Abstract:
:Knowledge of ureteric anatomy is essential for ureteric injury prevention in laparoscopic gynecologic surgery. Rates of injury increase with limited surgical experience and reduced surgical volume. Currently, there are no low-fidelity or high-fidelity simulation models for teaching and practicing ureteric dissection. Our goal was to design a laparoscopic simulation model for retroperitoneal anatomy with high face validity that is low-cost and easily reproducible. A low-fidelity 3-dimensional simulation model was developed that represents key anatomic structures encountered during retroperitoneal dissection and ureteric identification. Materials, construction steps, and costs were determined. The models were trialed by expert laparoscopic surgeons. Demographic information that included age, gender, surgical experience, and complex laparoscopic case volumes was collected. Face validity was assessed with a 5-item Likert-scale. The total cost of 1 model ranged from $65 to $75. The majority of the materials that were used were reusable, except for 2 components that cost <$1 per use. Seven expert surgeons participated in the study, all of whom were fellowship-trained minimally invasive gynecologic surgeons or currently enrolled in this type of fellowship program. Participants agreed or strongly agreed that the model resembled the texture of the ureter, vessels, and peritoneal layer (n=6; 86%), approximated the correct anatomic course of the ureter (n=7; 100%), and closely approximated live surgery (n=5; 71%). They also agreed or strongly agreed that the model would be useful for teaching laparoscopic retroperitoneal dissection (n=7; 100%), for assessing a learner's ability before performing in the operating room (n=6; 86%), was low-cost (n=7; 100%), and was easily reproducible (n=6; 86%). This unique model fills a gap in laparoscopic simulation training. No other low- or high-fidelity models for laparoscopic retroperitoneal ureteric dissection have been identified in the literature. This simulation model is low-cost, easily reproducible, closely resembles retroperitoneal dissection during laparoscopic gynecologic surgery, and can be used for education and assessment.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Yousuf AA,Frecker H,Satkunaratnam A,Shore EMdoi
10.1016/j.ajog.2017.07.004subject
Has Abstractpub_date
2017-10-01 00:00:00pages
483.e1-483.e3issue
4eissn
0002-9378issn
1097-6868pii
S0002-9378(17)30846-3journal_volume
217pub_type
杂志文章abstract:OBJECTIVE:This study compared myoendometrial versus placental radial uterine arteries from late-pregnant rats to evaluate differences in passive mechanical properties and arterial wall hyperplasia. STUDY DESIGN:Myoendometrial and placental radial uterine arteries were dissected from late-pregnant (day 17-19) Sprague-D...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.06.094
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:We estimated the risk of complications at birth of extremely large babies (≥5000 g). STUDY DESIGN:This was a cohort study including all births of extremely large babies in 1996 through 2005 and comparison cohort with normal birthweight (1:2) identified in the national birth registration. RESULTS:There were ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.12.036
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:Women in the postpartum period are at high risk for complications from influenza. Pharmacokinetic data of oseltamivir phosphate in postpartum women, however, are lacking. STUDY DESIGN:Seven healthy patients within 48 hours of delivery were recruited. Each woman received 75 mg of oseltamivir phosphate. Plasma...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.01.056
更新日期:2011-06-01 00:00:00
abstract::Seventeen pregnant rabbits were studied under conscious, unstressed conditions after catheterization of the right ventricle (RV), a femoral artery (A), and a uterine vein (UV). Respiratory gas tensions, pH, and oxygen saturations and contents were determined serially throughout the latter half of gestation. The uterin...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(85)80054-5
更新日期:1985-07-15 00:00:00
abstract::In a double-blind controlled multicentric study involving 94 patients with an intrauterine fetal death, we investigated the efficacy and tolerance of mifepristone (RU 486), a steroid compound that antagonizes progesterone action at the receptor level. Success of treatment was defined as the occurrence of fetal expulsi...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/0002-9378(90)91193-g
更新日期:1990-08-01 00:00:00
abstract::Forelimb movements in the unanesthetized fetal lamb in utero were measured by means of transit-time ultrasound in conjunction with triceps and biceps electromyographic activity. The relationships between forelimb movements and electrocortical activity, hypoxia, and spontaneous labor were studied. There was no evidence...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90231-3
更新日期:1981-07-01 00:00:00
abstract::We investigated the effects of nifedipine, a calcium entry blocker, on the fetal and maternal circulation. Nifedipine was administered intravenously for 30 minutes to chronically instrumented pregnant ewes. Infusion of 5 micrograms.kg-1.min-1 resulted in a 30% to 50% increase in total and regional fetal cerebral blood...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80104-7
更新日期:1987-10-01 00:00:00
abstract::In Western culture, the ethical principles of respect for persons can be further divided into 2 categories - a) autonomy and b) protection of the vulnerable; beneficence; and justice. The principles of ethics can be directed towards 2 levels: microethics - concerned with the individual and macroethics - concerned w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)91287-m
更新日期:1990-04-01 00:00:00
abstract::Infertility was examined among 343 diethylstilbestrol-exposed and 303 unexposed daughters whose mothers participated in an evaluation of diethylstilbestrol use during pregnancy 35 years ago. Of the married individuals who were not using contraception and who were actively trying to conceive, a greater proportion of di...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90012-9
更新日期:1988-03-01 00:00:00
abstract::Identification of a 3100-year-old lithopedion in the Archaic Southwest antedates its first clinical notation by 2100 years. It was only the "autopsy" of time (excavation of the site) that allowed its presence to be brought to light. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 历史文章,杂志文章
doi:10.1016/0002-9378(93)90148-c
更新日期:1993-07-01 00:00:00
abstract::In the next decade many women will turn to the medical community for advice on maintaining or improving health after menopause. Estrogen replacement therapy, with or without progestins, alleviates menopausal symptoms, prevents or manages osteoporosis, and reduces the increased cardiovascular disease risk that results ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1067/mob.2001.109656
更新日期:2001-02-01 00:00:00
abstract::One hundred eighty-six patients with epithelial tumors of the ovary who were managed at the M. D. Anderson Hospital and Tumor Institute underwent an exploratory operation ("second-look" operation) to assess the status of the cancer. Fifty-eight patients were found to have no evidence of disease (NED) and chemotherapy ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32778-8
更新日期:1980-12-15 00:00:00
abstract::Maternal heart rate (MHR), blood pressure (BP), the differential index (DI) describing the short-term component of fetal heart rate (FHR) variability, and the interval index (II) describing the long-term component were measured in eight subjects in the midtrimester before, during, and after the mothers smoked a standa...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)91013-x
更新日期:1983-07-15 00:00:00
abstract::A chart for displaying neonatal survival data regarding low birth weight and early gestational age is presented. Survival data at two institutions for infants with low birth weight and early gestational age are compared. This format is useful for student and resident teaching, for counseling parents-to-be about potent...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90026-7
更新日期:1984-07-01 00:00:00
abstract::In many developing countries, services to prevent the mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) operate with limited contact with HIV care and treatment programs, despite significant advances in the accessibility of both services. There is a need to deliver more complex multidrug PMTCT...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2007.03.068
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:The study was conducted to systematically investigate previous anecdotal reports of memory decline during pregnancy. STUDY DESIGN:We used a longitudinal design to investigate memory in women throughout pregnancy and in the postpartum period. Closely matched, nonpregnant women were similarly studied at equiva...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70073-0
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:The standard weekly dose of 17-alpha hydroxyprogesterone caproate (17OHP-C; 250 mg/wk) to reduce the risk of recurrent preterm birth was adopted without regard to patient characteristics. We examined the relationship between prepregnancy body mass index (BMI) and gestational age at birth after 17OHP-C prophyl...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.04.018
更新日期:2015-08-01 00:00:00
abstract::Serum corticosteroid-binding globulin (CBG) concentrations in blood respond to endogenous or exogenous estrogens in a dose-response manner and serve as a biologic assay for estrogens. Because endometrial carcinoma is associated with unopposed or excessive estrogen stimulation, the CBG binding capacity of sera of patie...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90480-4
更新日期:1981-03-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to report our experience with placental bed biopsy with the use of forceps. STUDY DESIGN:Placental bed biopsies were undertaken transcervically under ultrasound guidance in 313 women who underwent termination of pregnancy between 7 and 20 weeks of gestation, in 104 women with a ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.126866
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the effect of docosahexaenoic acid supplementation on plasma phospholipid docosahexaenoic acid content and indices of depression and information processing for women who breast-feed. STUDY DESIGN:Mothers who planned to breast-feed their infants were assigned randoml...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mob.2003.275
更新日期:2003-05-01 00:00:00
abstract::The treatment of two pregnant thyrotoxic patients with propranolol alone is discussed. One patient had a spontaneous remission during pregnancy wile taking propranolol. In the other patient treatment with propranolol allowed postponement of definitive therapy until after delivery, when the fetus was no longer at risk....
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(75)90648-1
更新日期:1975-01-15 00:00:00
abstract::Sixty-one percent of refractory vulvodynia patients evaluated in a tertiary care vulvovaginal clinic had clinically relevant dermatoses based on dermatopathologist-analyzed vulvar biopsy including: lichen sclerosus, allergic/irritant dermatitis, lichen planus, and other inflammatory or neoplastic dermatoses. Given the...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.03.004
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:Identifying patients at risk for preterm delivery continues to be difficult. We analyzed fetal fibronectin immunoassays in 763 subjects with threatened preterm delivery from 10 clinical sites. STUDY DESIGN:Symptomatic women between 24 weeks 0 days and 34 weeks 6 days with intact amniotic membranes and cervic...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/s0002-9378(97)70561-1
更新日期:1997-03-01 00:00:00
abstract::Twelve cases of retroperitoneal mucinous cystadenoma or mucinous cystadenocarcinoma in women have been reported in the literature. We report an additional case. The histogenesis of mucinous cystadenomas and mucinous cystadenocarcinomas in the retroperitoneum is not clear, but that these lesions may arise from teratoma...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90201-9
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVE:Our purpose was to test whether cocaine stimulates uterine activity in nonpregnant and pregnant rats. STUDY DESIGN:The carotid artery and jugular vein were chronically catheterized, and a microballoon probe was inserted into the uterine cavity of 15 pregnant and 14 nonpregnant female rats. Conscious animals ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70273-9
更新日期:1996-07-01 00:00:00
abstract::To determine whether abnormalities of the androgen receptor previously observed in skin fibroblasts from patients with androgen insensitivity syndrome also occur in the gonads of affected individuals, androgen receptor activity in the gonads of a patient with testicular feminization syndrome was investigated. Using co...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(84)90434-4
更新日期:1984-11-01 00:00:00
abstract:OBJECTIVE:Our objective was to evaluate women with clinical signs or chemical evidence of androgen excess by corticotropin stimulation testing. STUDY DESIGN:Seventy-six women with evidence of androgen excess were evaluated by corticotropin stimulation testing. Results were examined by plasma levels of dehydroepiandros...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91406-9
更新日期:1992-08-01 00:00:00
abstract::The investigation of estrogen and/or androgen administration on physical and psychological symptoms in the surgical menopause was carried out in a prospective, double-blind, crossover design. When patients who received either a combined estrogen-androgen drug or androgen alone were compared with those who received est...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(85)90001-8
更新日期:1985-01-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to conduct a systematic review of the literature of studies that examined the association between factor V Leiden and/or prothrombin gene variant and intrauterine growth restriction. STUDY DESIGN:This systematic review of studies assesses the association between factor V Leiden ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ajog.2004.09.011
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:In contrast to conventional laparoscopic sterilization, newer hysteroscopic approaches avoid the need for hospital admission, general anesthesia, and prolonged recovery. However, there are concerns that the feasibility, safety, and efficacy of hysteroscopic sterilization may be lower than established laparos...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.07.011
更新日期:2017-11-01 00:00:00