onto robotic arms 1 and 2. An 8-mm assistant cannula is also placed through the multilumen single-site port; a flexible 2-mm CO2 laser fiber and all conventional 5-mm laparoscopic instruments are introduced through this cannula as needed. Intramyometrial dilute vasopressin is injected, and fibroid enucleation is performed. The hysterotomy is repaired in layers with unidirectional barbed suture (Stratafix; Ethicon). The teleoperator is undocked. The single-site port is exchanged for a self-retaining wound retractor with gel-sealed cap. An endoscopic pouch is placed in the abdomen, and the specimen is placed within the pouch. The edges of the pouch are exteriorized. Extracorporeal tissue extraction is performed with a scalpel. A running mass closure of the fascia and peritoneum is performed, followed by a subcuticular closure of the skin. MAIN OUTCOME MEASURE(S):Median number and size of fibroids removed, specimen weight, operative time, estimated blood loss, and perioperative complications. RESULT(S):The technique described in our video was successfully employed in our first 10 patients. The median number of fibroids removed was 2.5 (range: 1-8); the median size of the largest myoma was 6 cm (range: 4-8 cm); the median specimen weight was 70 g (range: 26-154 g); the median operating time was 202 minutes (range: 141-254 minutes); the median blood loss was 87.5 mL (range: 10-300 mL). No conversions to multiport robotic or open myomectomy occurred. No major complications occurred, and no patients required blood transfusion. CONCLUSION(S):Robot-assisted laparoscopic single-site myomectomy employing a multilumen port and wristed, semirigid needle drivers is a safe and reproducible technique. Our technique allows surgeons to offer myomectomy and contained, extracorporeal tissue extraction via a single 2.5-cm umbilical incision in select patients with low tumor burden.
journal_name
Fertil Steriljournal_title
Fertility and sterilityauthors
Gargiulo AR,Lewis EI,Kaser DJ,Srouji SSdoi
10.1016/j.fertnstert.2015.07.1159subject
Has Abstractpub_date
2015-11-01 00:00:00pages
e13issue
5eissn
0015-0282issn
1556-5653pii
S0015-0282(15)01671-4journal_volume
104pub_type
杂志文章abstract:OBJECTIVE:To investigate the role of different cellular types (epithelial and stromal endometrial cells and peritoneal cells) in the ectopic implantation of endometrium and to evaluate the importance of endocrine environment on the adhesion of endometrial cells to the peritoneum. DESIGN:Experimental prospective study....
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(02)03370-8
更新日期:2002-11-01 00:00:00
abstract::The International Committee for Monitoring Assisted Reproductive Technology's 7th World Report for the year 2000 analyzes wide variations in live and multiple birth rates from 49 countries and six regions by type of assisted reproductive technology, age, number of embryos transferred, and multiple births. More than 46...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2006.01.011
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To report the case of an infertile female patient with cystic fibrosis who was diagnosed with endocervical metaplasia of the endometrium at diagnostic hysteroscopy and successfully treated with an oral estroprogestinic formulation. DESIGN:Case report. SETTING:University hospital. PATIENT(S):A 27-year-old i...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2005.07.1336
更新日期:2006-03-01 00:00:00
abstract::A 26-year-old patient underwent pelvic lymphadenectomy and trachelectomy because of cervical cancer stage IB. Later she developed symptoms from obturator nerve entrapment. Examinations could not reveal metastatic cancer disease, but endometriosis surrounding the obturator nerve was discovered. Laparoscopic removal of ...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2008.03.024
更新日期:2009-02-01 00:00:00
abstract::The human chorionic gonadotropin (hCG) beta subunit curve of normal singleton in vitro fertilization (IVF) pregnancies shows cyclic peaks during the first 56 days after embryo transfer (ET). This phenomenon is not demonstrable in normal spontaneous conceptions. The hCG curves of 151 singleton IVF pregnancies achieved ...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract:OBJECTIVE:To investigate hypoestrogenic "inactive phases" (IP) in the follicular phase of the menstrual cycle, with respect to age, reproductive stage, and follicular depletion. DESIGN:Analysis of prospectively collected menstrual bleed and estrone-3-glucuronide data. SETTING:Center for Population and Health, Georget...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2012.07.1101
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To compare buoyant density and sedimentation kinetics of human immunodeficiency virus 1 (HIV-1) in two sperm-washing media, Percoll and Pureception. DESIGN:Laboratory study. SETTING:University hospital. PATIENT(S):None. INTERVENTION(S):Buoyant density and sedimentation kinetics of HIV-1 particles (MOLT-4/...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2007.09.025
更新日期:2008-11-01 00:00:00
abstract::A prospective randomized study was conducted in 100 women with leiomyomas in order to evaluate the effect of gestrinone, a synthetic derivative of ethynil-nor-testosterone. Patients in group A received capsules containing 2.5 mg of gestrinone three times weekly orally. Those in group B received capsules containing 5.0...
journal_title:Fertility and sterility
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0015-0282(16)60722-7
更新日期:1989-06-01 00:00:00
abstract::Seminiferous tubules from rats killed 24 hours after injection of pargyline, a monoamine oxidase inhibitor, did not grow well in tissue culture when compared to control tubules. Treated tubules showed severe tubular degeneration and loss of cellular detail after nine days in culture. Animals injected with pargyline fo...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)40992-1
更新日期:1975-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the expression of chemokines that regulate natural killer (NK) and T-regulatory (T-reg) cell activity in eutopic and ectopic endometrial tissue samples from endometriosis patients. DESIGN:Case-control study (Canadian Task Force classification II-2). SETTING:Tertiary referral hospital. PATIENT(S...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2013.02.038
更新日期:2013-06-01 00:00:00
abstract::This population-based study assessed information needs related to fertility and sexual function in 250 non-Hodgkin's lymphoma survivors from a Los Angeles Surveillance, Epidemiology, and End Results cancer registry 2-5 years after diagnosis. Results suggest that many survivors have persistent fertility and sexual conc...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2007.08.081
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To describe the reproductive health history and characteristics of women having bariatric surgery and to determine whether this differs by age of onset of obesity. DESIGN:Retrospective and cross-sectional analyses of self-reported survey data. SETTING:Six sites of the Longitudinal Assessment of Bariatric Su...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2009.08.028
更新日期:2010-09-01 00:00:00
abstract::Twelve human uteri containing intrauterine contraceptive devices (IUDs) and ten uteri without IUDs were obtained at hysterectomy. Samples of fluid were collected from the uterine lumina by absorbing the fluid in small pieces of lens paper. In the samples of luminal fluid we measured the concentration of beta-galactosi...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)42078-9
更新日期:1976-09-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that over a 4-week treatment period, Nal-Glu GnRH antagonist ([AcD2Nal1, D4ClPhe2, D3Pal3, Arg5, DGlu6 [AA], DAla10] GnRH) at a dose of 200 micrograms/kg per day SC would suppress levels of immunologically active and biologically active LH and FSH more completely than a dose of 100 micr...
journal_title:Fertility and sterility
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE:To describe a woman with a nonmosaic (45,X) form of Turner's syndrome who gave birth to a girl with 45,X Turner syndrome. DESIGN:Patient report. SETTING:Outpatient clinic of a university hospital. PATIENT(S):A woman with typical phenotypic features of Turner syndrome and a 45,X karyotype and her daughter w...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2004.02.129
更新日期:2004-10-01 00:00:00
abstract::Embryo transfer is facilitated with ultrasound guidance. The 16 ultrasound-guided transfers were rated easier, and there was less catheter distortion, in comparison with 12 transfers guided by "clinical feel." The benefits we ascribe to ultrasound guidance are as follows: (1) transfers can be done with the patient sup...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)48317-2
更新日期:1985-01-01 00:00:00
abstract::The penetration of a gonadotropin-releasing hormone agonist (GnRH-a), Buserelin (Hoechst AG, Frankfurt, West Germany), into human follicular fluids (FF) was studied by means of a radioimmunoassay (RIA) and a bioassay. Acute nasal administration of a therapeutic dose of Buserelin (300 and 600 micrograms) before the ovu...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)60852-x
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVE:To investigate whether proteins secreted in urine differ between women with and without endometriosis. DESIGN:Laboratory study using human urine. SETTING:University-based laboratory. PATIENT(S):Women with and without endometriosis undergoing laparoscopy, hysteroscopy and curettage. INTERVENTION(S):Urine c...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2010.05.016
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:To determine the incidence and type of mixoploidy in human blastocysts produced in vitro. DESIGN:A laboratory study of spare blastocysts from an IVF program. SETTING:University hospital laboratory. PATIENT(S):Thirty-nine couples undergoing IVF or intracytoplasmic sperm injection. INTERVENTION(S):A total o...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(02)04393-5
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the feasibility and the efficacy of in vitro maturation (IVM) when immature oocyte collection was performed in the early follicular, late follicular, or luteal phases in women with cancer who require urgent chemotherapy. DESIGN:Retrospective cohort study. SETTING:University teaching hospital. P...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2016.09.041
更新日期:2017-01-01 00:00:00
abstract::It is suggested that heparin given in the peri-implantation period may improve clinical outcomes in women undergoing assisted reproduction techniques (ART). This systematic review evaluates the use of heparin in subfertile women undergoing ART. ...
journal_title:Fertility and sterility
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.fertnstert.2014.09.005
更新日期:2015-01-01 00:00:00
abstract::Since the advent of preimplantation genetic testing for aneuploidy (PGT-A) in the 1990s, substantial changes in test methodology and technology now allow the detection and reporting of intermediate chromosome copy number (commonly referred to as mosaicism) for aneuploidy in a trophectoderm biopsy sample. Clinicians ar...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2020.05.014
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To examine the association between the midfollicular FSH-LH ratio and the number of follicles, and the multifollicular ovarian response to gonadotropin stimulation in patients with polycystic ovary syndrome (PCOS) with normal basal LH and FSH levels. SUBJECT(S):Eighteen patients who had an abandoned treatmen...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(97)80069-6
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:To present a case of laparoscopic removal of a heterotopic cesarean scar pregnancy under ultrasound guidance. DESIGN:Case report. SETTING:Private hospital. PATIENT(S):A 34-year-old woman with heterotopic cesarean scar pregnancy. INTERVENTION(S):Laparoscopic removal of heterotopic cesarean scar pregnancy. ...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2008.01.067
更新日期:2009-04-01 00:00:00
abstract::Twenty-four women who had undergone total salpingectomy due to ectopic pregnancy and who subsequently underwent a laparotomy for a second ectopic pregnancy in their opposite tube were treated by the author. Treatment consisted of linear salpingostomy (n = 20) and partial salpingectomy (n = 4). The intrauterine pregnan...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)60025-0
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the association between genetic variants in Ser-Arg (SR) protein-coding genes and the susceptibility of nonobstructive azoospermia (NOA) in Chinese men. DESIGN:Case-control study. SETTING:State Key Laboratory of Reproductive Medicine in Nanjing Medical University conducted the genotyping and exa...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2014.02.033
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To compare the effects of solid barriers (PDLA membrane and foil, Interceed), innovative barrier solutions (Adept and Hyalobarrier Gel, phospholipid emulsion), and Ringer's lactate solution in preventing postsurgical peritoneal adhesions in the rat. DESIGN:Prospective, randomized experimental study. SETTING...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/j.fertnstert.2006.05.023
更新日期:2006-10-01 00:00:00
abstract::A case is described in which, after a tubal sterilization procedure and subsequent unilateral tubal anastomosis, an ectopic gestation occurred in the contralateral, unrepaired, distal tubal segment. On the basis of this case and related evidence, the authors suggest that in cases in which only a unilateral tubal anast...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(16)59068-2
更新日期:1987-03-01 00:00:00
abstract:OBJECTIVE:The present study examines the safety, effectiveness, and local tissue response for a new transcervical fallopian tube permanent contraceptive device, the STOP device (Conceptus, Inc., San Carlos, CA). DESIGN:Nonrandomized prospective evaluation of tubal occlusion and histologic response. SETTING:Inpatient,...
journal_title:Fertility and sterility
pub_type: 杂志文章
doi:10.1016/s0015-0282(01)02858-8
更新日期:2001-11-01 00:00:00
abstract::Obesity seems to exert a small but important extraovarian effect that may influence cycle outcome during assisted reproduction. Future investigation should focus on elucidating whether the endometrium is truly responsible for this deficit, and if it is, determining the mechanisms involved. ...
journal_title:Fertility and sterility
pub_type: 评论,杂志文章
doi:10.1016/j.fertnstert.2007.03.079
更新日期:2008-06-01 00:00:00