Abstract：
:Robotic-assisted laparoscopic hysterectomies are being performed at higher rates since the da Vinci Surgical System (Intuitive Surgical, Inc, Sunnyvale, CA, USA) received US Food and Drug Administration approval in 2005 for gynecologic procedures. Despite the technological advancements over traditional laparoscopy, a discrepancy exists between what the literature states and what the benefits are as seen through the eyes of the end-user. There remains a significant learning curve in the adoption of safe and efficient robotic skills. The authors present important considerations when choosing to perform a robotic hysterectomy and a step-by-step technique. The literature on perioperative outcomes is also reviewed.
journal_name
Obstet Gynecol Clin North Amjournal_title
Obstetrics and gynecology clinics of North Americaauthors
Simpson KM,Advincula APdoi
10.1016/j.ogc.2016.04.008subject
Has Abstractpub_date
2016-09-01 00:00:00pages
479-93issue
3eissn
0889-8545issn
1558-0474pii
S0889-8545(16)30021-3journal_volume
43pub_type
杂志文章,评审abstract：:The normal vaginal, or resident, flora is complex and easily includes over a dozen different organisms, many of them potential pathogens. The quantitative nature of the vaginal flora also is a factor in development of symptoms. This complex milieu is further varied by nature's changes over the years from birth to meno...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-06-01 00:00:00
abstract：:Abnormal uterine bleeding occurs secondary to a wide variety of functional and structural abnormalities. Although there is clearly a place for surgery, medical therapy has enormous potential for most women, especially those with dysfunctional uterine bleeding. To provide women with appropriate options for therapy, the...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8545(00)80021-2
更新日期：2000-06-01 00:00:00
abstract：:Women with unexplained recurrent pregnancy loss (RPL) represent a highly heterogeneous group of patients. Past studies have investigated systemic endocrine and immunologic mechanisms as potential causes for pregnancy loss in unexplained RPL, while exciting new work has focused on spermatozoal, embryonic, and endometri...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2013.10.008
更新日期：2014-03-01 00:00:00
abstract：:Medical treatment of ectopic pregnancy with methotrexate has been shown to be effective and safe in appropriate patients. When considering medical management, the definitive diagnosis of an ectopic pregnancy and the assurance that the patient is a candidate are of paramount concern. An understanding of the mechanism o...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8545(05)70162-5
更新日期：2000-09-01 00:00:00
abstract：:Advancements in cancer screening techniques have allowed for earlier detection of cancer at premalignant or early stages of disease. Several organizations have guidelines for screening strategies for breast, cervical, colon, and lung cancer. Ovarian cancer remains the deadliest cancer of the female reproductive tract;...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2019.04.007
更新日期：2019-09-01 00:00:00
abstract：:The diagnosis of ectopic pregnancy remains a challenge to the clinician, despite advances in sonographic and biochemical technology. Contemporary practice requires an understanding of the normal sonographic features and hormonal profiles for normal pregnancy as well as the pathogenesis of an ectopic nidation. Frequent...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-03-01 00:00:00
abstract：:This article evaluates the complicated scenario for physicians when they must advise pregnant oncology patients and their families. Included in this discussion are a review of literature that addresses both maternal and fetal rights and an analysis of metaphysical considerations unique to this situation. Additionally,...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8545(05)70004-8
更新日期：1998-06-01 00:00:00
abstract：:The ever-increasing value of diagnostic and operative hysteroscopy for patients with AUB serves as an appropriate, although belated, tribute to Pantaleoni who in 1869 dared to look inside a woman's uterus. Future generations of women and their physicians will be indebted to this physician-pioneer. Contemporary instrum...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8545(05)70068-1
更新日期：1999-03-01 00:00:00
abstract：:The placenta can serve as a valuable source of information about maternal and fetal conditions during the pregnancy; however, the abilities to perform a preliminary gross examination and interpret a placental pathology report are variable among obstetricians. This article discusses the indications for placental submis...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2019.10.007
更新日期：2020-03-01 00:00:00
abstract：:Electrosurgery is used on a daily basis in the operating room, but it remains poorly understood by those using it. In addition, the physics of electrosurgery are far more complicated than those of laser. Common belief notwithstanding, electrosurgery has an enormous capacity for patient injury if used incorrectly, even...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2010.05.007
更新日期：2010-09-01 00:00:00
abstract：:The appropriate use of screening mammography can significantly decrease deaths from breast cancer. Physicians and patients must become more vigilant in using available diagnostic modalities if we are to improve upon the survival of patients with breast cancer. ...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-09-01 00:00:00
abstract：:The serum CA-125 level is elevated in most women with endometriosis. Although tests are readily available to measure the marker, simple modifications of the present assays are required to improve and standardize the quality of the measurements. The serum test has low sensitivity and would not be appropriate for genera...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-03-01 00:00:00
abstract：:It is an unfortunate fact that all pregnancies do not end with healthy babies and healthy mothers. Families who have experienced an adverse pregnancy outcome require accurate information about the risk of recurrence to plan future childbearing. This article examines the recurrence risk of four complications of pregnan...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2008.04.003
更新日期：2008-09-01 00:00:00
abstract：:This article discusses the role of ultrasound in assessing endometrial and uterine factors affecting the implantation of the embryo. Modern ultrasound equipment includes advanced Doppler and three-dimensional facilities that refine our understanding of factors that affect implantation such as endometrial blood flow. T...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2019.08.002
更新日期：2019-12-01 00:00:00
abstract：:Cervical cancer is a preventable disease that is curable when it is detected early. For advanced-stage cancer, the prognosis is worse. Over the years, much progress has been made in radiation therapy and in chemotherapy, but it took three decades for the arrival of concurrent chemoradiation therapy, which significantl...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8545(02)00024-4
更新日期：2002-12-01 00:00:00
abstract：:Lichen planus is an inflammatory mucocutaneous condition with a myriad of clinical manifestations. There are 3 forms of lichen planus that effect the vulva: papulosquamous, hypertrophic, and erosive. Erosive lichen planus can progress to vulvar scaring, vaginal stenosis, and squamous cell carcinoma; these long-term se...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2017.04.004
更新日期：2017-09-01 00:00:00
abstract：:Obesity has increased dramatically in the United States over the last several decades, with approximately 40% of pregnant women now considered overweight or obese. Obesity has been shown to be associated with numerous poor pregnancy outcomes, including increased rates of preeclampsia, gestational diabetes, fetal macro...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2015.01.008
更新日期：2015-06-01 00:00:00
abstract：:Voiding dysfunction in women results from either a failure of the bladder to contract appropriately or a failure of the urethra or bladder neck to relax during attempts at micturition. Complaints of urinary frequency and urgency most often accompany voiding dysfunction. Associated symptoms, which are not always presen...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-12-01 00:00:00
abstract：:The use of antiretroviral agents to treat patients infected with HIV has become increasingly complex. Obstetricians caring for the pregnant woman infected with HIV must, no less than the HIV specialist, be familiar with the various medications now available. This article profiles each of the antiretroviral agents curr...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8545(05)70347-8
更新日期：1997-12-01 00:00:00
abstract：:A review of all relevant randomized controlled trials provides strong evidence that corticosteroid therapy causes a significant reduction in respiratory distress syndrome (RDS) in preterm babies overall. This reduction in RDS is accompanied by a reduced incidence of neonatal death, intraventricular hemorrhages, and ne...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 临床试验,杂志文章,随机对照试验,评审
doi：
更新日期：1992-06-01 00:00:00
abstract：:Hematologic disorders in pregnancy are relatively common and encompass a wide spectrum of clinical conditions. The treatment and obstetric management of the majority of these diseases are well established, although controversy exists in areas such as sickle cell disease and ITP. Once the diagnosis of a specific disord...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-12-01 00:00:00
abstract：:The concept of having an in-house obstetrician (serving as an obstetrics [OB] hospitalist) available 24 hours a day, 7 days a week provides a safety net for OB events that many need immediate intervention for a successful outcome. A key precept of risk management, that of loss prevention, fits perfectly with the addit...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2015.05.008
更新日期：2015-09-01 00:00:00
abstract：:The study of multiple gestations in older mothers has been furthered by the analyses of large data sets published in recent years. These initial analyses are counterintuitive in that the obstetric and neonatal outcomes of the older mothers (>40 years) are better than those of their younger counterparts (aged 25-29). C...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2004.10.010
更新日期：2005-03-01 00:00:00
abstract：:Hydatidiform moles are divided into two syndromes: those of complete and partial moles. Both forms are genetically, morphologically, and clinically distinct. Choriocarcinoma can be associated with the complete mole that has not been described for the partial syndrome. Residual trophoblastic disease, on the contrary, c...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1988-09-01 00:00:00
abstract：:Obesity is increasing at epidemic rates in all women, but especially in minority women and children. Factors that contribute to this include changes in caloric intake and expenditure (calories), cost and ease of acquiring food along with pressures from the marketplace and media (commerce) and the community response to...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2009.04.003
更新日期：2009-06-01 00:00:00
abstract：:PID is a common infection in reproductive-age women that presents an enormous public health and economic burden. It is responsible for much short- and long-term morbidity that may necessitate interventions subsequent to the original infection. Mild PID seems to be much more common than severe or "classic" PID, and the...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8545(03)00088-3
更新日期：2003-12-01 00:00:00
abstract：:Gonorrhea is the most common sexually transmitted disease in the United States. This article discusses the epidemiology, pathogenesis of Neisseria gonorrhoeae, diagnosis, clinical manifestations, and treatment of this important disease. ...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-09-01 00:00:00
abstract：:It is now widely accepted that cancer of the breast is a systemic disease and that some patients will not be cured even with the most extensive local treatment. This acceptance has resulted in a more conservative approach and participation of the patient in treatment planning. A number of factors influence the definit...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-12-01 00:00:00
abstract：:Interstitial cystitis, or painful bladder syndrome, can present with lower abdominal pain/discomfort and dyspareunia, and pain in any distribution of lower spinal nerves. Patients with this condition experience some additional symptoms referable to the bladder, such as frequency, urgency, or nocturia. It can occur acr...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.ogc.2014.05.004
更新日期：2014-09-01 00:00:00
abstract：:Since its initial approval by the US Food and Drug Administration (FDA) 20 years ago for the treatment of strabismus, hemifacial spasm, and blepharospasm in adults, botulinum toxin (BTX) has become one of the most frequently requested products in cosmetic rejuvenation around the world. After years of clinical success ...
journal_title：Obstetrics and gynecology clinics of North America
pub_type： 杂志文章
doi：10.1016/j.ogc.2010.10.002
更新日期：2010-12-01 00:00:00
