New Advances in Gynecological Surgery: Part II

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: closed (20 December 2023) | Viewed by 3075

Special Issue Editors

Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
Interests: gynecological surgery; hysteroscopy; laparoscopy; endometriosis; gynecological oncology; urogynecology
Special Issues, Collections and Topics in MDPI journals
Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
Interests: laparoscopic surgery; hysteroscopic surgery; gynecological surgery; endometriosis; gynecological oncology; obstetrics; assisted reproductive techniques
Special Issues, Collections and Topics in MDPI journals
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

Special Issue Information

Dear Colleagues,

Over the years, gynecological surgery has evolved due to the numerous technological innovations that have paved the way for new therapeutic approaches. Minimally invasive surgery is the standard approach to the performance of several gynecologic procedures. Surgical innovations in hysteroscopic surgery (mini-resectoscopes, intrauterine morcellators, tissue retrieval systems, diode lasers, new miniaturized mechanical instruments, endometrial ablation devices, and portable and entry-level hysteroscopes) have radically changed the methods of treating intrauterine pathologies.

Laparoscopic surgery has widely extended its applications, with the development of miniaturized instruments (mini- and micro-laparoscopy), CO2 laser vaporization, diode laser vaporization, in-bag contained port-site power morcellement or transvaginal extraction of the surgical specimen, and even the adoption of natural orifice specimen extraction (NOSE), following bowel resection for deep infiltrating endometriosis robotic-assisted surgery has been adopted in several countries. Robotics may offer technological and ergonomic benefits that overcome the limitations associated with conventional laparoscopy. In addition, the recent development of vaginal natural orifice transluminal endoscopic surgery (vNOTES) has allowed us to combine the advantages of a minimally invasive approach, such as laparoscopy, with the known benefits of vaginal surgery. In this Special Issue, we would like to move this field forward by inviting original clinical and basic research articles, meta-analyses, and systematic reviews focused on new advances in gynecological surgery.

The purpose of this Special Issue is to address the recent developments of gynecological surgical procedures and new technological advances. We look forward to receiving your submissions to move the field of gynecological surgery forward.

Dr. Felice Sorrentino
Prof. Dr. Luigi Nappi
Dr. Antonio Simone Laganà
Guest Editors

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Keywords

  • hysteroscopy
  • laparoscopy
  • robotics
  • vNOTES
  • laser
  • gynecological surgery
  • resectoscope

Published Papers (2 papers)

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Research

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11 pages, 4513 KiB  
Article
The Feasibility of Practical Training in Minimally Invasive Surgery at Medical School—A Prospective Study on the Pelvitrainer
Medicina 2024, 60(1), 159; https://doi.org/10.3390/medicina60010159 - 15 Jan 2024
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Abstract
Background and Objectives: The acquisition of practical skills at medical school is an important part of the multidimensional education program of future physicians. However, medical schools throughout the world have been slow in incorporating practical skills in their curriculum. Therefore, the aims [...] Read more.
Background and Objectives: The acquisition of practical skills at medical school is an important part of the multidimensional education program of future physicians. However, medical schools throughout the world have been slow in incorporating practical skills in their curriculum. Therefore, the aims of the present prospective study were (a) to demonstrate the feasibility of such surgical training, (b) to objectify its benefit in medical education, and (c) to investigate the impact of such training on subsequent career choices. Material and Methods: We introduced a two-day laparoscopy course on the pelvitrainer as part of the curriculum of the gynecological internship of fifth year medical students from 2019 to 2020. The results of the students’ training were matched to those of surgeons who completed the same curriculum in a professional postgraduate laparoscopy course from 2017 to 2020 in a comparative study design. Additionally, we performed a questionnaire-based evaluation of the impact of the course on medical education and subsequent career choices directly before and after completing the course. Results: A total of 261 medical students and 206 physicians completed the training program. At baseline, the students performed significantly more poorly than physicians in a median of three of four exercises (p < 0.001). However, this evened out in the final runs, during which students performed more poorly than physicians only in one exercise and even better than physicians in one. The general integration of surgical training in medical school curricula was rated very low (12.4% on the VAS, IQR 3–16%) despite the high demand for such training. In the survey, the course was deemed very beneficial for medical education (median VAS 80.7%, IQR 73–98%), but did not appear to influence the students’ subsequent career preferences. Conclusions: The acquisition of practical surgical skills during medical school is significantly under-represented in many medical faculties. The benefits of such training, as demonstrated in our study, would improve the education of future physicians. Full article
(This article belongs to the Special Issue New Advances in Gynecological Surgery: Part II)
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Review

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Review
Adenomyosis and Infertility: A Literature Review
Medicina 2023, 59(9), 1551; https://doi.org/10.3390/medicina59091551 - 26 Aug 2023
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Abstract
Background and Objectives: Adenomyosis (the presence of ectopic endometrial glands and stroma below the endometrial–myometrial junction) is a benign condition which is increasingly diagnosed in younger women suffering from infertility. The aim of this narrative review was to study the pathophysiology and [...] Read more.
Background and Objectives: Adenomyosis (the presence of ectopic endometrial glands and stroma below the endometrial–myometrial junction) is a benign condition which is increasingly diagnosed in younger women suffering from infertility. The aim of this narrative review was to study the pathophysiology and prevalence of adenomyosis, the mechanisms causing infertility, treatment options, and reproductive outcomes in infertile women suffering from adenomyosis. Materials and Methods: A literature search for suitable articles published in the English language was performed using PubMed from January 1970 to July 2022. Results: The literature search retrieved 50 articles that met the purpose of this review and summarized the most recent findings regarding the accuracy of diagnostic methods, pathophysiology, and the prevalence of adenomyosis and optimal strategies for the treatment of infertile women with adenomyosis. Conclusions: Adenomyosis is a common gynecological disorder, affecting women of reproductive age. It negatively affects in vitro fertilization, pregnancy and the live birth rate, as well as increases the risk of miscarriage. With the advent of non-invasive diagnoses with MRI and TVUS, the role of adenomyosis in infertility has been better recognized. Overall, more randomized controlled trials (RCTs) are needed to provide strong data on the accuracy of diagnostic methods, the pathophysiology and the prevalence of adenomyosis, the fertility outcomes of patients and the optimal strategy for the treatment. Full article
(This article belongs to the Special Issue New Advances in Gynecological Surgery: Part II)
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