Article
Health Care Sciences & Services
Su Hyeon Choi, Seyeon Won, Nara Lee, So Hyun Shim, Mi Kyoung Kim, Mi-La Kim, Yong Wook Jung, Bo Seong Yun, Seok Ju Seong
Summary: The aim of this study was to introduce a coaxial-robotic single-site myomectomy (C-RSSM) technique to compensate for the shortcomings of robotic single-site myomectomy (RSSM) using semi-rigid instruments and to compare the surgical outcomes of C-RSSM and RSSM. The results showed that the C-RSSM group had a lower estimated blood loss (75.0 vs. 210.5 mL, p = 0.001) and a shorter operating time (101.0 vs. 146.1 min, p = 0.008) compared to the RSSM group. Therefore, C-RSSM is associated with shorter operative time and lower estimated blood loss.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Medicine, General & Internal
Sa-Ra Lee, Ju-Hee Kim, Young-Jae Lee, Shin-Wha Lee, Jeong-Yeol Park, Dae-Shik Suh, Dae-Yeon Kim, Sung-Hoon Kim, Yong-Man Kim, Young-Tak Kim
Summary: The study compared the perioperative outcomes of single-incision robotic myomectomy and multiport robotic myomectomy, finding no significant differences in operative time, estimated blood loss, and other outcomes. Although patients in the two groups had different demographic characteristics initially, these differences disappeared after propensity score matching.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Obstetrics & Gynecology
Priscila Almeida Barbosa, Marina Villaescusa, Marina Paula Andres, Luiz Flavio Cordeiro Fernandes, Mauricio S. Abrao
Summary: Several methods, such as vasopressin and barbed sutures, can help control bleeding during laparoscopic myomectomy by reducing blood loss. However, intravenous infusion of tranexamic acid (TXA) did not show a significant difference in bleeding control. Uterine artery occlusion (UAO) and emergency uterine artery embolization may also be feasible in reducing and treating bleeding before converting to laparotomy, but further studies are needed to confirm their efficacy.
CURRENT OPINION IN OBSTETRICS & GYNECOLOGY
(2021)
Article
Oncology
Shi-Fang Zhou, Hai-Yan Wang, Kun Wang
Summary: This study compared the surgical outcomes of laparoendoscopic single-site myomectomy (LESS-M) and conventional laparoscopic myomectomy (CLM) and found that in certain conditions, CLM had shorter operation time and less blood loss than LESS-M. The results suggest that LESS-M is safe and feasible, but the use of single-port surgery should be carefully considered in specific scenarios.
ANNALS OF TRANSLATIONAL MEDICINE
(2021)
Editorial Material
Obstetrics & Gynecology
Rodrigo Pinto Fernandes, Fabio Fin, Raquel Magalhaes, Rene Pareja, Armando Romeo, Audrey Tsunoda, Arnaud Wattiez
Summary: The study demonstrates the importance of planning all steps of laparoscopic myomectomy to ensure the safety and success of the procedure. The patient recovered well post-operation, confirming the effectiveness of the method.
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY
(2021)
Article
Health Care Sciences & Services
Seyeon Won, Su Hyeon Choi, Nara Lee, So Hyun Shim, Mi Kyoung Kim, Mi-La Kim, Yong Wook Jung, Bo Seong Yun, Seok Ju Seong
Summary: This study compared the surgical outcomes between robotic single-site plus two port myomectomy (RSTM) and conventional robotic multi-port myomectomy (CRM). The results showed that RSTM had a shorter operative time, less hemoglobin decrement, and shorter duration of hospital stay compared to CRM.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Article
Obstetrics & Gynecology
Sandra Coll, Silvia Feliu, Claudia Montero, Maria Pellise-Tintore, Francesc Tresserra, Ignacio Rodriguez, Pere Nolasc Barri-Soldevila
Summary: A retrospective analysis of 625 patients who underwent laparoscopic myomectomy revealed that the most common symptom was heavy uterine bleeding. The use of temporary clipping of uterine arteries and infundibulopelvic ligaments during surgery was found to be associated with fewer intraoperative bleedings compared to injecting intramyometrial adrenaline.
EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY
(2021)
Article
Obstetrics & Gynecology
Peng-Hsuan Huang, Meng-Chieh Tsai, Wan-Hua Ting, Hui-Hua Chen, Ho-Hsiung Lin, Sheng-Mou Hsiao
Summary: The clinical outcome of laparoscopic myomectomy using Quill (TM) suture appears to be comparable to that using V-Loc (TM) suture.
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
(2022)
Article
Endocrinology & Metabolism
Zhaojun Zeng, Ying Liu, Jingxian Xia
Summary: This study aimed to assess the clinical efficacy and safety of laparoscopic myomectomy for uterine fibroids. The findings showed that compared to open surgery, laparoscopic myomectomy reduced intraoperative bleeding, shortened operation time and hospital stay, and lowered the incidence of postoperative complications. It also resulted in better clinical outcomes.
JOURNAL OF BIOLOGICAL REGULATORS AND HOMEOSTATIC AGENTS
(2023)
Article
Obstetrics & Gynecology
Sarah Simko, Kai Dallas, Andrea L. Molina, Matthew T. Siedhoff, Kelly N. Wright, Jennifer T. Anger, Mireille D. Truong
Summary: This study assessed the rates of complications and reoperations after myomectomy for myoma disease and identified associated factors. The results showed that minimally invasive myomectomy had lower complication rates compared to abdominal myomectomy, although it had higher reoperation rates throughout the study period. However, the odds of reoperation after minimally invasive myomectomy decreased each year and surpassed abdominal myomectomy in 2015.
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY
(2022)
Review
Medicine, General & Internal
Mihai Cristian Dumitrascu, Catalin-George Nenciu, Adina-Elena Nenciu, Amalia Calinoiu, Adrian Neacsu, Monica Cirstoiu, Florica Sandru
Summary: Laparoscopy is a common procedure for benign gynecological tumors, but it can be challenging for myomas. Ongoing research focuses on improving outcomes through port access, suture type, morcellation, and complication management. Myomectomy is the main surgical option for uterus-sparing procedures, with laparoscopic technique being crucial due to potential impacts on fertility and pregnancy outcomes. This review collates data on different suture techniques, including advantages, difficulties, and possible long-term impacts.
FRONTIERS IN MEDICINE
(2023)
Editorial Material
Obstetrics & Gynecology
Shengke Wang, Dongdong Wang, Fujie Zhao
Summary: This study presents a method that combines two novel ligation techniques for laparoscopic myomectomy for large lateral intraligamental myomas. The technique demonstrates significant advantages in reducing bleeding and avoiding unintentional injuries, particularly in broad ligament myomas, and does not increase the cost of surgery.
FERTILITY AND STERILITY
(2022)
Article
Obstetrics & Gynecology
Ayman Taher, Dalia Farouk, Mohamed Mahmoud Mohamed Kotb, Nevein Kamal Ghamry, Khaled Kholaif, Ahmed A. Mageed A. Allah, Ahmed Said Ali, Omneya M. Osman, Hala Nabil, Yomna Islam, Mohamed Sobhy Bakry, Bassem Aly Islam, Mahmoud Alalfy, Salma Ashraf Nassar, Almandouh H. Bosilah, Ashraf A. Ghanem, Nansy Mohamed Ali Rund, Rania Refaat, Hamada Ashry Abdel Wahed Ali, Ahmed Bakry, Ahmed S. A. Ashour, Mohamed Nabil, Sherif Sameh Zaki
Summary: The study demonstrates that carbetocin significantly reduces intraoperative blood loss and the need for blood transfusion during abdominal myomectomy, leading to lower postoperative hemoglobin levels and fewer side effects compared to placebo.
FERTILITY AND STERILITY
(2021)
Review
Surgery
Antonio Mercorio, Luigi Della Corte, Dominga Boccia, Mario Palumbo, Sabrina Reppuccia, Cira Buonfantino, Lara Cuomo, Maria Borgo, Antonio Zitiello, Maria Chiara De Angelis, Antonio Simone Lagana, Giuseppe Bifulco, Pierluigi Giampaolino
Summary: Adhesion formation after gynecological surgery is still a challenge. Minimally invasive surgical approaches combined with meticulous microsurgical principles and the use of adhesion-reducing substances can reduce the risk of new adhesion formation but cannot eliminate it completely. Myomectomy is the most adhesiogenic procedure and postoperative adhesions can affect fertility. Therefore, the benefits versus risks should be considered when using surgery as infertility treatment. Factors such as the size and location of fibroids play a significant role in adhesion development and post-surgical infertility, highlighting the importance of effective strategies against adhesion formation in this setting. This review aims to evaluate the incidence and factors of adhesion formation and discuss the best available preventive measures.
FRONTIERS IN SURGERY
(2023)
Article
Obstetrics & Gynecology
Jeremy C. Applebaum, Edward K. Kim, Margaret Rush, Divya K. Shah
Summary: This retrospective cohort study compared postoperative complication rates between same-day discharge patients and patients admitted to hospital after minimally invasive myomectomy. The study found that regardless of myoma burden, same-day discharge after minimally invasive myomectomy is associated with low complication rates.
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY
(2023)
Article
Oncology
Rafal Watrowski, Dan Cacsire Castillo-Tong, Eva Obermayr, Robert Zeillinger
ANTICANCER RESEARCH
(2020)
Article
Nutrition & Dietetics
Malgorzata Mizgier, Rafal Watrowski, Justyna Opydo-Szymaczek, Elzbieta Jodlowska-Siewert, Giovanni Lombardi, Witold Kedzia, Grazyna Jarzabek-Bielecka
Summary: The study found positive correlations between dietary fats and hormone parameters in PCOS and healthy girls, as well as positive correlation between SHBG and protein intake and negative correlation between SHBG and carbohydrate intake. In PCOS patients, an inverse correlation was observed between androgen concentrations and work/school and/or leisure time physical activity.
Article
Medicine, General & Internal
Stoyan Kostov, Ilker Selcuk, Angel Yordanov, Yavor Kornovski, Hakan Yalcin, Stanislav Slavchev, Yonka Ivanova, Svetla Dineva, Deyan Dzhenkov, Rafal Watrowski
Summary: Lymphadenectomy is an important surgical treatment for gynecological cancers. Pelvic and paraaortic lymphadenectomy are commonly performed procedures that help with staging, prognosis, and postoperative management. Anatomical variations of the vessels in the paraaortic region are common and can lead to complications during the surgery. It is crucial for surgeons to have detailed knowledge of these variations to prevent iatrogenic vessel injury.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Medicine, General & Internal
Stoyan Kostov, Ilker Selcuk, Rafal Watrowski, Yavor Kornovski, Hakan Yalcin, Stanislav Slavchev, Yonka Ivanova, Deyan Dzhenkov, Angel Yordanov
Summary: Except for early-stage tumors and fertility preservation, the surgical treatment of gynecological malignancies is not limited to the affected organ. Dissecting tissues in the region of metastatic iliac lymph nodes or gynecological tumors near the pelvic sidewall is necessary. In addition, surgeries for deep infiltrating endometriosis or oncological procedures often require dissection of the pelvic sidewall. Precise dissection and detailed anatomical knowledge are crucial. Terminology regarding the pelvic sidewall is controversial, and this study aims to define a new term and boundaries of a potential avascular space, the medial psoas space, for surgical guidance.
Review
Biotechnology & Applied Microbiology
Stoyan Kostov, Rafal Watrowski, Yavor Kornovski, Deyan Dzhenkov, Stanislav Slavchev, Yonka Ivanova, Angel Yordanov
Summary: Hereditary cancer syndromes, which result from low penetrant polymorphisms or single gene disorders, account for approximately 5-10% of all cancers. Significant progress has been made in the evaluation and management of these syndromes in the past decade. However, hereditary syndromes associated with gynecologic malignancies present a challenge for oncogynecologists, who tend to focus more on staging, histological type, and treatment options rather than considering inherited cancers and obtaining detailed family histories.
ONCOTARGETS AND THERAPY
(2022)
Article
Oncology
Rafal Watrowski, Eva Obermayr, Christine Wallisch, Stefanie Aust, Nicole Concin, Elena Ioana Braicu, Toon Van Gorp, Annette Hasenburg, Jalid Sehouli, Ignace Vergote, Robert Zeillinger
Summary: In this study, new proteomic-based models for non-invasive diagnosis of ovarian cancer (OC) were developed and validated. These models showed excellent performance in postmenopausal women but performed poorly in premenopausal patients and those with normal CA125 levels. Comparison with other algorithms and markers revealed no clear superiority of any model.
Review
Medicine, General & Internal
Salvatore Giovanni Vitale, Rafal Watrowski, Fabio Barra, Maurizio Nicola D'Alterio, Jose Carugno, Thozhukat Sathyapalan, Ilker Kahramanoglu, Enrique Reyes-Munoz, Li-Te Lin, Bulent Urman, Simone Ferrero, Stefano Angioni
Summary: Abnormal uterine bleeding is a common symptom in perimenopausal women, and various treatment options exist to alleviate symptoms and improve quality of life. Hysterectomy offers definitive symptom relief, while uterus-preserving minimally invasive treatments have high patient satisfaction but still carry the risk of recurrence and further intervention.
Article
Obstetrics & Gynecology
Radmila Sparic, Zoran Bukumiric, Radomir Stefanovic, Andrea Tinelli, Stoyan Kostov, Rafal Watrowski
Summary: This study evaluated the factors influencing long-term health-related quality of life (HRQoL) after excisional treatments for squamous intraepithelial cervical lesions (SIL). The results showed that women interested in reproduction had higher HRQoL scores, while women without pregnancy desire had lower HRQoL scores. Anxiety and depression were also found to be related to HRQoL.
JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2022)
Review
Medicine, General & Internal
Veronika Guenther, Leila Allahqoli, Rafal Watrowski, Nicolai Maass, Johannes Ackermann, Soeren von Otte, Ibrahim Alkatout
Summary: The human microbiome, particularly the vaginal microbiome, has gained importance in reproductive medicine due to its potential influence on infertility and implantation failure. Non-Lactobacillus-dominated microbiomes have been associated with dysbiosis and may negatively impact reproductive outcomes. Screening the microbiome and administering antibiotic and/or probiotic treatment could improve pregnancy outcomes.
Review
Biochemistry & Molecular Biology
Salvatore Giovanni Vitale, Anna Maria Fulghesu, Mislav Mikus, Rafal Watrowski, Maurizio Nicola D'Alterio, Li-Te Lin, Mohsin Shah, Enrique Reyes-Munoz, Thozhukat Sathyapalan, Stefano Angioni
Summary: MicroRNAs (miRNAs) play crucial regulatory roles in tissue development, differentiation, and metabolic processes. In the context of PCOS, altered miRNA levels have been associated with hormonal changes, glucose and lipid metabolism, and fertility issues. This systematic review provides an overview of miRNA expression, hormonal changes, and metabolic correlations in PCOS, highlighting the potential of miRNAs as therapeutic targets and diagnostic markers.
Editorial Material
Surgery
Rafal Watrowski, Stoyan Kostov, Radmila Sparic
FRONTIERS IN SURGERY
(2022)
Review
Medicine, General & Internal
Stoyan Kostov, Ilker Selcuk, Rafal Watrowski, Svetla Dineva, Yavor Kornovski, Stanislav Slavchev, Yonka Ivanova, Deyan Dzhenkov, Angel Yordanov
Summary: Ovarian cancer is a leading cause of death in gynecological malignancies, often presenting at an advanced stage. The most common routes of spread are peritoneal and lymphatic dissemination. The right subphrenic space is a target site for peritoneal metastases, particularly in the right upper quadrant. Complete cytoreduction is the most important prognostic factor.
Article
Surgery
Stoyan Kostov, Yavor Kornovski, Rafal Watrowski, Stanislav Slavchev, Yonka Ivanova, Angel Yordanov
Summary: Ovarian cancer is a common cause of death in women and usually spreads through the peritoneal dissemination and direct invasion. Optimal cytoreduction and adjuvant chemotherapy are the main treatment strategies. The radical surgical cytoreduction procedure, known as the Hudson procedure, has been modified over the years, but there are still disagreements and gaps regarding certain surgical steps. The purpose of this article is to outline the critical steps of the Hudson procedure and discuss the associated controversies and perioperative morbidity.
Article
Medicine, General & Internal
Stoyan Kostov, Yavor Kornovski, Vesela Ivanova, Deyan Dzhenkov, Dimitar Metodiev, Rafal Watrowski, Yonka Ivanova, Stanislav Slavchev, Dimitar Mitev, Angel Yordanov
Summary: Uterine corpus sarcomas are rare malignant neoplasms which pose challenges in diagnosis and treatment due to the small number of clinical trials, lack of evidence-based data, and insufficient interest from the pharmaceutical industry. The development of clinical practice guidelines and treatment protocols is also difficult due to the low frequency of these malignancies.
CLINICS AND PRACTICE
(2021)
Review
Surgery
Rafal Watrowski, Stoyan Kostov, Ibrahim Alkatout
Summary: Laparoscopic surgery is widely used in gynecology and general surgery, but may be associated with complications. Adverse events can be related to laparoscopic entry, pneumoperitoneum, or the use of instruments. This review provides comprehensive information on surgical complications in laparoscopy with a special focus on gynecology.
VIDEOSURGERY AND OTHER MINIINVASIVE TECHNIQUES
(2021)
