Abstract:
STUDY OBJECTIVES:To compare the intraoperative direct costs of a single-use energy device with reusable energy devices during laparoscopic hysterectomy. DESIGN:A randomized controlled trial (Canadian Task Force Classification I). SETTING:An academic hospital. PATIENTS:Forty-six women who underwent laparoscopic hysterectomy from March 2013 to September 2013. INTERVENTIONS:Each patient served as her own control. One side of the uterine attachments was desiccated and transected with the single-use device (Ligasure 5-mm Blunt Tip LF1537 with the Force Triad generator). The other side was desiccated and transected with reusable bipolar forceps (RoBi 5 mm), and transected with monopolar scissors using the same Covidien Force Triad generator. The instrument approach used was randomized to the attending physician who was always on the patient's left side. Resident physicians always operated on the patient's right side and used the converse instruments of the attending physician. MEASUREMENTS AND MAIN RESULTS:Start time was recorded at the utero-ovarian pedicle and end time was recorded after transection of the uterine artery on the same side. Costs included the single-use device; amortized costs of the generator, reusable instruments, and cords; cleaning and packaging of reusable instruments; and disposal of the single-use device. Operating room time was $94.14/min. We estimated that our single use-device cost $630.14 and had a total time savings of 6.7 min per case, or 3.35 min per side, which could justify the expense of the device. The single-use energy device had significant median time savings (-4.7 min per side, p < .001) and total intraoperative direct cost savings ($254.16 per case). CONCLUSIONS:A single-use energy device that both desiccates and cuts significantly reduced operating room time to justify its own cost, and it also reduced total intraoperative direct costs during laparoscopic hysterectomy in our institution. Operating room cost per minute varies between institutions and must be considered before generalizing our results.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Holloran-Schwartz MB,Gavard JA,Martin JC,Blaskiewicz RJ,Yeung PP Jrdoi
10.1016/j.jmig.2015.08.881subject
Has Abstractpub_date
2016-01-01 00:00:00pages
72-7issue
1eissn
1553-4650issn
1553-4669pii
S1553-4650(15)01489-2journal_volume
23pub_type
杂志文章,随机对照试验abstract::Essure is a popular method of permanent sterilization that offers a minimally invasive approach that avoids the risks of traditional sterilization procedures in the operating room. Despite the rarity of complications, there has been concern in the popular media over the safety of Essure. We describe the third reported...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.07.020
更新日期:2016-01-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate whether the systematic use of an intrauterine manipulator influences the accuracy of frozen section analysis in early-stage endometrial cancer. DESIGN:Case-control study (Canadian Task Force classification II-1). PATIENTS:Three hundred fourteen consecutive women with early-stage endometria...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.11.007
更新日期:2011-03-01 00:00:00
abstract:STUDY OBJECTIVE:To compare reduction of pain after laparoscopy for ablation or excision of endometriosis. DESIGN:Prospective, randomized, double-blind study (Canadian Task Force classification I). SETTING:Endometriosis and pelvic pain clinic at a university teaching hospital. PATIENTS:Women of reproductive age with ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2014.04.002
更新日期:2014-11-01 00:00:00
abstract::STUDY OBJECTIVE: To evaluate factors associated with the use of hemostatic agents during traditional laparoscopic or robotic hysterectomy. DESIGN:A retrospective cohort trial (Canadian Task Force classification III). SETTING:A single medical center in Cincinnati, OH, from August 1, 2013, to July 31, 2014. PATIENTS:...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2016.08.827
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:This study aimed to compare the risks of intraoperative and postoperative urologic complications after robotic radical hysterectomy (RRH) compared with laparoscopic radical hysterectomy (LRH). DATA SOURCES:We searched Pubmed, EMBASE, and the Cochrane Library for studies published up to March 2019. Related ar...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.jmig.2019.07.008
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVES:To examine the effect of body mass index (BMI) on postoperative 30-day morbidity and mortality after surgery to treat endometrial cancer. DESIGN:Retrospective cohort study (Canadian Task Force classification II-2). SETTING:National Surgical Quality Improvement Program. PATIENTS:Patients with endomet...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.07.014
更新日期:2015-01-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if the number of myomas removed during myomectomy for symptomatic relief affects long-term fertility outcomes in reproductive-aged women. DESIGN:Retrospective cohort survey study (Canadian Task Force classification II-2). SETTING:University hospital. PATIENTS:One hundred forty-four patie...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.01.016
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:To estimate the effect of intraabdominal pressure and risk factors related to the occurrence of subcutaneous emphysema during laparoscopic surgery. DESIGN:Prospective randomized study (Canadian Task Force classification I). SETTING:University hospital. PATIENTS:Two hundred patients who underwent gyne...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2011.08.006
更新日期:2011-11-01 00:00:00
abstract:STUDY OBJECTIVE:To examine the rate of abstract publication from the Society of Gynecologic Surgeons Annual Scientific Meeting (SGSASM), 2004 to 2012. STUDY DESIGN:This is a retrospective study in which all abstracts presented at the SGSASM from 2004 to 2012 were reviewed. Information was collected on oral (O), oral p...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.05.020
更新日期:2015-09-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the clinical course and surgical and fertility outcomes of patients diagnosed with tubo-ovarian abscess (TOA) after fertility treatment. DESIGN:Parallel case series over 10 consecutive years (Canadian Task Force classification II-2). SETTING:Tel Aviv Sourasky Medical Center, a tertiary unive...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.06.004
更新日期:2019-01-01 00:00:00
abstract::Excessive opioid use and misuse is a pervasive and growing societal problem, and decreasing the surgical contribution to this epidemic represents an opportunity to improve outcomes. Here we describe patterns of opioid prescription, consumption, and persistent use among women undergoing minimally invasive hysterectomy ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.08.024
更新日期:2019-02-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate a unique learning system for uterine artery embolization (UAE) and examine its feasibility and clinical outcomes for the treatment of symptomatic uterine leiomyomas and adenomyosis when performed by obstetrician-gynecologists in cooperation with interventional radiologists (IVRs). DESIGN:Re...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.08.008
更新日期:2018-01-01 00:00:00
abstract::We present 2 case reports of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis that was successfully treated via laparoscopic ovarian cystectomy. In both cases, resection of an ovarian teratoma resulted in eventual full recovery. Although adnexectomy has been reported for tumor resection in anti-NMDAR encephalit...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.10.002
更新日期:2011-01-01 00:00:00
abstract::A panel of experts in the field of endometriosis expressed their opinions on management options in a 35-year-old patient desiring pregnancy with a history of previous surgery for endometrioma and bowel obstruction symptoms. Many questions that this paradigmatic patient may pose to the clinician are addressed, and vari...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.01.021
更新日期:2015-05-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the effects of the laparoscopic approach versus the vaginal route for the management of vaginal cuff closure during total laparoscopic hysterectomy on female sexual function in premenopausal patients with benign gynecologic conditions. DESIGN:A prospective study with a randomized, double-bli...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2016.07.007
更新日期:2016-09-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the feasibility of a noncontact radio sensor as an objective measurement tool to study postoperative recovery from endometriosis surgery. DESIGN:Prospective cohort pilot study. SETTING:Center for minimally invasive gynecologic surgery at an academically affiliated community hospital in conju...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.06.011
更新日期:2020-06-29 00:00:00
abstract:STUDY OBJECTIVE:To compare preoperative transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) with intraoperative ultrasound (IOUS) in surgeons first learning to use this technique. DESIGN:A prospective study of IOUS accuracy for mapping the size and location of myomas compared with TVUS or MRI (Canadian...
journal_title:Journal of minimally invasive gynecology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jmig.2018.11.006
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether cell salvage blood collection with a laparoscopic suction device is inferior to use of a traditional Yankauer suction device. DESIGN:Prospective, in vitro study. SETTING:Academic teaching hospital. INTERVENTIONS:Individual units of donated packed red blood cells were diluted with...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.10.002
更新日期:2013-01-01 00:00:00
abstract::Lower limb lymphedema and an accompanying lymphatic fistula (lymphorrhea) occur as complications after gynecologic surgery to treat cancer. Herein, we report the case of a 68-year-old woman who underwent resection and radiotherapy because of uterine cervical cancer (stage 2a) 20 years previously. Left lower limb and p...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.04.005
更新日期:2012-09-01 00:00:00
abstract::In healthcare, the goal of maximizing value by improving the quality of care and lowering costs has been notoriously challenging to achieve. The fee-for-service model in gynecology and other fields has historically promoted the reduction of nonsurgical or minimally invasive approaches in favor of complex, often morbid...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2018.11.013
更新日期:2019-02-01 00:00:00
abstract:STUDY OBJECTIVE:To provide surgeons with techniques for preemptive analgesia during minimally invasive gynecologic surgery. Postoperative pain management is an important component of patient care after gynecologic surgery. There have been numerous advances in pain management, including studies that show that preoperati...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.09.768
更新日期:2019-02-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate the effectiveness of vasopressin in reducing blood loss in laparoscopic supracervical hysterectomy (LSH). DESIGN:Retrospective chart analysis (Canadian Task Force classification II-2). SETTING:University-affiliated teaching hospital. PATIENTS:In all, 143 women who had LSH for benign gy...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.12.002
更新日期:2008-03-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the prevalence of adenomyosis and deep adenomyosis after NovaSure (Hologic Inc., Newark, DE) endometrial ablation in hysterectomy specimens after NovaSure endometrial ablation failure. DESIGN:Prospective observational study (Canadian Task Force classification II-2). SETTING:The TweeSteden...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.10.006
更新日期:2015-02-01 00:00:00
abstract::Value-based care is quality health care delivered effectively and efficiently. Data registries were created to collect accurate information on patients with enough clinical information to allow for adequate risk adjustment of postoperative outcomes. Because most gynecologic procedures are elective and preference-sensi...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.07.003
更新日期:2015-11-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the perioperative outcomes of various modes of myomectomy (abdominal [AM], laparoscopic [LM], or robotic [RM]) in cases of extreme myoma burden. DESIGN:Retrospective cohort study (Canadian Task Force classification II-2). SETTING:A tertiary academic center in Boston, Massachusetts. PATIEN...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.10.022
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the surgical technique and short-term outcomes for 26 cases of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) sacrocolpopexy for the treatment of pelvic organ prolapse (POP). DESIGN:Retrospective case series study (Canadian Task Force classification II-2). SETTING:Ac...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.08.009
更新日期:2019-01-01 00:00:00
abstract:STUDY OBJECTIVE:Although all ectopic pregnancies are associated with risk of hemorrhage, cornual pregnancies are feared for catastrophic hemorrhage and uncontrollable bleeding. The maternal mortality rate can be as high as 2.5%, which is 7 times higher than the mortality rate for ectopic pregnancies in general. Differe...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.04.005
更新日期:2017-01-01 00:00:00
abstract::Endometriosis is a common condition that affects as many as 10% to 20% of women of reproductive age. Because of the subtle clinical signs and symptoms and limitations of imaging methods, the diagnosis is frequently delayed or missed, with serious consequences including hypertension, hydronephrosis, and loss of kidney ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.09.006
更新日期:2010-01-01 00:00:00
abstract:STUDY OBJECTIVE:To estimate the effectiveness of unidirectional knotless barbed suture and continuous suture with intracorporeal knots in the repair of uterine wall defects during laparoscopic myomectomy. DESIGN:Randomized clinical study (Canadian Task Force Classification I). SETTING:Single-center study in a univers...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2010.06.007
更新日期:2010-11-01 00:00:00
abstract:STUDY OBJECTIVE:To review the laparoscopic staging procedure in a series of patients with early ovarian cancer and compare results with the literature. DESIGN:A prospective single-center study (Canadian Task Force classification II-2). SETTING:A hospital in Spain. PATIENTS:A total of 20 patients with apparent early ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.04.002
更新日期:2008-07-01 00:00:00