Abstract:
STUDY OBJECTIVE:The primary objective was to compare carbon dioxide (CO2) absorption rates in patients undergoing gynecologic laparoscopy with a standard versus valveless insufflation system (AirSeal; ConMed, Utica, NY) at intra-abdominal pressures (IAPs) of 10 and 15 mm Hg. Secondary objectives were assessment of surgeons' visualization of the operative field, anesthesiologists' ability to maintain adequate end-tidal CO2 (etCO2), and patients' report of postoperative shoulder pain. DESIGN:A randomized controlled trial using an equal allocation ratio into 4 arms: standard insufflation/IAP 10 mm Hg, standard insufflation/IAP 15 mm Hg, valveless insufflation/IAP 10 mm Hg, and valveless insufflation/IAP 15 mm Hg. SETTING:Single tertiary care academic institution. PATIENTS:Women ≥ 18 years old undergoing nonemergent conventional or robotic gynecologic laparoscopic surgery. INTERVENTIONS:A standard or valveless insufflation system at IAPs of 10 or 15 mm Hg. MEASUREMENTS AND MAIN RESULTS:One hundred thirty-two patients were enrolled and randomized with 33 patients per group. There were 84 robotic cases and 47 conventional laparoscopic cases. CO2 absorption rates (mL/kg*min) did not differ across groups with mean rates of 4.00 ± 1.3 in the valveless insufflation groups and 4.00 ± 1.1 in the standard insufflation groups. The surgeons' rating of overall visualization of the operative field on a 10-point Likert scale favored the valveless insufflation system (median visualization, 9.0 ± 2.0 cm and 9.5 ± 1.8 cm at 10 and 15 mm Hg, respectively) over standard insufflation (7.0 ± 3.0 cm and 7.0 ± 2.0 cm at 10 and 15 mm Hg, respectively; p <.001). The anesthesiologists' ability to maintain adequate etCO2 was similar across groups (p = .417). Postoperative shoulder pain scores were low overall with no significant difference across groups (p >.05). CONCLUSION:CO2 absorption rates, anesthesiologists' ability to maintain adequate etCO2, and postoperative shoulder pain did not differ based on insufflation system type or IAP. Surgeons' rating of visualization of the operative field was significantly improved when using the valveless over the standard insufflation system.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Madueke-Laveaux OS,Advincula A,Grimes CL,Walters R,Kim JH,Simpson K,Truong M,Young C,Landau R,Ryntz Tdoi
10.1016/j.jmig.2019.05.005subject
Has Abstractpub_date
2020-01-01 00:00:00pages
225-234issue
1eissn
1553-4650issn
1553-4669pii
S1553-4650(19)30218-3journal_volume
27pub_type
杂志文章,随机对照试验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:STUDY OBJECTIVE:The effect of the different types of vaginal cuff closures on posthysterectomy sexual function has not been investigated in depth. We evaluated if there is a difference between transvaginal versus a laparoscopic closure after total laparoscopic hysterectomy (TLH) on female sexual function, using a valid...
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.2019.03.018
更新日期:2020-01-01 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::Hysteroscopic sterilization is rapidly replacing interval laparoscopic sterilization. Six years after the Food and Drug Administration's approval of Essure hysteroscopic sterilization, U.S. and worldwide literature and clinical experience have confirmed the safety, effectiveness, and low rate of adverse events reporte...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2009.02.009
更新日期:2009-05-01 00:00:00
abstract:STUDY OBJECTIVE:The identification of less invasive methods with acceptable diagnostic value for evaluating intrauterine abnormalities can improve the satisfaction of patients and physicians. Although hysteroscopy plus biopsy has favorable predictive and diagnostic values, limited studies have evaluated its value, and ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.02.016
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:To identify risk factors associated with postoperative urinary retention in patients undergoing outpatient minimally invasive hysterectomy. DESIGN:A retrospective cohort study. SETTING:An academic medical center. PATIENTS:All patients undergoing outpatient minimally invasive hysterectomy between Janu...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.06.003
更新日期:2020-01-01 00:00:00
abstract::Diaphragm metastases in ovarian cancer can be safely resected robotically in selected patients. The technique is similar to laparotomy, whether it is a peritoneal or full-thickness excision. Trocar placement is very important for successful resection and is dependent on the location of the disease. Metastases involvin...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.12.018
更新日期:2020-01-01 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:STUDY OBJECTIVE:To compare laparoscopic insufflators with different insufflation characteristics and evaluate the effects of resistance and leakage on maintenance of nominal pressure. DESIGN:Prospective study (Canadian Task Force classification II-2). SETTING:Laboratory of university clinic. INTERVENTIONS:Measuremen...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.10.007
更新日期:2006-05-01 00:00:00
abstract::Heterotopic pregnancy refers to the simultaneous presence of ectopic pregnancy and intrauterine pregnancy. With the advent of assisted reproductive technology, the overall incidence of heterotopic pregnancies has risen. We report a case of a 36-year-old woman with type 2 diabetes mellitus and 1-year of primary inferti...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.11.003
更新日期:2020-01-01 00:00:00
abstract::Uterine inversion is a rare obstetric emergency usually occurring in the immediate postpartum period after the third stage of labor. The incidence is reported to be between 1 in 550 to 1 in several thousand deliveries. Delayed postpartum uterine inversion is even less common, and may present a management challenge. We...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.12.003
更新日期:2010-03-01 00:00:00
abstract:STUDY OBJECTIVE:To assess all electromechanical morcellators used in gynecology to achieve an objective comparison between them and to make suggestions for improvements in future developments. DESIGN:Literature review. INTERVENTION:The PubMed, Web of Science, EMBASE, and MAUDE databases were systematically searched f...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2013.12.121
更新日期:2014-05-01 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 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
abstract::We performed a literature review of reports comparing a levonorgestrel-releasing intrauterine device (LNG-IUD) with transcervical polyp resection (TCRP) as a treatment for heavy menstrual bleeding (HMB). Our second objective was to investigate the effectiveness of LNG-IUD and TCRP in reducing menstrual bleeding and th...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2015.06.016
更新日期:2015-11-01 00:00:00
abstract:STUDY OBJECTIVE:We sought to determine whether relief of chronic pelvic pain symptoms with hormonal treatment is predictive of presence or absence of endometriosis or location of endometriosis within the pelvis. DESIGN:A retrospective, chart review (Canadian Task Force classification II-3). SETTING:A private practice...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2007.09.002
更新日期:2008-01-01 00:00:00
abstract:STUDY OBJECTIVE:To compare outcomes after minimally invasive surgery (MIS) vs open radical hysterectomy for early stage cervical cancer incorporating 2018 Federation of Gynecology and Obstetrics (FIGO) staging. DESIGN:A retrospective analysis. SETTING:A single teaching hospital. PATIENTS:Patients after radical hyste...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.07.021
更新日期:2020-07-28 00:00:00
abstract::To reduce bladder function impairment and avert the serious complications of anastomotic leakage after segmental rectosigmoidectomy and to minimize the persistence of endometriotic lesions associated with discoid resection, we used the double circular stapling (DCS) technique. This technique enables excision of bowel ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.07.022
更新日期:2014-01-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the efficacy of prostaglandin F2α (PGF2α) in hysteroscopic myomectomy of submucous myomas. DESIGN:Single-blind, randomized clinical trial study. SETTING:Teaching hospital, affiliate of Iran University of Medical Sciences, Tehran, Iran. PATIENTS:Forty-four patients with symptomatic submucous...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.05.026
更新日期:2020-01-01 00:00:00
abstract::Because it is minimally invasive, laparoscopic surgery is preferred over open surgery. However, it is often difficult to maintain an adequate surgical field during the procedure. As in open laparotomy, securing an adequate surgical field is important for adequate visualization. We evaluated the effectiveness and safet...
journal_title:Journal of minimally invasive gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jmig.2011.04.012
更新日期:2011-07-01 00:00:00
abstract::The pelvic uterus-like mass is a rare phenomenon in which an extrauterine mass, comprised of smooth muscle and a central cavity lined by endometrium, is found within the pelvis. The mass is associated with endometriosis and in some of the cases with congenital Müllerian malformations. There is an ongoing debate whethe...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.03.002
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:To determine whether accuracy of visual diagnosis of endometriosis at laparoscopy is determined by stage of disease. DESIGN:Prospective longitudinal cohort study (Canadian Task Force classification II-2). SETTING:Tertiary referral centers in three Australian states. PATIENTS:Of 1439 biopsy specimens, endom...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.04.017
更新日期:2013-11-01 00:00:00
abstract:STUDY OBJECTIVE:To present a series of robotic laparoendoscopic single-site surgery (LESS) and reduced-port hysterectomy cases and discuss the surgical technique required for successful use on this new platform. DESIGN:Retrospective case series. SETTING:Academic medical center. PATIENTS:All patients undergoing robot...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.08.009
更新日期:2020-08-20 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the effect of endometrial ablation on 6 premenstrual symptoms for up to 1 year after treatment. DESIGN:Prospective cohort of 59 women awaiting endometrial ablation (Canadian Task Force classification II-2). SETTING:University tertiary care hospital. PATIENTS:Adult women of childbearing ag...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.01.023
更新日期:2015-05-01 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:We sought to estimate effectiveness of transdermal scopolamine to prevent postoperative nausea and vomiting after gynecologic laparoscopy. DESIGN:Patients were randomized to receive preoperative transdermal scopolamine or placebo. Main outcome measure was incidence of nausea during the first 24 hours p...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2007.08.616
更新日期:2008-01-01 00:00:00
abstract:STUDY OBJECTIVES:To evaluate the rate of intrauterine adhesions after hysteroscopic resection of hyperplastic and/or cancer areas and the efficacy of combined treatment. DESIGN:Observational retrospective study. SETTING:Patients affected by endometrial atypical hyperplasia of the endometrium or early stage endometria...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.06.004
更新日期:2015-11-01 00:00:00
abstract::Laparoendoscopic single-site surgery (LESS) and natural orifice translumenal endoscopic surgery are now being used in gynecologic oncologic procedures. We used our expertise with LESS to perform nerve-sparing laparoscopic radical hysterectomy. A 45-year-old woman with stage IA2 cervical cancer was referred to us. The ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.04.019
更新日期:2013-11-01 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:OBJECTIVE:To illustrate the laparoscopic surgical management of a particular localization of extrauterine pregnancy misdiagnosed until 12 weeks gestational age, complicated by hemoperitoneum and abortion. DESIGN:Canadian Task Force III on the Periodic Health Examination's Levels of Evidence. SETTING:The prevalence of...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.01.023
更新日期:2017-01-01 00:00:00