March 27th 2025
A new study found that open-label placebos can effectively reduce the intensity and interference of premenstrual syndrome symptoms, even when patients know they are taking a placebo.
Identifying Health Care Inequities in Screening, Diagnosis, and Trial Access for Breast Cancer Care: Taking Action With Evidence-Based Solutions
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16th Annual International Symposium on Ovarian Cancer and Other Gynecologic Malignancies™
May 3, 2025
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Addressing Healthcare Inequities: Tailoring Cancer Screening Plans to Address Inequities in Care
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Clinical Consultations™: Guiding Patients with Genital Psoriasis Toward Relief Through a Multidisciplinary Approach
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Burst CME™: The Patient Journey – Unmet Needs From Diagnosis Through Management of Migraine
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Burst CME™: Setting the Stage – Individualizing Migraine Care for Diverse Populations Across Care Settings
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Burst CME™: Optimizing the Use of CGRP Targeted Agents for the Treatment of Migraine
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Burst CME™: Optimizing Migraine Management – Addressing Unmet Needs, Individualizing Care for Diverse Populations, and Utilizing CGRP Targeted Agents
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‘REEL’ Time Patient Counseling™: Fostering Effective Conversations in Practice to Create a Visible Impact for Patients Living with Genital Psoriasis
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Navigating Low-Grade Serous Ovarian Cancer – Enhancing Diagnosis, Sequencing Therapy, and Contextualizing Novel Advances
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Burst CME™: Implementing Appropriate Recognition and Diagnosis of Low-Grade Serous Ovarian Cancer
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Burst CME™: Stratifying Therapy Sequencing for LGSOC and Evaluating the Unmet Needs of the Standard of Care
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Burst CME™: Understanding Novel Advances in LGSOC—A Focus on New Mechanisms of Action and Clinical Trials
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Cases and Conversations™: Navigating the Complexities of Managing Myasthenia Gravis in Pediatric and Pregnant Patient Populations
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Expert Illustrations and Commentaries™: Visualizing Glucocorticoid Receptor Modulation in Platinum-Resistant Ovarian Cancer—Looking at Novel Pathways With an Eye Toward the Future of Treatment
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The First World Congress On: Controversies in Obstetrics, Gynecology & Infertility
June 30th 2011Laparoscopic hysterectomy was first described in 1989 (Reich) and rapidly thereafter in 1991 laparoscopic pelvic lymphadenectomy was also described (Querleu). During the 1990s the role of pelvic and latterly para aortic lymphadenectomy has been extended and is now an integral part of best practice Gynaecological Oncology Departments.
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Gasless Gynecologic Laparoscopy
June 30th 2011After more than 50 years, pneumoperitoneum with carbon dioxide remains the standard for creating a working space for laparoscopic surgery. Although the physiologic problems resulting from CO2 pneumoperitoneum have been well documented, they are becoming more of a concern as older, more debilitated women are undergoing longer, more extensive laparoscopic procedures
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Laparoscopic Supracervical Hysterectomy in a Rural Minnesota Hospital
June 30th 2011Hysterectomy continues to be a common gynecologic operation. Approximately 600,000 patients undergo surgical removal of the uterus annually at a considerable cost to payers, patients, and society at large. Currently most hysterectomies are via the abdominal or vaginal approach but fortunately for patients laparoscopic assisted procedures are becoming more popular. Many studies have shown the laparoscopic approach as safe, effective, and a less intrusive alternative to open surgery.
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Transvaginal Hydro Laparoscopy: Preliminary Assessment of Cost-Effectiveness
June 30th 2011Transvaginal hydro laparoscopy (THL) is a new approach to pelvic anatomic evaluation in the infertile woman. In this procedure a dilating trocar is inserted through the osterior vaginal wall for endoscopic pelvic examination. Normal saline is used to float the bowel out of the pelvis so that one can evaluate the distal Fallopian tubes, ovarian surfaces, pelvic sidewalls, and the cul-de-sac. The THL procedure makes in-office pelvic endoscopy, hysteroscopy, and dye hydrotubation a reality.
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Hysteroscopic Resection Techniques
June 30th 2011In the last 20 years there has been an increased acceptance of hysteroscopic surgery into the gynecological surgical armamentarium. Endometrial ablation and resection offer viable alternatives to hysterectomy for women with intractable uterine bleeding.
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Hemisection Technique for Laparoscopic Myomectomy
June 29th 2011More than ten years have passed by since we first performed a laparoscopic myomectomy in our Department using Semm’s technique. As far as a subserous myoma is concerned, there are no particular problems; difficulties arise when dealing with intramural myomas.
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Laparoscopic Approach to Pelvic Prolapse
June 29th 2011From its beginnings back in 1991, in our Department, the laparoscopic approach to pelvic prolapse has changed considerably over the decade. Initially limited to strict reproduction of the techniques carried out by laparotomy, the introduction of a number of complementary procedures has provided an answer to all the situations encountered in the field of female genital prolapse repair.
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Laparoscopic Excision of Deep Fibrotic Endometriosis of the Cul-de-sac and Rectum
June 29th 2011Diagnosis and treatment of endometriosis is the most frequent reason for gynecologic operative laparoscopy in the United States (Peterson et al,1990). Therefore, the laparoscopist must be thoroughly familiar with the current standards of diagnosis and management of this complex disease.
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Laparoscopic Management of Hypogastric Vein Injury during Pelvic Lymphadenectomy
June 29th 2011The first laparoscopic lymphadenectomy was reported in the late 1980’s and safety of this procedure has been largely proved. Familiarity with instrumentation and management of complication is a prerequisite to perform this procedure.
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Laparoscopic rectosigmoid resection in case of deep endometriosis
June 29th 2011Introduction: Intestinal endometriosis is a disabling disease present in 6% to 30% of deep endometriosis cases. It can be the cause of abdominal bloating, constipation, intestinal cramping and painful bowel movements, defecation pain and intestinal stenosis up to intestinal occlusion. Colorectal endometriosis requires surgical treatment that can be performed by abdominal route or by laparoscopy. The present study describes the total laparoscopic rectosigmoid resection in case of deep endometriosis with bowel involvement.
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Myoma arising in a Cervical Stump
June 29th 2011After having been almost abandoned, supracervical hysterectomy has been recently re-advocated, especially after the development of laparoscopy, because it is stated to have less morbidity and minor intra-operative complications. However, long term outcomes report high incidences of late complications
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A Modified Technique for Laparoscopic Assisted Vaginal Hysterectomy
June 29th 2011Vaginal hysterectomy can be the standard procedure for removing the uterus, but surgical skills and indications to vaginal surgery are variable. Laparoscopic assistance to vaginal hysterectomy is a way to change the approach to hysterectomy. In this paper we describe our retroperitoneal technique for laparoscopic securing of the uterine pedicles.
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Laparoscopic Radical Hysterectomy and Bilateral Pelvic Lymphadenectomy using the Harmonic Scalpel
June 29th 2011The patient was a 30 year old female patient, para 0, who was diagnosed to have a cervical adenocarcinoma on a screening PAP smear. A subsequent endocervical curettage revealed a moderately differentiated adenocarcinoma with focal invasion. She underwent a cone biopsy and a repeated endocervical curettage which revealed an adenocarcinoma in situ with two foci of microinvasion consisting with a Stage IA2 lesion.
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Laser Surgery for Endometriosis
June 28th 2011To interpret the literature describing the results of surgery for endometriosis, a clear understanding of the evolution and limitations of the various techniques is necessary. Up to the end of the 1970’s, minimal and mild endometriosis was destroyed endoscopically by heat application (endothermia) and by unipolar or bipolar coagulation. Treatment of more severe endometriotic disease was mostly radical by hysterectomy, often leaving some rectovaginal endometriosis which has not been fully recognised before 1989.
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Laser surgery for endometriosis : deep endometriosis
June 28th 2011Endometriosis can infiltrate the surrounding tissues resulting in an important sclerotic, and inflammatory reaction which can translate clinically in nodularity, bowel stenosis and ureteral obstruction. The most severe forms such as rectovaginal endometriosis and endometriosis invading the rectum or the sigmoid have been known since the beginning of this century. These conditions, however, are relatively rare with an estimated prevalence of less than 1%.
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Laparoscopy, looking inside the abdomen through a tube placed through a small incision, is a procedure commonly used by gynecologists to diagnose and treat a number of medical conditions. Since the early 1900's when rudimentary laparoscopes were used to visualize, but not treat, abdominal diseases, advancements in this technique have led to the ability to perform complex surgical procedures through a few small incisions, rather than the larger incisions used in the past.
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Welcome to this, my first column for OBGYN.net. My hope is that my monthly articles will entertain, question and stimulate you in all areas of OBGYN. I am a general obstetrician and gynecologist working in North London, United Kingdom with particular interests in endoscopic surgery and urogynaecology. I am also an award winning medical journalist. Over the coming months I hope to share my experiences and thoughts with you, challenge our beliefs and contribute to the ongoing debate that shapes improvements in clinical care. I welcome your feedback.
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Most patients with endometriosis do not have intestinal (GI) involvement. Among the difficult cases of endometriosis I see from around the world, only 27% have GI involvement. Since over 1900 patients with endometriosis have undergone surgery at St. Charles, that means I’ve operated on over 500 patients with GI involvement. The symptoms of GI involvement depend on the severity and location of the disease. The severity of disease depends on the depth of invasion into the bowel wall.
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S.I.G.N. for Hysteroscopic Surgery
June 28th 2011If we consider how the management of our patient's medical problems has changed throughout the years, it is easy to despair at the well-meaning intentions of our predecessors. Though we still cannot be complacent about many of the current treatment options for patients, a new era of evidence based practice as opposed to the intuitive based practice of former times has evolved. Evidence based practice is not a panacea, but it can provide us with an insight into the advantages and disadvantages of existing therapies, and expose their weaknesses thus encouraging further research.
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Diagnostic Laparoscopy in Gynaecological Problems: A Retrospective Study
June 28th 2011Objective: To study the findings obtained by diagnostic laparoscopy in gynaecological problems in order to re-assess the role of laparoscopy in the diagnosis of gynaecological problems during the study period.
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Tubal Ectopic Pregnancy: Laparoscopy vs. Laparotomy
June 28th 2011Objectives: To compare the efficiency of laparoscopic treatment versus conventional abdominal surgery in the treatment of ectopic pregnancy (EP) and to review the clinical presentation, evaluate methods of diagnosis, and identifying the risk factors.
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Extraperitoneal Laparoscopic Aortic Lynphadenectomy in Gynecological Cancer
June 28th 2011A preliminary examination under anaesthesia should be performed, the results of pre-operative investigations should be checked to confirm the indications and limitations of the proposed procedure. The retroperitoneal lomboaortic lymphadenectomy achieved via a left internal iliac approach (Dargent et al, 2ooo). The left side is chosen for this approach because most of the lymphnodes are found in the left paraortic region (Michel et al,1998) and because it is also possible to dissect on the right side via this approach (Dargent et al, 2000).If the preoperative work-up reveals right side adenopathy, a similar approach on the right is entirely possible.
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FERTILOSCOPY in the MANAGEMENT OF FEMALE INFERTILITY
June 28th 2011Following the first studies carried on by S. Gordts, the technique of Fertiloscopy has been developed, starting in 1997, by A.Watrelot at the "Centre Lyonnais de recherche et d'étude de la stérilité (CRES®)". Fertiloscopy is a new minimally invasive methods for the exploration of the posterior cul-de-sac which allows a complete work out of the mechanical factors of female infertility.
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Total laparoscopic hysterectomy (TLH) has for me since 1996 completely replaced all abdominal hysterectomies, except when the uterus is bigger than 1 kilo. A series of larger uteri have been operated (my biggest was 1850 grams) but when a uterus is larger than 1 kilo it is preferable to discuss the surgery in detail with the patient beforehand.
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