Abstract:
:Minimally invasive gynecologic surgery provides a number of clinical advantages compared with open laparotomy. Over the past 25 years, important modifications and innovations have further expanded the utility of these techniques. Complications such as surgical site infection, venous thromboembolism, and wound cellulitis or dehiscence rise in concert with escalating obesity, so it stands to reason that these patients would derive the most benefit from minimally invasive surgery. Yet, surgical complexity also rises proportionally, requiring fastidious technique and allowing little margin for error. As nonsurgical interventions become more commonplace and the rate of morbid obesity continues to increase, those women actually requiring a gynecologic operation through an abdominal approach will be ever more likely to present a number of challenges to safe completion of minimally invasive surgery. This article frames the topic and offers some tips across the range of care to enhance the likelihood of achieving success in this patient population most in need of surgical expertise.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Schorge JOdoi
10.1097/AOG.0000000000003588subject
Has Abstractpub_date
2020-01-01 00:00:00pages
199-210issue
1eissn
0029-7844issn
1873-233Xpii
00006250-202001000-00026journal_volume
135pub_type
杂志文章abstract:OBJECTIVE:To test the hypothesis that preeclamptic women are more readily inducible than are nonpreeclamptic women, regardless of cervical condition. METHODS:One hundred eighty-three preeclamptic women and 461 nonpreeclamptic women requiring labor induction were studied prospectively. Patients were categorized by Bish...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/S0029-7844(97)00043-4
更新日期:1997-04-01 00:00:00
abstract::Granulosa cells of developing preovulatory follicles from ovaries of 6 rhesus monkeys were studied with the electron microscope. They did not contain the cytoplasmic structures known to be associated with steroidogenesis. Such structures were found only in the luteinized granulosa cells of atretic follicles in the pr...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1976-05-01 00:00:00
abstract::The case report of a fatal result in an abortion requested because X-ray diagnostic studies of the gallbladder and intestine had been made during an undiagnosed early pregnancy is presented. A uterine vacuum aspirator had not been purchased by the hospital. A portable laboratory vacuum pump with an appropriate sucti...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1972-05-01 00:00:00
abstract::A well-woman visit provides an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks. Given the shifting and complex landscape of care, in which many women may not receive all the recommended preventive services, obstetrician-gynecologists have an opportunity to co...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002898
更新日期:2018-10-01 00:00:00
abstract::Combination chemotherapy has dramatically improved the results of treatment for embryonal rhabdomyosarcoma of the vagina in children, but little attention has been directed toward vaginal sarcomas in adults. This report of 17 cases of primary sarcoma of the adult vagina includes ten leiomyosarcomas, four mixed mesoder...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-05-01 00:00:00
abstract:OBJECTIVE:To assess whether the G allele of the serotonin receptor 1A C(-1019)G polymorphism is associated with premenstrual dysphoric disorder. METHODS:The study sample comprised 53 women with clinically diagnosed premenstrual dysphoric disorder (age range 27-46 years, mean 37.7 years) and 51 healthy control subjects...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000284448.73490.ac
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:To describe the incidence and type of fetal injury identified in women undergoing cesarean delivery. METHODS:Between January 1, 1999, and December 31, 2000, a prospective cohort study of all cesarean deliveries was conducted at 13 university centers. Information regarding maternal and infant outcomes was abs...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1097/01.AOG.0000237116.72011.f3
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Cervical varices are an extremely rare complication of pregnancy; they can result in significant maternal morbidity secondary to acute hemorrhage. There is limited evidence to guide the management of cervical varices during termination of pregnancy. CASE:A 37-year-old woman presented with recurrent vaginal ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000435449.01356.99
更新日期:2014-02-01 00:00:00
abstract::A single-transducer mechanical sector scanner was used to examine the first-trimester fetus. Fifty-six examinations of 31 patients demonstrated an orderly developmental progression of fetal activity beginning with beating of the fetal heart (7 weeks), progressing to fetal trunk movement (8 weeks), and culminating in i...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the role of second-look laparotomy following platinum-based chemotherapy in patients with fallopian tube cancer. METHODS:We conducted a retrospective chart review of 35 patients with tubal cancer who underwent a second-look laparotomy following cytoreductive surgery and platinum-based combination...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
abstract::Over an 11-year period (1971 to 1981), 212 urinary conduit surgeries were performed by the Department of Gynecology at the University of Texas, M. D. Anderson Hospital and Tumor Institute at Houston. The urinary diversions were performed as part of the pelvic exenteration operation in 154 patients, for radiation injur...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198605000-00015
更新日期:1986-05-01 00:00:00
abstract:OBJECTIVE:To estimate trends in postpartum glucose testing in a cohort of women with gestational diabetes mellitus (GDM). METHODS:A validated computerized algorithm using Kaiser Permanente Northwest automated data systems identified 36,251 live births or stillbirths from 1999 through 2006. The annual percentage of pre...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318184db63
更新日期:2008-10-01 00:00:00
abstract::Fifteen infertile women diagnosed by endometrial dating to have a luteal phase defect were treated with human pituitary follicle-stimulating hormone (hFSH) for 45 cycles. Human follicle-stimulating hormone was administered intramuscularly in a dose of 50 IU/day (group 1) for 35 cycles and 100 IU/day (group 2) for ten ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract::During childhood and adolescence, the rate of malignancy in ovarian enlargement is reported to be high-approximately 35% in many large series from tertiary centers. To assess whether this represents an overestimation because of the referral patterns of these institutions, a retrospective review was conducted at five h...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:Screening of pregnant women for vaginal and rectal carriage of group B streptococci may also identify group A streptococcal carriers. The clinical significance of prenatal group A streptococcal carriage is unknown. CASES:Two women developed group A streptococcal puerperal sepsis after delivery at one hospit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01611-8
更新日期:2001-11-01 00:00:00
abstract::Acknowledgement of the importance of patient autonomy and increased patient access to information has prompted more patient - generated requests for surgical interventions not necessarily recommended by their physicians. Decision making in obstetrics and gynecology should be guided by the ethical principles of respect...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000291581.16747.24
更新日期:2008-01-01 00:00:00
abstract::The most common anomalies of implantation of the placenta and umbilical cord include placenta previa, placenta accreta spectrum, and vasa previa, and are associated with considerable perinatal and maternal morbidity and mortality. There is moderate quality evidence that prenatal diagnosis of these conditions improves ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004175
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To determine the safety, tolerability, and efficacy of combination gefitinib and methotrexate to treat ectopic pregnancy. METHODS:We performed a phase I, single-arm (nonrandomized), open-label study. Twelve women with ectopic pregnancies were administered methotrexate (50 mg/m, intramuscular) and 250 mg oral...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182a14cfb
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:To obtain estimates of the effects of amniotomy on the risk of cesarean delivery and on other indicators of maternal and neonatal morbidity (Apgar score less than 7 at 5 minutes, admission to neonatal intensive care unit [NICU]). DATA SOURCES:Published studies were identified through manual and computerized ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:
更新日期:1996-05-01 00:00:00
abstract::Variability of the baseline fetal heart rate is correlated with good fetal outcome, and loss of baseline variability has been observed as a sign of fetal distress. Central nervous system depressing drugs may also decrease fetal heart rate variability, and thus recognition of the effect of medication on the baseline fe...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the degree to which prenatal knowledge of fetal anomalies and sociodemographic characteristics determined outcome of 53,000 pregnancies. METHODS:Pregnancies were consecutively evaluated at a university hospital between 1984 and 1997. The severity of anomalies was graded by using an ordinal scale,...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01673-8
更新日期:2002-02-01 00:00:00
abstract::Phenylketonuria (PKU) is an autosomal recessive disorder of phenylalanine (Phe) metabolism characterized by a deficiency of the hepatic enzyme, phenylalanine hydroxylase, an enzyme responsible for the conversion of phenylalanine to tyrosine, and elevated levels of Phe and Phe metabolite. All women with PKU or hyperphe...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181c6f93d
更新日期:2009-12-01 00:00:00
abstract::The efficacy and safety of bromocriptine mesylate (5 to 7.5 mg per day for up to 24 weeks) were studied in 22 clinical trials involving 226 patients who had amenorrhea/galactorrhea associated with hyperprolactinemia and no demonstrable pituitary tumor. Of the 187 patients evaluated for efficacy, 80% experienced reinit...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1097/00006250-198003000-00002
更新日期:1980-03-01 00:00:00
abstract::Reported are 172 patients considered for external cephalic version at gestational age greater than 37 weeks. Their outcome was compared with 40 similar patients in whom external version was not attempted. One hundred fifty-eight patients had attempted version, and success was achieved in 122 (77%). Intrapartum vertex ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Because of donor oocyte programs, women who previously were considered too old to successfully achieve conception and delivery can now bear children. To our knowledge, there have been no previous reports of pregnancy outcome in women over age 50 who conceived using donor oocytes. This study presents the preg...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::Intrauterine retention of fetal bone is a rare complication of abortion that can cause secondary infertility by an unknown mechanism. We report such a case in which menstrual fluid prostanoids were measured to elucidate the possible pathophysiology. The pattern of prostanoid increases was similar to that seen in intra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::The adult respiratory distress syndrome is a common cause of acute hypoxemic respiratory failure in the adult that is associated with a high mortality. There is a limited experience with managing this entity in the gravid patient. A case of successful management of mother and fetus through spontaneous delivery is pres...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVE:To examine the association between the mode of delivery and the risk of offspring obesity by age 21 years using a large community-based birth cohort study in Australia. METHODS:We followed-up a subsample of 2,625 offspring for whom we had measured physical assessments, including height and weight at 21 years...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000016
更新日期:2013-12-01 00:00:00
abstract::A case of ovarian carcinoma with bilateral metastases to the breasts is presented. This is the first report of simultaneous involvement of both breasts presenting as an inflammatory tumor. Axillary lymph node enlargement preceded breast involvement. The related literature is reviewed briefly, and the unpredictable inv...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198003001-00029
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE:To perform a systematic review of the literature on the accuracy of prediction models in the preoperative assessment of adnexal masses. DATA SOURCES:Studies were identified through the MEDLINE and EMBASE databases from inception to March 2008. The MEDLINE search was performed using the keywords ["ovarian neo...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318195ad17
更新日期:2009-02-01 00:00:00