Abstract:
STUDY OBJECTIVE:We sought to estimate the impact of sentinel nodes in gynecologic oncology on fellowship training and discuss potential solutions. DESIGN:Retrospective multi-institution cohort (Canadian Task Force classification II-2). SETTING:Three tertiary cancer referral cancer centers. PATIENTS:Patients with endometrial and vulvar cancer undergoing lymph node evaluation. INTERVENTIONS:Patient history and fellow case volumes were evaluated retrospectively for type of lymph node assessment. MEASUREMENTS AND MAIN RESULTS:Minimally invasive endometrial cancer and vulvar cancer fellow case volumes in 3 large institutions were reviewed and average annual volumes calculated for each clinical gynecologic oncology fellow. For vulvar cancer, probabilities of sentinel lymph node mapping and laterality of lesions were estimated from the literature. For endometrial cancer, estimates of lymphadenectomy rates were determined using probabilities calculated from our historic database and from review of the literature. Modeling the approaches to lymphadenectomy in endometrial cancer (full, selective, and sentinel), 100% versus 68% versus 24%, respectively, of patients would require complete pelvic lymphadenectomy and 100% versus 34% versus 12% would require para-aortic lymphadenectomy. In vulvar cancer, rates of inguinal femoral lymphadenectomy are expected to drop from 81% of unilateral groins to only 12% of groins. CONCLUSIONS:Sentinel lymph node biopsy for endometrial and vulvar cancer will play an increasing role in practice, and coincident with this will be a dramatic decrease in pelvic, para-aortic, and inguinal femoral lymphadenectomies. The declining numbers will require new strategies to maintain competency in our specialty. New approaches to surgical training and continued medical education will be necessary to ensure adequate training for fellows and young faculty across gynecologic surgery.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Kumar A,Wallace SA,Cliby WA,Glaser GE,Mariani A,Leitao MM,Frumovitz M,Langstraat CLdoi
10.1016/j.jmig.2018.08.006subject
Has Abstractpub_date
2019-01-01 00:00:00pages
727-732issue
4eissn
1553-4650issn
1553-4669pii
S1553-4650(18)30406-0journal_volume
26pub_type
杂志文章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:STUDY OBJECTIVE:To investigate the feasibility, safety, and short-term outcomes of robotic surgery (RS) for gynecologic oncologic indications (cervical, endometrial, and ovarian cancer) in elderly patients, especially women age 65 to 74 years (elderly group [EG]) compared with women age ≥75 years (very elderly group [V...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.01.007
更新日期:2018-01-01 00:00:00
abstract::Radiation treatment planning for women with locally advanced cervical cancer (stages IB2-IVA) is often based on positron emission tomography (PET). PET, however, has poor sensitivity in detecting metastases in aortocaval nodes. We have initiated a study with the objective of determining whether pre-therapeutic laparos...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jmig.2013.07.007
更新日期:2014-01-01 00:00:00
abstract::Cornual, interstitial, and angular pregnancies are terms that are often used interchangeably in both the literature and clinical setting to describe various ectopic pregnancies. The diagnosis of these pregnancies can be difficult, and fear of disrupting an intrauterine pregnancy can cause hesitation during evaluation ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.08.002
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Infection in natural orifice transluminal endoscopic surgery (NOTES) remains controversial. OBJECTIVE:To estimate the frequency of infection during NOTES peritoneoscopy with different routes of access and to compare with laparoscopy. DESIGN:Prospective randomized controlled study (Canadian Classification t...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.08.001
更新日期:2011-11-01 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:To perform a cost-minimization analysis comparing robotic-assisted, laparoscopic, and abdominal sacrocolpopexy. DESIGN:Cost-minimization analysis using a micro-costing approach (Canadian Task Force classification III). MEASUREMENTS AND MAIN RESULTS:A decision model was developed to compare the costs (...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.03.011
更新日期:2010-07-01 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 OBJECTIVE:To estimate the clinical significance of pouch of Douglas (POD) obliteration in women undergoing laparoscopic excision of endometriosis. DESIGN:Prospective study (Canadian Task Force Classification II-2). SETTING:University-affiliated tertiary referral center for endometriosis. PATIENTS:A total of 45...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.01.011
更新日期:2011-05-01 00:00:00
abstract:STUDY OBJECTIVE:The aim of our study was to determine if laparoscopic radical hysterectomy (LRH) can be routinely used for the treatment of early-stage cervical cancer. DESIGN:From May 2008, LRH was planned for all primarily operable cervical cancer patients after receiving informed consent in our department. The surg...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.09.009
更新日期:2015-02-01 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::Presacral and retrorectal space tumors are relatively rare lesions, the location of which can result in the onset of symptoms that are not well-defined. Retrorectal teratomas are resected to alleviate these symptoms and to rule out malignancy. Complete resection by one of the open abdominal or sacral approaches was tr...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.06.011
更新日期:2008-09-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the incidence of equipment failure in gynecologic endoscopy and investigate causes and consequences. DESIGN:A prospective observational single-center study between January and April 2006. SETTING:Gynecologic surgery department of a university hospital. INTERVENTIONS:In all, 116 endoscopi...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.08.019
更新日期:2009-01-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate rates of urologic injury in patients who underwent robotic hysterectomy compared with laparoscopic, vaginal, and open hysterectomy. DESIGN:A retrospective analysis (Canadian Task Force classification II-2). SETTING:Henry Ford Health System, 2013 to 2016. PATIENTS:Women who underwent robot...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.01.004
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:To study the safety, feasibility, learning curve, and surgical outcome for single-port laparoscopic full staging of endometrial cancer. DESIGN:A retrospective study (Canadian Task Force classification II-3). SETTING:A university academic hospital. PATIENTS:Women with endometrial cancer undergoing sin...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.06.017
更新日期:2017-01-01 00:00:00
abstract::This systematic review aimed to investigate complications related to initial trocar insertion among 3 different laparoscopic techniques: Veress needle (VN) entry, direct trocar entry (DTE), and open entry (OE). A literature search was completed, and complications were assessed. Major vessel injury, gastrointestinal in...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/j.jmig.2018.06.023
更新日期:2019-01-01 00:00:00
abstract::Our objective was to evaluate complications reported to the Manufacturer and User Facility Device Experience (MAUDE) database and to look for trends of complications among various endometrial ablation devices. This database was not intended to be used either to evaluate rates of adverse events or to compare adverse ev...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2007.05.008
更新日期:2007-07-01 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::Hemangiomas are known to be common benign tumors. However, hemangiomas of female genital organs are very rare. Furthermore, a retroperitoneal hemangioma arising from ovarian vessels has never been reported. Here we report a case of a 29-year-old woman with a retroperitoneal cavernous hemangioma arising from the ovaria...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.07.017
更新日期:2009-11-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the impact of ultrasound-guided transvaginal ovarian needle drilling (TND) versus laparoscopic ovarian drilling (LOD) on ovarian reserve and pregnancy rate in patients with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS). DESIGN:A randomized clinical trial (Canadian Task F...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2018.01.036
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the efficacy of laparoscopic ultrasound (LUS) as compared with contrast-enhanced magnetic resonance imaging (CE-MRI) and transvaginal ultrasound (TVUS) in detection of uterine myomas. DESIGN:Retrospective study of imaging methods used in a trial of LUS-guided radiofrequency volumetric ther...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.04.015
更新日期:2013-11-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate the feasibility of laparoscopic management of a huge myoma nascendi. DESIGN:Step-by-step video demonstration of the surgical procedure (Canadian Task Force classification III-C). SETTING:Uterine myoma is the most common benign neoplasm of the female reproductive tract, with an estimated...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2016.09.003
更新日期:2017-01-01 00:00:00
abstract:STUDY OBJECTIVE:We detected mesh erosion and serious postoperative complications in 3 women after performing laparoscopic promontofixation (LPF) using glue for mesh fixation. Glue, largely used in hernia surgery repair, is proposed by some gynecologic surgeons because it saves time and is easier to use than traditional...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.12.022
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the feasibility of total laparoscopic hysterectomy (TLH) using the Hohl instrument in an initial cohort of patients. DESIGN:Retrospective cohort analysis (Canadian Task Force classification II-3). SETTING:Department of Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.04.006
更新日期:2005-09-01 00:00:00
abstract::Ectopic pregnancy is commonly managed via either laparoscopic salpingostomy or salpingectomy. However, there is a proficiency gain curve in mastering these 2 surgical procedures, and an effective simulated model is essential for training students of gynecology. The objective of this study was to develop and evaluate a...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.06.020
更新日期:2011-11-01 00:00:00
abstract::Splenic rupture is a rare and severe complication of laparoscopic surgery. We report a case of delayed splenic rupture as a severe complication of laparoscopy, occurring 5 days after surgery performed on a 52-year-old woman with history of abdominal surgery and with acute pelvic infection. Subcapsular hematoma, result...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.08.615
更新日期:2008-01-01 00:00:00
abstract::Vasopressin has been used in gynecologic surgery since the 1950s. Since its initial introduction, multiple applications of vasopressin have been explored. The expansion of vasopressin usage in gynecologic surgery is being fueled in part by the increase in minimally invasive surgical techniques, in which alternative me...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2012.03.022
更新日期:2012-07-01 00:00:00
abstract::There is an ongoing debate regarding the benefits and drawbacks of the various routes of hysterectomy. A number of studies have examined overall quality of life outcomes as well as specific patient-reported outcomes including physical, psychosocial, and sexual functioning after hysterectomy. Existing studies have used...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.08.019
更新日期:2019-02-01 00:00:00
abstract::The reproductive outcome in 41 consecutive patients with cesarean-induced isthmocele and secondary infertility was evaluated prospectively. Patients included menopausal women (mean [SD; 95% CI] age, 35 [4.1; 29-42] years), with fertility duration of 3 to 8 (4.6 [28]) years with isthmocele, postmenstrual abnormal uteri...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.10.011
更新日期:2011-03-01 00:00:00
abstract:STUDY OBJECTIVES:To estimate whether variability in the size and ratios of the lower and upper abdomen exist in women undergoing robotic gynecologic surgery and whether demographic variables are significantly associated, and to determine the association between abdominal wall dimensions and supraumbilical robotic port ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.04.008
更新日期:2010-09-01 00:00:00