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Reproductive Surgery: Current Trends and Future Perspectives
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Reproductive Surgery: Current Trends and Future Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: closed (25 January 2024) | Viewed by 6017

Special Issue Editors

Dr. Antonio Simone Laganà

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Guest Editor
Unit of Gynecologic Oncology, ARNAS “Civico—Di Cristina—Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
Interests: women’s health; gynecological oncology; minimally invasive procedures; up-to-date management; gynecology; reproductive health; surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Mislav Mikuš

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Guest Editor
Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, Petrova 13, 10 000 Zagreb, Croatia
Interests: minimally invasive surgery; endometriosis; adenomyosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

To date, reproductive surgery represents an important field of gynecology, aimed to preserve and restore the anatomy and functions of reproductive organs in both males and females. Indeed, several diseases such as endometriosis, adenomyosis, uterine fibroids, uterine malformations, pelvic inflammatory disease, and several other conditions may impair female fertility. These diseases are often found in women of reproductive age wishing to conceive; thus, fertility-sparing surgery is of paramount importance, and the surgeon dealing with them should be precisely trained for this purpose. In addition, the indications, timing, and techniques should be carefully evaluated and discussed with the patients, with or without subsequent assisted reproduction, especially using minimally invasive surgery (e.g., laparoscopy, robotic surgery, and hysteroscopy). In this regard, oocyte and ovarian tissue cryopreservation should be taken into account, especially when severe conditions, such as deep infiltrating endometriosis, are planned for surgical treatment. Finally, new perspectives are offered by novel approaches, from new instruments to innovative approaches such as uterine transplantation.

Considering these elements, the Special Issue “Reproductive surgery: current trends and future perspectives” aims to collect the most robust pieces of evidence about the topic and stimulate further discussion on future perspectives.

Dr. Antonio Simone Laganà
Dr. Mislav Mikuš
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • female infertility
  • male infertility
  • reproductive surgery
  • endometriosis
  • uterine fibroids
  • uterine malformations
  • pelvic inflammatory disease
  • fertility preservation
  • fertility-sparing surgery
  • minimally invasive surgery
  • laparoscopy
  • hysteroscopy
  • robotic surgery
  • assisted reproduction
  • oocyte cryopreservation
  • ovarian tissue cryopreservation
  • uterine transplantation

Published Papers (3 papers)

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Research

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9 pages, 516 KiB  
Article
Does Hysteroscopic Dissection of Partial Uterine Septum Represent a Risk Factor for Placental Abnormalities in Subsequent Pregnancy Compared with Controls Undergoing Other Hysteroscopic Surgery? Results from a Large Case–Control Analysis
by Pia Hajšek, Gaetano Riemma, Sara Korošec, Antonio Simone Laganà, Vito Chiantera, Mislav Mikuš and Helena Ban Frangež
J. Clin. Med. 2023, 12(1), 177; https://doi.org/10.3390/jcm12010177 - 26 Dec 2022
Cited by 5 | Viewed by 1672
Abstract
Background: Hysteroscopic septum dissection (HSD) is thought to improve fertility and pregnancy outcomes. However, the available literature suggests that uterine surgery can cause placental abnormalities in subsequent pregnancies. Methods: A case–control study was performed at the University Medical Center of Ljubljana, Department of [...] Read more.
Background: Hysteroscopic septum dissection (HSD) is thought to improve fertility and pregnancy outcomes. However, the available literature suggests that uterine surgery can cause placental abnormalities in subsequent pregnancies. Methods: A case–control study was performed at the University Medical Center of Ljubljana, Department of Human Reproduction, from 1 January 2016 to 31 December 2018. The primary outcome was the association between HSD and the occurrence of placental abnormalities. We included women who underwent HSD due to infertility. Age-matched women who underwent hysteroscopic surgery for other issues were considered as controls. In addition, we divided the groups according to conception method. Only singleton pregnancies and first delivery were considered. Results: A total of 1286 women (746 who underwent HSD and 540 controls) were included in the analysis. HSD had no influence on placental abnormalities since the ratio was comparable regardless of the method of conception (113/746 vs. 69/540; p = 0.515). Infertile women who conceived naturally after HSD had a normal placentation rate comparable to women who did not undergo HSD (380/427 vs. 280/312; p = 0.2104). The rate of placental abnormalities in women who achieved pregnancy with IVF/ICSI procedures following HSD was comparable to that of women who did not undergo HSD (52/319 vs. 33/228; p = 0.5478). Placenta previa occurred significantly more often in infertile women without HSD after IVF/ICSI compared to natural conception (2/312 vs. 7/228; p = 0.0401). Conclusions: HSD was not associated with higher rate of placental abnormalities in the first singleton pregnancy compared with other hysteroscopic procedures. A higher rate of placenta previa in pregnancies following IVF/ICSI procedures, which was shown by our research, is corroborated by previous research findings. Full article
(This article belongs to the Special Issue Reproductive Surgery: Current Trends and Future Perspectives)
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Review

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14 pages, 304 KiB  
Review
An Overview of Postoperative Intraabdominal Adhesions and Their Role on Female Infertility: A Narrative Review
by Stefan Ghobrial, Johannes Ott and John Preston Parry
J. Clin. Med. 2023, 12(6), 2263; https://doi.org/10.3390/jcm12062263 - 15 Mar 2023
Cited by 8 | Viewed by 2498
Abstract
Postoperative intraabdominal adhesions can occur after more than 90% of gynecologic surgeries. They not only cause chronic pelvic pain and small bowel obstruction, but are also one of the main reasons for infertility. Adhesions are not only a burden for the affected patients, [...] Read more.
Postoperative intraabdominal adhesions can occur after more than 90% of gynecologic surgeries. They not only cause chronic pelvic pain and small bowel obstruction, but are also one of the main reasons for infertility. Adhesions are not only a burden for the affected patients, but are also a burden for the healthcare system, since the treatment of adhesion-associated complications costs a considerable amount of money. The gold standard for the diagnosis of adhesions is by laparoscopy, although other methods, such as transvaginal hydro-laparoscopy, are being discussed as better alternatives. Ideally, adhesions are avoided inherently, by operating carefully and by using microsurgical principles. If this is not possible, gel barriers have been shown to be successful in reducing postoperative adhesions. Full article
(This article belongs to the Special Issue Reproductive Surgery: Current Trends and Future Perspectives)

Other

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8 pages, 888 KiB  
Case Report
A Clinical and Ethical Dilemma: Expectant Management for Ectopic Pregnancy with a Vital Fetus in a Low-Resource Setting
by Michele Orsi, Foday Musa Janneh, Amadu Sesay, Abdul Karim Bah and Nitsuh Addis Tiru
J. Clin. Med. 2023, 12(17), 5642; https://doi.org/10.3390/jcm12175642 - 30 Aug 2023
Viewed by 1292
Abstract
Background: Guidelines recommend the prompt surgical removal of any ectopic pregnancy (EP) in the presence of a vital embryo. This treatment impacts future fertility, particularly in low-resource settings where access to assisted reproductive techniques is limited. In addition, growing evidence is reporting live [...] Read more.
Background: Guidelines recommend the prompt surgical removal of any ectopic pregnancy (EP) in the presence of a vital embryo. This treatment impacts future fertility, particularly in low-resource settings where access to assisted reproductive techniques is limited. In addition, growing evidence is reporting live births after conservative management of initially undiagnosed abdominal pregnancies. Therefore, the discussion on the acceptability of expectant management in selected cases has been recently raised. Case: We present and discuss the case of a woman with vital first trimester EP who refused surgical treatment at Princess Christian Maternity Hospital, Freetown, Sierra Leone. She was initially diagnosed with a 12 week pregnancy located in the left adnexal region without hemoperitoneum. She refused both surgical treatment and hospital admission and did not come back to the hospital for antenatal care until 26 weeks of gestational age. Therefore, she was admitted and finally delivered, at 34 weeks of gestation, a 1.9 kg healthy baby which was alive. To disentangle the potential conflict between the ethical principles of medical treatment’s beneficence and the patient’s autonomy, we provide an update on counselling for a patient with early vital EP in a resource-limited setting and discuss the knowledge gap in this area. Conclusions: Limited access to fertility treatment in low- and middle-income countries may justify the discussion of expectant management as an option in selected cases of uncomplicated vital EP. Full article
(This article belongs to the Special Issue Reproductive Surgery: Current Trends and Future Perspectives)
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