Journal of minimally invasive gynecology
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J Minim Invasive Gynecol · Jan 2019
Randomized Controlled Trial Multicenter StudyNew Crosslinked Hyaluronan Gel for the Prevention of Intrauterine Adhesions after Dilation and Curettage in Patients with Delayed Miscarriage: A Prospective, Multicenter, Randomized, Controlled Trial.
To evaluate the efficacy of a new crosslinked hyaluronan (NCH) gel in reducing the formation of intrauterine adhesions (IUAs) after dilation and curettage (D&C). ⋯ The current study demonstrates that IUAs are frequently formed after D&C for delayed miscarriage in women without a previous history of D&C procedures, and the application of NCH gel significantly reduces IUA formation.
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J Minim Invasive Gynecol · Jan 2019
Predictors of Overnight Admission after Minimally Invasive Hysterectomy in the Expert Setting.
To identify predictors of overnight admission after laparoscopic and robot-assisted hysterectomy to improve preoperative counseling and patient optimization. ⋯ Perioperative factors such as age, hematocrit, surgery time, and surgical history as well as intraoperative factors such as prolonged operative time are predictive of overnight hospital stay.
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J Minim Invasive Gynecol · Nov 2018
EditorialSurgical Catastrophe. Supporting the Gynecologic Surgeon after an Adverse Event.
Medical errors and adverse events (AEs) are unavoidable, and the effect of adverse outcomes on providers can be devastating. An intraoperative AE is often directly attributable to surgeon technical error or suboptimal intraoperative judgment. ⋯ Common reactions to AEs and individual and organizational strategies to support clinicians through the aftermath are reviewed. The goal of this commentary is to create awareness of the mental health impact and to describe options to help physicians involved in intraoperative AEs to recover from their experience related to bad surgical outcomes.
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J Minim Invasive Gynecol · Nov 2018
Case ReportsNerve-Sparing Technique during Laparoscopic Radical Hysterectomy: Critical Steps.
To show the feasibility and safety of nerve-preserving laparoscopic radical hysterectomy (type C1 Querleu-Morrow Classification [1]) for the treatment of early cervical cancer. ⋯ Nerve-sparing laparoscopic radical hysterectomy is an attractive surgical approach for early-stage cervical cancer. Direct visualization of the pelvic autonomic nervous system (sympathetic and parasympathetic branches) innervating the bladder and rectum makes the nerve-sparing approach a safe and feasible procedure.
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J Minim Invasive Gynecol · Nov 2018
Observational StudyAssessment of Obstetric and Gynecologic Food and Drug Administration Device Approvals and Recalls.
To evaluate and compare the recall rates of obstetric and gynecologic devices approved via the Food and Drug Administration's 510(k) and premarket approval (PMA) processes. ⋯ The recall event rate for the 510(k) approval process is 13.6 times the rate for the PMA approval process for obstetric and gynecologic devices. Analysis of the results suggests improper device risk classification, inappropriate assignment of the approval process, increased device malfunctions, recalls by the 510(k) process and, therefore, increased risk to patients by these devices. This warrants a call for improvement and increased scrutiny in the 510(k) approval process for devices used in obstetrics and gynecology.