Abstract:
:Radical trachelectomy is considered in patients with early-stage cervical cancer who desire future fertility. This article is accompanied by a video that provides step-by-step demonstration of a uterine artery-sparing robotic-assisted radical trachelectomy in a patient with stage IB1 squamous cell carcinoma of the cervix, a 2-cm mass, and a desire for future fertility. We also conducted a review of the literature examining the use of uterine artery-sparing techniques among minimally invasive radical trachelectomies. Using PubMed, Google Scholar, and Ovid search tools, 28 total publications were reviewed, of which 16 were eligible for use in our comparison. With the addition of our case report, a total of 154 cases sparing the uterine artery and 40 cases sacrificing the uterine artery were examined, including both conventional laparoscopic and robotic-assisted approaches. Data describing patient demographics as well as surgical, oncologic, and fertility outcomes were collected. The mean age was 30 years for the spared group and 32 years for the sacrificed group. At least 42% of the women in the spared and 53% of the uterine artery-sacrificed group were nulliparous. The majority of cases in both the spared and sacrificed groups represented squamous cell histology (71% for spared and 51% for sacrificed) followed by adenocarcinoma (24% vs 43%). The majority of the patients in both groups had stage IB1 disease (79% for spared vs 65% for sacrificed). The operative times among the 2 groups were similar, with a mean time of 314 minutes (range, 170-420 minutes) in the spared group and 283 minutes (range, 172-345 minutes) in the sacrificed group. The mean estimated blood loss was 173 mL (range, 23-300 mL) in the spared group and 77 mL (range, 50-250 mL) in the sacrificed group. The recurrence rates for the uterine artery-sparing and -sacrificing groups were equal at 2.6% after a mean follow-up of 42 months and 26 months, respectively. The methods of reporting fertility outcomes were varied among the different publications, with 41 patients achieving pregnancy in the spared group and 2 patients achieving pregnancy in the sacrificed group. Among patients who were not trying to conceive or had not conceived, 15 patients in the spared group and 6 patients in the sacrificed group were reported to have normal menses. The successful preservation of uterine arteries supports the maintenance of uterine arterial blood flow and is used by many gynecologic surgeons performing minimally invasive radical trachelectomy, with promising oncologic and obstetric outcomes.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Kim S,Chung S,Azodi M,Menderes Gdoi
10.1016/j.jmig.2019.05.017subject
Has Abstractpub_date
2019-01-01 00:00:00pages
1389-1395issue
7eissn
1553-4650issn
1553-4669pii
S1553-4650(19)30259-6journal_volume
26pub_type
杂志文章,评审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:BACKGROUND:Transvaginal surgery is the most minimally invasive surgery for a gynecologic procedure but can be challenging for many to perform as evidenced by its declining rate. Vaginal removal of the adnexal structures can be difficult because of poor visualization. Factors such as abnormal pathology, incidental findi...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.01.028
更新日期:2018-01-01 00:00:00
abstract::Postmenopausal women with adnexal masses suspicious for malignancy must undergo surgery for histopathologic confirmation. The low positive predictive value for malignancy of the currently available preoperative examinations results in 5 to 220 surgeries performed for each case of pelvic malignancy detected, depending ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2012.05.007
更新日期:2012-09-01 00:00:00
abstract::As minimally invasive surgery becomes the standard of care in the United States and around the world, the formal training of endoscopic surgeons is an issue of growing concern. With the implementation of the American Association of Gynecologic Laparoscopists/Society of Reproductive Surgeons (AAGL/SRS)-sponsored fellow...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.03.010
更新日期:2009-07-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate risk of leakage and tissue dissemination associated with various contained tissue extraction (CTE) techniques. DESIGN:In vitro study (Canadian Task Force classification: II-1). SETTING:Academic hospital simulation laboratory. INTERVENTION:Beef tongue specimens weighing 400 to 500 g were s...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.06.004
更新日期:2014-09-01 00:00:00
abstract::The randomized controlled trial (RCT) is designed to measure the efficacy of an intervention and is considered to be the most rigorous form of research, allowing for causal inferences to be made between treatments and outcomes. When designing an RCT, one must consider its essential methodological components including ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2015.02.012
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVES:To report the surgical outcomes of laparoscopic myomectomy (LM) and abdominal myomectomy (AM) at a high-volume tertiary care hospital, to evaluate the risk of conversion during LM, and to analyze the associated risk factors. DESIGN:Retrospective cohort study (Canadian Task Force classification II). PATIENT...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.10.017
更新日期:2016-03-01 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::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::We performed a search of PUBMED and MEDLINE for articles concerning surgical management of early stage endometrial cancer from 1950 to 2011. From the articles collected we extracted data such as estimated blood loss, operating room time, complications, conversion to laparotomy, and length of hospital stay. Forty-seven...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2012.02.006
更新日期:2012-07-01 00:00:00
abstract:STUDY OBJECTIVE:Because of the rapid growth of minimally invasive surgical procedures, we developed an ultrathin fiberscopic imaging system for laser surgery that could be an important instrument for clinical use in an office setting. METHODS AND MAIN RESULTS:A new device, consisting of a custom 1.1-mm diameter flexib...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.04.024
更新日期:2015-09-01 00:00:00
abstract:STUDY OBJECTIVE:To determine which patient characteristics are associated with an increased risk of postablation pelvic pain. DESIGN:Canadian Task Force classification II-2. METHODS:Data were collected from a retrospective cohort of patients who underwent endometrial ablation between January 2006 and September 2010 a...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.04.006
更新日期:2013-09-01 00:00:00
abstract::Abnormal uterine bleeding and other gynecologic complications associated with a previous cesarean section scar are only recently being identified and described. Herein we report a rare case of a woman with recurring massive uterine bleeding after 2 cesarean sections. Curettage and hormone therapy were unsuccessfully u...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.10.005
更新日期:2015-02-01 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:STUDY OBJECTIVE:To compare the effectiveness of and patient satisfaction with different routes of misoprostol administration for short-term cervical priming before operative hysteroscopy. DESIGN:Randomized blinded trial (Canadian Task Force classification I). SETTING:University hospital. PATIENTS:One hundred and twe...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2016.12.024
更新日期:2017-01-01 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:STUDY OBJECTIVE:To evaluate the efficacy of total surgical treatment of ectopic cervical pregnancy [1] with a minimally invasive approach performed by hysteroscopy [2]. DESIGN:Step-by-step video demonstration of the surgical technique using 5 mm hysteroscopy followed by 10 mm resectoscopy. SETTING:A research and univ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.01.009
更新日期:2019-01-01 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
abstract::A 69-year-old woman had a 4-year history of recurrent giant condylomas (Buschke-Lowenstein tumor) in the anal and perianal regions, with extension to the vulva and vagina. After failure of 3 surgical excisions, one of which was radical, the condition was successfully treated using carbon dioxide laser vaporization and...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.05.007
更新日期:2010-09-01 00:00:00
abstract::Laparoscopic transabdominal cervicoisthmic cerclage (LTCC) is an alternative, less-morbid option to the traditional transabdominal cerclage, indicated for patients with cervical incompetence. Experience with the technique is based on case reports and a few case series. Considering LTCC for twin gestations, reports are...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.05.011
更新日期:2009-09-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the 10-year subjective outcome of use of retropubic tension-free vaginal tape (TVT). DESIGN:Structured telephone interview (Canadian Task Force classification II-3). SETTING:Universitiy-affiliated tertiary medical center. PATIENTS:Sixty consecutive women with urodynamically confirmed stress...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.07.006
更新日期:2011-11-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the feasibility of office hysteroscopy in patients with pregnancy-related problems such as retained trophoblastic tissue, persistent molar tissue, pregnancy with in situ intrauterine device (IUD), isthmocele, embryoscopy, and osseous metaplasia. DESIGN:Retrospective cohort chart review of u...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.11.004
更新日期:2014-05-01 00:00:00
abstract:STUDY OBJECTIVE:To demonstrate step-by-step the technique of hysteroscopic adhesiolysis (HA) by means of a blunt spreading technique using double-action forceps to dissect and restore the layer between the anterior and posterior uterine walls in a patient with severe intrauterine adhesions (IUAs), particularly in cases...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.10.011
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the accuracy of historic averages for estimating operating room (OR) time for hysterectomy among women with small and large uteri. DESIGN:A retrospective cohort study. SETTING:Data from women who underwent abdominal, vaginal, or laparoscopic hysterectomy between 2015 and 2017 at the Univer...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.01.003
更新日期:2019-01-01 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 demonstrate the technique of laparoscopic vaginal reconstruction in a rare case of mid-vaginal septum with secondary infertility. DESIGN:A step-by-step explanation of the technique using videos and pictures (Canadian Task Force classification IV). SETTING:Transverse vaginal septum is a rare conditi...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2016.02.011
更新日期:2016-07-01 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:Sacrocolpopexy (SCP) has become the standard procedure to correct uterovaginal prolapse in women, but techniques and approaches are not standardized. We report the results of the Austrian Sacrocolpopexy Registry, which aimed to collect data on surgical techniques and perioperative outcomes. DESIGN:The ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.10.020
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Laparoscopic colposuspension has been shown in some studies to have equivocal results as open colposuspension, and in addition to treating stress incontinence can also reduce anterior vaginal wall compartment prolapse, as described by Burch in 1961 [1]. STUDY OBJECTIVE:To demonstrate a novel modified techni...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.05.016
更新日期:2014-11-01 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