2014 Award Winning Abstracts & Videos

quality of life (HRQL) scale which consists of 6 subscales. Study Objective: To evaluate clinical aspects of patients who had Measurements and Main Results: Sample size calculation suggested that Endometrial cancer after Endometrial Ablation (EA). 16 women needed to be recruited to demonstrate adequate power.Twenty Design: Retrospective study (Canadian Task Force classification II-3). women completed questionnaires at baseline and 3 months post surgery. Setting: University affiliated Tertiary medical center in Southeastern Eighteen women completed questionnaires at 6 months. Prior to surgery, Michigan. women had poor quality of life as evidenced by high symptom severity Patients: 3 patients who underwent endometrial ablation after exclusion of score and low HRQL scores. These scores were lower than those in the endometrial malignancy by biopsy, and were diagnosed later as having published literature suggesting that women with submucous fibroids are Endometrial cancer. more symptomatic. In addition, there was considerable impact on daily Intervention: Patient who underwent endometrial ablation. Measurements and Main Results: All patients had multiple risk factors for endometrial cancer prior to EA [Table 1]. UFS-QoL and VAS scores at baseline and 3 months post surgery At time of EA, 2 patients were postmenopausal and additional patient was Subscale Baseline (Mean) 3 months (mean) p value 37 years old. In all cases, endometrial cancer was excluded by endometrial sampling prior to EA. The EA method was Hysteroscopic endometrial Symptom severity score 70.78 32.66 \0.001 resection. an aborting myoma. This was Stage II at presentation and has required WEDNESDAY, NOVEMBER 19, 2014 Concern 9.0 59.75 \0.001 Abstracts / Journal of Minimally Invasive Gynecology 21 (2014) S1–S44 S7 Vaginal bleeding was the first ominous symptom in all cases, and it occurred further treatment. The second was occult found at the time of prolapse Listed below are the winning abstracts and videos for the 43rd AAGL Global21 Congress on17.5 Minimally Invasive Gynecology. Abstracts /// Journal of Minimally Invasive Gynecology (2014) S1–S44 S7 Abstracts Journal of Minimally Invasive Gynecology 21 (2014) S1–S44 S7 Abstracts Journal of Minimally Invasive Gynecology 21 (2014) S1–S44 S7 Activities 67.32 \0.001 1 Plenary 1 Laparoscopy in a time range of 70-120 months post EA. Endometrial cancer was surgery and would have been considered Stage Ia1 if not morcellated. She ly Invasive All Gynecology 21 (2014) S136–S190 of these awards willAM) be presented during the General SessionThe on Wednesday, November 19, 2014 7:45am toevidence 9:05am, completely and sentfor for frozen section. Theresult result wasreported reported asnegative. negative. TheCT CTimaging imaging presented several implants inat the pelvic peritoneum, the Energy 25.71 70.71 \0.001 confirmed by office sampling. (11:00 -for 11:09 has not had any other treatment and remains without of presented several implants in pelvic peritoneum, the completely and sent frozen section. was as completely and sent frozen section. The result was reported as The CT imaging presented several implants in the pelvic peritoneum, the completely andAM sent for frozen section.The The result was reported asnegative. negative. The CT imaging presented several implants in the the pelvic peritoneum, the Then the excised cervix was removed and sent for frozen section. After a sigmoid and the small intestine. Control 25.25 67.50 \0.001 lly Invasive Gynecology 21 (2014) S136–S190 Surgery included total hysterectomy, bilateral salpingo-oophorectomy and recurrence 2 years after the surgery. except for the Robert B. Hunt award, which will be presented during the JMIG Reception. They will also be presented at sigmoid and the small intestine. Then the excised cervix was removed and sent for frozen section. After a Then the excised cervix was removed and sent for frozen section. After sigmoid and the small intestine. g of Comparison of demographic, historical and clinical parameters did notaa Then the excised cervix was removed and sent for frozen section. After sigmoid and the small intestine. Morcellated Uterine Pathology in 815 Consecutive negative endocervical margin was confirmed onfrozen frozen section,the thecervical cervical After aaa laparoscopic laparoscopic exploration for staging staging the disease, complete Self-consciousness 27.92 67.08 \0.001Invasive Gyn LN sampling. Final pathology was Endometroid Adenocarcinoma in all Conclusion: The majority of the cases this series (99.75%) benign. After exploration for the disease, aMinimally negative endocervical margin was confirmed on section, / Journal ofwere negative endocervical margin was confirmed on frozen section, the After exploration for staging the disease, aaa complete complete wing distinguish these 3 scheduled cases except that the patient with stage III disease had3 their regularly times. negative endocervical margin was confirmed frozen section, the6cervical cervical After a laparoscopic laparoscopic exploration forinAbstracts staging the disease, complete Patients aofSingle Academic Institution ng of Comparison demographic, andonclinical did not stumpwere were closed and the upper vagina sutured. Ittook took us about hours to laparoscopic cytoreduction was performed. Sexual function 24.34 57.50 was 0.25%. Uterine \0.001 cases, at at aundiagnosed stage of IA, IBupper andhistorical IIIC, respectively. Theparameters patient with stage The incidence of endometrial cancer in this population laparoscopic cytoreduction was performed. stump closed and the vagina sutured. It us about 6 hours to stump were closed and the upper vagina sutured. It took us about 6 hours to laparoscopic cytoreduction was performed. ionprolonged postmenopausal bleeding. stump were closed and theexcept upper vagina sutured. It Sekhon took us about 6and hours to laparoscopic cytoreduction was performed. finish the procedure, procedure, no intraoperative complications occurred blood Ascher-Walsh CJ,3 Rosen L, Perera E,the Robbins L,III Barr R,blood wing Wepresente presente the video ofscores. the laproscopic procedure. distinguish these cases that patientA, with stage disease had activities andthe high pain Following surgery, thereofwas significant or r Total HRQL 20.15 \0.001 IA disease did receive adjuvant patient with stage IB sarcomas are very rare and none were found in the66.16 series 815 aconsecutive We video of the laproscopic procedure. finish the no intraoperative complications occurred and finish the procedure, no intraoperative complications occurred and blood We presente the video of the laproscopic procedure. ostConclusion: EAnot should be utilized withtreatment, caution inthe patients with risk factors finish the procedure, no intraoperative complications occurred and blood We presente the video of the laproscopic procedure. losswas wasM. 400ml. The patient delivered baby at34.2 34.2with week’s gestation. After ionprolonged undiagnosed postmenopausal bleeding. Mamik Obstetrics, Gynecology and Reproductive Sciences, Icahn Conclusion: Inall selected patients with expert expert laparoscopic surgeons, improvement in quality of life measures at 3 25.2 months (table 1) and this 2013 disease received pelvic radiation and the patient stage IIIC disease VAS score 68.4 0.004 patients undergoing power morcellation. loss 400ml. The patient delivered baby at week’s gestation. After loss was 400ml. The patient delivered baby at 34.2 week’s gestation. After Conclusion: In selected patients with laparoscopic surgeons, Conclusion: In selected patients with expert laparoscopic surgeons, for endometrial cancer, particularly in postmenopausal age group. loss was delivered baby atNew 34.2 week’s gestation. After Conclusion: In selected with expert laparoscopic surgeons, one more more year’s follow-up, bothNew the mother and infant were healthy. postConclusion: EA The should be utilized with caution in patients riskhealthy. factors cytoreduction of ovarian /// patients tube carcinoma can be performed safely by by School of400ml. Medicine atpatient Mt. Sinai, York, York did not changeof significantly at 6 months (table 2).be There was a reduction in received radiation +chemotherapy. Patients stage Iwith disease are in Sett one year’s the mother and infant were one more year’s follow-up, both the and infant were cytoreduction ovarian tube carcinoma can performed safely cytoreduction of ovarian tube carcinoma can be performed safely by . At Further studies arefollow-up, needed to both establish amother risk with assessment model tohealthy. guide one more year’s follow-up, both the mother and infant were healthy. cytoreduction of ovarian / tube carcinoma can be performed safely by NB: Higher the symptom severity score, the poorer the quality of life. Compared toatcancer, the abdominal abdominal and vaginalwith radical trachelectomy, for endometrial particularly inthe postmenopausal age III group. laparoscopy. due Forto survival analysis is isand necessary to promote promote multicenter absenteeism fibroid analysis symptoms pain scores after surgery. There remission for least 4abdominal years, while patient stage disease died Pati Compared to the and vaginal radical trachelectomy, Compared to the and vaginal radical trachelectomy, laparoscopy. For survival necessary to multicenter laparoscopy. For survival analysis is necessary to promote multicenter No application of EA for abnormal uterine bleeding. Compared to the abdominal and vaginal radical trachelectomy, For analysis is necessary toofpromote 2laparoscopy. Plenary 1 survival - Laparoscopy The higher the HRQL scores, the better thescores quality life 3 andmulticenter Best Paper on Hysteroscopy Study Objective: To assess the provided risk of abnormal uterine pathology in radical trachelectomy provided wider and amplified view of m. At Further studies are needed to establish a risk assessment model to guide prospective studies. was no statistically significant difference in between 6 months. 9laparoscopic month from diagnoses. laparoscopic radical trachelectomy aaaawider and amplified view of Inte laparoscopic radical trachelectomy provided wider and amplified view of prospective studies. prospective studies. rted. laparoscopic radical trachelectomy provided wider and amplified view of prospective studies. (11:10 AM 11:15 AM) patients undergoing laparoscopic supracervical hysterectomy or surgicalfields, fields, andfor lower disturbance tothe themobile mobileof ofuterus. uterus. No application of EA abnormal uterine bleeding. Conclusion: This is the first prospective study looking at quality of life surgical and lower disturbance to mob surgical fields, and lower disturbance to the mobile of uterus. ood surgical fields, and lower disturbance to the mobile of uterus. 492 laparoscopic myomectomy specimen power morcellation. 492 AM - 8:00with AM) rted. Table 1 (7:45 measures women hysteroscopic myomectomy. Women with sme Laparoscopic Management an Advanced Interstitial UFS-QoLinand VAS undergoing scores at of baseline and 6 months after surgery ost24 Video Sessionhave Oncology Design: Retrospective chart review. lood Risk for Endometrial Cancer Myomectomy: submucous fibroids significantlyAbstracts poorer quality of oflife indicators / Journal Minimally Invasive pelv Gyn 21 Factors Video Session 1---Oncology Oncology 492 24 Video Session 1111----Oncology Quality of Life after Hysteroscopic 24 Video Session Oncology Pregnancy 85% 21 Video Session 1 21 Video Session 1 Oncology 24 Video Session Oncology Subscale Baseline (Mean) 6 months (Mean) p value 21 Video Session 1 - Oncology post(11:49 AM--compared -11:55 11:55AM) AM) University prior AM, to surgery to of theObstetrics publishedand literature on fibroids. (11:28 AM---Hospital. 11:34 AM) cavi (11:49 ASetting: Prospective Observational Study (11:49 AM 11:55 AM) Ecker LeeAM TTM. Department Gynecology, Mageemeet Abstracts / Journal of Minimally Invasive Gyn Risk Factor Case 1 Case 2 Case 3 (11:28 AM 11:34 AM) (11:28 AM 11:34 AM) (11:49 AM 11:55 AM) Quality of 825 LifeAM after Hysteroscopic Myomectomy: 85% (11:28 - 11:34 AM) portion of the mesh. This is repeated posteriorly. technique allows the Patients: consecutive laparoscopic supracervical hysterectomies or 760 Hysteroscopic myomectomy is associated withThis significantly improved proc T.2 1Obstetrics and Gynaecology, Universiity Uchil D,1 Vandrevala % by Womens Hospital of UPMC, Pittsburgh, Pennsylvania Comparing New Technique for Minimal Invasive Para Symptom severity 70.78 39.58length. \0.001 Sentinel Lymph NodeMapping Mapping for Endometrial A Prospective Observational Study Comparing New Technique for Minimal Invasive Para meet Comparing New Technique for Minimal Invasive Para secure attachment of the mesh to the full vaginal laparoscopic myomectomies from 6/06 through 2 7/13 performed by the quality life measures at 3 and 6 months post surgery. Sentinel Lymph Node for Endometrial Sentinel Lymph Node Mapping for Endometrial Comparing New Technique for Minimal Invasive Para portion of the mesh. This is repeated posteriorly. This technique allows the 760 base wing Age (years) 66 Research 37 Design Service 62 Hospital London, Kingdom; Sentinel Lymph Node Mapping for Endometrial 1Lewisham, 2 1 United Chr Aortic Infra Renal Lymphadenectomy Using Barb Concern 9.0 49.71 0.002 Cancer: AVandrevala Contemporary Approach toSurgical Surgical T. Obstetrics and Gynaecology, Universiity % by Uchil D, A Aortic Infra Renal Using Aortic Infra Renal Lymphadenectomy Using Barb same surgeon. Cancer: Contemporary Approach to Interstitial pregnancy represents only 2-4% ofBarb all ectopics but has a secure attachment ofLymphadenectomy the mesh to the fullSafe, vaginal length. Cancer: A Contemporary Approach to Surgical Aortic Infra Renal Lymphadenectomy Using Barb Mea % at South East, University of Surrey, Guidlford, Kingdom Obesity + United + Cancer: A Contemporary Approach to Surgical 2 Suture to Standard Techniques. It Is Feasible and Reso Activities 17.5 54.41 \0.001 Chr wing Staging Lewisham, Research or Design Service Hospital London, United Kingdom; Suture to Standard Techniques. Suture to Standard Techniques. It Is Safe, Feasible and Intervention: Laparoscopic supracervical hysterectomy laparoscopic mortality up to 2.5%. Staging (m/k Staging Suture torate Standard Techniques. It It Is Is Safe, Safe, Feasible Feasible and and life 493 Hypertension + + 1 1 1 2 1 Staging Effective Para Energy 25.71 59.03 \0.001 Reso % at Barbi A, T,111Surrey, Kolev V.222 111OB/GYN, OB/GYN, Lenox HillHospital, Hospital, New LiuL, L,111East, 11 Kolev South University of Guidlford, United Kingdom myomectomy with removed byquality power morcellation. Means and Effective Effective 758 Here we present the case of a 25yo G3/1101 who was incidentally found to Ther 1 Kolev Barbi A, T, Kolev V. Lenox Hill New Liu Barbi A, Kolev T, Kolev V. OB/GYN, Lenox Hill Hospital, New Liu L, Tospecimen assess difference in of life measures following Study Objective: Effective Diabetes Mellitus + 2 Barbi A, Kolev T, Kolev V. OB/GYN, Lenox Hill Hospital, New Liu L, Mikl Nahas S. Gynecologic Oncology, Trillium Health Partners, Credit Valley life Control 25.25 66.18/Partners, \0.001 Para Mount Sinai Beth Israel, New York,New NewYork York York,New New York; 22 OB/GYN, standard deviations calculated withSinai SPSS software package. 10-Year Retrospective Analysis of Unintended Nahas S. Gynecologic Oncology, Trillium Health Credit Valley Nahas S. Gynecologic Oncology, Trillium Health Partners, Credit Valley Abstracts Journal of Minimally Invasive Gyn have an 11 week 2 day interstitial pregnancy. After resection of the 36.1 2 hysteroscopic myomectomy in women with submucous fibroids. OB/GYN, Mount Beth Israel, New York, York, York; 758 OB/GYN, Mount Sinai Beth Israel, New York, New York York, New York; port Nahas S. Gynecologic Oncology, Trillium Health Partners, Credit Valley Dysfunctional Bleeding - Israel, + - York Minilaparoscopic Repair of a Vesicovaginal Fistula Canada 0.006 OB/GYN, Mount Sinai Beth New York, New York;Uterine Asso Hospital,University University ofToronto, Toronto, Mississauga, Ontario, Study Objective: To assess difference in quality of lifeNew measures following Self27.92 51.96 Mikl Measurements and Main Results: cases wereYork, laparoscopic Pregnancies Essure Sterilization Hospital, of Mississauga, Ontario, Canada Hospital, University of Toronto, Mississauga, Ontario, Canada pregnancy, theafter defect was closed with a in 2-0the unidirectional barbed suture bein Design: Prospective observational study. 394 ieve Hospital, University of Toronto, Mississauga, Ontario, Canada Post Menopausal Bleeding + + Mattingly P, Taylor B. Obstetrics and Gynecology, Carolinas Medical Sentinellymph lymphmyomectomy node (SLN)mapping mapping may bean ancases acceptable surgical strategy hysteroscopic in women with submucous fibroids. port Minilaparoscopic of a Following Vesicovaginal Fistula Asso activities and high Repair pain scores. surgery, there was a significant or re supracervical hysterectomies andmay 431 were laparoscopic Netherlands in 3consciousness layers. Sentinel node (SLN) be acceptable surgical strategy Sentinel lymph node (SLN) mapping may be acceptable surgical strategy follo Setting: Secondary teaching hospital in+an inner London. Sentinel lymph nodecare (SLN) mapping mayand be an acceptable strategy Objective: To demonstrate newand surgical technique inminimal minimal invasive The + surgical Family Cancer (Uterine/Ovarian/ Center, Charlotte, North Carolina betweenh/o acomplete complete lymphadenectomy no nodal evaluation inpatients patients Design: Prospective observational study. ieve Mattingly P, Taylor B.E.Obstetrics Gynecology, Carolinas Medical Objective: To aaaanew surgical technique in invasive improvement indemonstrate all(2014) quality of life measures at 3 months (table 1) and this 2013 myomectomies. Sexual function 24.34 71.32 \0.001 Objective: To demonstrate new surgical technique in minimal invasive Abstracts / evaluation Journal of in Minimally Invasive Gynecology 21 S1–S44 S7 Veersema S, Hitzerd Obstetrics & Gynecology, St. Antonius Hospital, between a lymphadenectomy and no nodal between a complete lymphadenectomy and no nodal evaluation in patients satis Objective: To demonstrate new surgical technique in minimal invasive Abstracts / Journal of Minimally Invasive Gynecology 21 (2014) S1–S44 S7 Prememopausal women with submucosal fibroids undergoing Patients: between a complete lymphadenectomy andNational no nodalComprehensive evaluation in patients com infra renal parasignificantly aortic lymphadenectomy compared tostandard standard techniques. Breast/Colon) with endometrial cancer. Themost mosthospital recent Cancer The Setting: Secondary care The teaching in inner Comprehensive London. infra renal para aortic lymphadenectomy compared to techniques. did not change at 6 months (table 2). There was a reduction in infra renal para aortic lymphadenectomy compared to standard techniques. Center, Charlotte, North Carolina Sett Total HRQL 20.15 57.66 \0.001 with endometrial cancer. recent National Cancer Nieuwegein, Utrecht, Netherlands with endometrial cancer. The recent National Comprehensive Cancer and infra renal para aortic lymphadenectomy compared to standard techniques. hysteroscopic myomectomy. with endometrial cancer. The most most recent National Comprehensive Cancer This video demonstrates a minilaparoscopic repair acases vesicovaginal fistula, our Method: Retrospective data collection for allofcases with high risk Network guidelines includes recommendations and techniques for SLN completely and sent for frozen section. The result was reported as negative. The CT imaging presented several implants in the pelvic peritoneum, the com absenteeism due to fibroid symptoms and pain scores after surgery. There Patients: Prememopausal women with submucosal fibroids undergoing Method: Retrospective data collection for all with high risk Method: Retrospective data collection for all cases with high risk Pati VAS score 68.4 28.1 \0.001 Network guidelines includes and for SLN Network guidelines includes recommendations and techniques for SLN h/o: history ofsent for diffe completely andPatients frozenrecommendations section. The result(Uterine was techniques reported assymptoms negative. The CT imaging presented several implants in the pelvic peritoneum, the Demographics Method: Retrospective data collection for all cases with high risk Network guidelines includes recommendations and techniques for SLN completed the UFS-QoL fibroid Intervention: using 3mm laparoscopic instruments. Athat year of oldaavesicovaginal multigravida with a simu endometrial cancer andintestine. cancerthat required fullstaging. staging. mapping for endometrial endometrial cancer. Theand use offor pericervical injection of Then the excised cervix was removed sent frozen section. section. Afterof sigmoid and thesmall small This video demonstrates aovarian minilaparoscopic repair fistula, our was no statistically significant difference in38becoming scores between 3staging. and 6 months. hysteroscopic myomectomy. endometrial cancer and ovarian cancer required full endometrial cancer and ovarian cancer that required aaincreasingly full staging. Study Objective: Essure sterilization is popular Inte mapping cancer. The use of pericervical injection mapping for endometrial cancer. The use of pericervical injection of ThenQuality the for excised cervix was removed and sent for frozen After aa sigmoid and the intestine. were endometrial cancer and ovarian cancer that required fullMean Mean Age Mean Parity Mean BMI Mean Pre-op uterine Mean Mass of the Number mapping for endometrial cancer. The use of pericervical injection of and of Life) questionnaire and an additional questionnaire on history of cervical incompetence underwent a transvaginal cerclage inco Result: A total of 23 patients were included, ten cases without the use of Vfluorescent indocyanide green dye, combined with infrared camera and negative endocervical was confirmed on with frozen section, the cervical After laparoscopic exploration for staging the disease, amethod complete using laparoscopic instruments. Astaging 38 year old multigravida with a simu Conclusion: This ispatients the first prospective study at quality ofof life Intervention: Patientsmargin completed the UFS-QoL (Uterine fibroid symptoms in the3mm Netherlands. Even though Essure is cases alooking permanent of Result: A total of 23 were included, ten without the use VResult: A total of 23 patients were included, ten cases without use of Vmob fluorescent indocyanide green dye, combined infrared camera and fluorescent indocyanide green dye, combined with infrared camera and negative endocervical margin was confirmed on frozen section, the cervical After aaweeks, laparoscopic exploration for the disease, athe complete with F,2 Result: A total of 23 patients were included, ten cases without the use of Vfluorescent indocyanide green dye, combined with infrared camera and impact on daily activities and VAS scores for pain before hysteroscopic (SD) (SD) (SD) size in (SD) specimen in grams (SD) of myomas (SD) without any recognized complications. However, she presented with A pa lock(group (group 1), and13 13 withpregnancies theuse use ofunderwent V-lock suture (group 2). Comparing the laparoscopic approach canaid aid inidentification, identification, isolation, and removal stump were and the upper vagina sutured. It took took usquestionnaire about hours to laparoscopic cytoreduction was performed. history ofin1), cervical incompetence ahave transvaginal cerclage inco measures women undergoing hysteroscopic myomectomy. Women with and Quality of approach Life) and an additional on contraception, unintended afterwards been2). reported. The lock and with the of V-lock suture (group Comparing lock (group 1), and 13 with the use of V-lock suture (group 2). Comparing smea the laparoscopic can in isolation, and the laparoscopic approach can aid in identification, isolation, and removal stump were closed closed and questionnaire the upper vagina sutured. It us about 663removal hours to laparoscopic cytoreduction was performed. 7 re y, 2 lock (group 1), and 13 with the use of V-lock suture (group 2). Comparing the laparoscopic approach can aid in identification, isolation, and removal myomectomy. Women completed the same questionnaires at and 6 urinary incontinence later in that pregnancy andBMI diagnosed with a pain group 1 to group 2, they had an average age 60 to 63, 28.5 to 29, length of SLNs. F, finish the procedure, no intraoperative complications occurred and blood We presente the video of the laproscopic procedure. without any recognized complications. However, she presented with A pa submucous fibroids significantly poorer quality life indicators Lapx myomectomy, 40.45 (11.95) 0.22 (0.58) 24.67 (5.36) 13.56 (302.57) 3.38 (3.04) impact on procedure, daily activities and VAS scores for pain before hysteroscopic aim of11(3.29) this study isthey tohave identify factors that contribute to of the occurrence of group to 2, had an average age 60 to BMI 28.5 to 29, length group to group 2, they had an average age 60 to 63, 63, BMI 28.5 to 29, length pelv of SLNs. of SLNs. finish the noThe intraoperative complications occurred and blood We presente thefistula. video of the318.96 laproscopic procedure. requ y group togroup group 2, they had an average age 60 63, BMI 28.5 to 29, length of SLNs. months postoperatively. UFS-QoL consists of 37 questions which are vesicovaginal When vaginal repair is tonot feasible, para ofstay stay1to (LOS) 1to toselected 1,EBL EBL 140 tothat 120, operative time 233 tovesicovaginal 251 minutes, loss was 400ml. The patient delivered baby at 34.2 34.2 week’s gestation. After urinary incontinence later in pregnancy and diagnosed with a pain y, Conclusion: In patients with expert laparoscopic surgeons, prior surgery compared to the published literature on fibroids. myomectomy. Women completed thebaby same questionnaires at 3 and 6 unintended pregnancies after Essure sterilization. of (LOS) 1 1, 140 120, operative time 233 to 251 minutes, n=431 of stay (LOS) 1 to 1, EBL 140 to 120, operative time 233 to 251 minutes, cavi loss was 400ml. The patient delivered at week’s gestation. After fibro Conclusion: In patients with expert laparoscopic surgeons, of stay (LOS) 1traditionally toselected 1, EBL 140 to post 120, operative time 233 to 251 minutes, grouped to year’s produce a Symptom Severity scale and a Health related fistulas have been repaired by laparotomy. However, requ number oflymph lymph node to 13, operative complication to 1, and and one follow-up, both the consists mother and infant were healthy. vesicovaginal fistula. When vaginal repair iswith not feasible, para cytoreduction of ovarian /to tube carcinoma can be performed safely by y Hysteroscopic myomectomy is carcinoma associated significantly improved months postoperatively. UFS-QoL of 37infant questions which are number of node 7777/to 13, post operative complication 000safely to 22 Video Session 1The Oncology number of lymph node 13, post operative complication to 1, Design: Retrospective case-series analysis. Lapx SCH, n=394 47.61 (7.84) (1.62) 27.70 (6.49) 13.97 (5.05) 586.12 (1089.03) NAvesicovaginal proc one more more year’s follow-up, both the mother were healthy. cytoreduction of ovarian tube be performed by norm number of lymph node to 13, post operative complication to 1, 1, and and 22 Video Session 1abdominal ----Oncology 22 Video Session 11scale Oncology quality of life (HRQL) which consists of1.55 6 and subscales. literature shows that laparoscopic repair is acan safe and feasible 0multicenter alternative. her q readmission rate 0 in both groups. 22 Video Session Oncology Compared to the and vaginal radical trachelectomy, fistulas have traditionally been repaired by laparotomy. However, requ laparoscopy. For survival analysis is necessary to promote quality ofNational life measures at groups. 3analysis and 6 months post surgery. grouped to produce aabdominal Symptom Severity scale radical and a Health related readmission rate 000survival in both readmission rate in both groups. base (11:35 AM 11:41 AM) and Compared toAM the---Main vaginal trachelectomy, Setting: multicenter. laparoscopy. For is necessary totechnique promote multicenter Con had readmission rate in both groups. (11:35 11:41 AM) (11:35 AM 11:41 AM) Sample size calculation suggested that Measurements and Results: The purpose of this video is to demonstrate a for a miniappr Conclusion: The new techniquerepair usingisthe the V-lock suture yields yields to aaa laparoscopic provided a wider wider and amplified amplified view view of of literature shows that laparoscopic a safe and feasible alternative. her (11:35 AM -trachelectomy 11:41 prospective studies. quality of liferadical (HRQL) scaleAM) which provided consists of 6 subscales. Conclusion: The new technique using V-lock suture to laparoscopic radical trachelectomy a and Conclusion: The new technique using the V-lock suture yields to Mea prospective studies. Patients: Thirty-five pregnancies were reported in thesuture Netherlands after andaq Conclusion: Thethis new usingwith the V-lock yields to a 16 women to be recruited to to demonstrate adequate laparoscopic repair of atechnique vesicovaginal fistula, using 3mm laparoscopic the Majority ofneeded theand cases in both groups were simple myomas (52.8% inthat the Here we describe several tools minimize blood during Successful Pregnancy after Targeted Hysteroscopy for power.Twenty significantly higher lymph node count similar operative time, LOS, surgical fields, lower disturbance the mobile of uterus. The purpose of video is tothrough tocount demonstrate aloss technique for a 12,000 miniappr had Measurements and Main Results: Sample size calculation suggested Successful Pregnancy after Targeted Hysteroscopy for significantly higher lymph node with similar operative time, LOS, Successful Pregnancy after Targeted Hysteroscopy for surgical fields, and lower disturbance to the mobile of uterus. significantly higher lymph node count with similar operative time, LOS, (m/k Essure sterilization from 2002 2013 out of an estimated plac 493 Successful Pregnancy after Targeted Hysteroscopy for 73.3% significantly higher lymph node count with similar time, LOS, women completed questionnaires at baseline and 3 months post surgery. instruments. were laparoscopic supracervical hysterectomy group and in the management of advanced pregnancy: development of the avascular EBL,and andreadmission readmission rate. Endometrial Adenocarcinoma laparoscopic repair ofrate. a ectopic vesicovaginal fistula, usingoperative 3mm laparoscopic the 16 women needed to be recruited to1 demonstrate adequate power.Twenty EBL, Endometrial Adenocarcinoma EBL, and readmission rate. Endometrial Adenocarcinoma Thera placements. tern 1 myomectomy 2months. Prior1 to 1 surgery, EBL, and readmission rate. Endometrial Adenocarcinoma Eighteen women completed questionnaires at 6 com laparoscopic group ) spaces to allow temporary ligation of all major contributory blood supplies, 22 Leyland 11 Obstetrics Ibrahim Al-Dossary M, LeaderA, A, NA.11post ArendasVideo K,11 Ibrahim instruments. were 24 Video Session Oncology 10-Year Retrospective of Unintended . women completed questionnaires at11 Leader baseline and 3 months surgery. 24 Video Session 11 Analysis -- Oncology 21 Session 11 --ofOncology 2 Leyland 1 1Obstetrics 36.1 Al-Dossary M, NA. Arendas K, Ibrahim Al-Dossary M, Leader A, Leyland NA. Obstetrics Arendas K, Intervention: Data regarding Essure placement procedure, confirmation 21 Video Session Oncology Ibrahim Al-Dossary M,1evidenced Leader A,there Leyland NA. Obstetrics Arendas K,1consecutive women had poor quality life as by high symptom severity Of 825 morcellated specimen, were noCanada; sarcomas. 16 injection of vasopressin, andSterilization judicious useinofthe vessel sealing devices. com andthe Gynecology, McMaster University, Hamilton, Ontario, (11:49 AM -Essure - 11:55 11:55 AM) Pregnancies after stern Best Surgical Video Eighteen women completed questionnaires at 6 months. Prior to surgery, (11:49 AM AM) bein (11:28 AM 11:34 AM) and Gynecology, McMaster University, Hamilton, Ontario, Canada; tests, and pregnancy outcome were obtained and analyzed of the reported and Gynecology, McMaster University, Hamilton, Ontario, Canada; (11:28 AM - 11:34 AM) n of score and low HRQL scores. These scores were lower than those in the 2 and Gynecology, McMaster University, Hamilton, Ontario, Canada; specimens showed some nuclear atypia but did not not have the combined 759 25 Video Session 2 Urogynecology 761 Obstetrics, Gynecology and Medicine (Endocrinology), Univerityseverity of 22 Netherlands women had Gynecology poor qualityand of life as evidenced by high symptom 25 Video Session 222 ---ofUrogynecology follo 25 Video Session Urogynecology cases to identify a cause failure. 2Obstetrics, Medicine (Endocrinology), Univerity of Obstetrics, Gynecology and Medicine (Endocrinology), Univerity of Comparing New Technique for Minimal Invasive Para ving 25 Video Session Urogynecology published literature suggesting that women with submucous fibroids are Obstetrics, Gynecology and Medicine (Endocrinology), Univerity of atypia, necrosis and to Ottawa, meet criteria a STUMP tumor. 2 495 Comparing New Technique for Minimal InvasiveSt.Para Abstracts Journal of Minimally Invasive Gynecology 21 (2014) S136–S190 S149 Sentinel Lymph Node Mapping for Endometrial (11:00 AM -11:06 11:06 AM) Ottawa, Ottawa Fertility Centre, Ontario, Canada 759 Sentinel Lymph Nodemitosis Mapping forscores Endometrial on of Veersema S,(8:00 Hitzerd E. Obstetrics & Gynecology, Antonius Hospital, score and low HRQL scores. These were/for lower than those in the 759 AM 8:15 AM) 761 satis (11:00 AM AM) (11:00 AM 11:06 AM) Obturator Neuralgia a Rare Complication of TVT Measurements and Main Results: The main causes of failure were Ottawa, Ottawa Fertility Centre, Ottawa, Ontario, Canada Ottawa, Ottawa Fertility Centre, Ottawa, Ontario, Canada 3 Plenary 1 Laparoscopy Lap Aortic Infra Infra Renal Renal Lymphadenectomy UsingBarb Barb more symptomatic. Incarcinomas addition, there was considerable on daily (11:00 AM -Lymphadenectomy 11:06 AM) (0.25%) endometrial were found. One was impact misdiagnosed as Ottawa, Fertility Centre, Ottawa, Ontario, Canada Aortic Using Cancer: A Contemporary Approach to Surgical ving Cancer:Ottawa Aliterature Contemporary Approach to Surgical published suggesting that women with submucous fibroids are Nieuwegein, Utrecht, Netherlands and Imp perforation (n=10), expulsion (n=7), and unilateral placement (n=7). Another Sling: Complete Resolution After Laparoscopic TVT Neovaginoplasty Using Labial and Vestibular (11:16 AMUsing -Techniques. 11:25 AM) Tela activities and carcinoma high pain can scores. Following surgery, there was a significant or requesting sterilization treated from January through December Obturator Neuralgia a Labial Rare Complication of 2010 TVT Suture to Standard Standard Techniques. Safe, Feasible and Lap Neovaginoplasty and Vestibular Suture to ItIt IsIs Safe, Feasible and Endometrial affect youngwas women under theage age of 40on in3-5% 3-5% Neovaginoplasty Using Labial and Vestibular Staging more symptomatic. In can addition, there considerable impact daily Staging Neovaginoplasty Using Labial and Vestibular diffe Endometrial carcinoma affect young women under the of 40 in Endometrial carcinoma can affect young women under the age of 40 in 3-5% End cause was luteal pregnancy (n=2). The occurrence of most pregnancies was Removal Advancement Flap in Patients with M€ u llerian Agenesis Endometrial carcinoma can affect young women under the age of 40 in 3-5% 1 1 1 2 1 improvement in all quality of life measures at 3 months (table 1) and this 2013 (II-2). Gala tors Sling: Complete Resolution After Laparoscopic TVT Effective 2 1OB/GYN, Tela of cases. In patients patients who desire future fertilityLenox and refuse refuse hysterectomy, Advancement Flap in Patients with M€ u Agenesis Effective Advancement Flap in Patients with M€ uullerian llerian Agenesis A, T, Kolev V. Lenox Hill Hospital, Hospital, New Liu L, Study Objective: Essure sterilization is becoming increasingly popular Unexpected Uterine and Other Gynecologic Pathology Barbi A,1 Kolev Kolev T,1desire Kolevfuture V. OB/GYN, Hill New Liucases. L,1 Barbi were Advancement Flap inSarcoma Patients with M€ llerian Agenesis of In who fertility and hysterectomy, of cases. In patients who desire future fertility and refuse hysterectomy, related to physician noncompliance (n=14). The other cases were associated Men Miklos JR, Moore RD, Chinthakanan O.Koo International Urogynecology Moon HS, Kim SG, Choi JK, Park GS, JS. Ob/Gyn, Good Moonhwa of cases. In patients who desire future fertility and refuse hysterectomy, did not change significantly at 6 months (table 2). There was a reduction in 22 scores Setting: University affiliated teaching hospital. Removal Nahas S. Gynecologic Oncology, Trillium Health Partners, Credit Valley UFS-QoL and VAS at baseline and 3 months post surgery conservative therapy after detailed counseling can be a option. This video Gala Nahas S.Netherlands. Gynecologic Oncology, Trillium Health Partners, Credit Valleyof Moon HS, Kim SG, Choi JK, Park GS, Koo JS. Ob/Gyn, Good Moonhwa Moon HS, Kim SG, Choi JK, Park GS, Koo JS. Ob/Gyn, Good Moonhwa OB/GYN, Mount SinaiLapx Beth can Israel, York,This Newvideo York York, in thepatient Even though Essure isPerformed aOb/Gyn, permanent method Malignancies Diagnosed after Hysterectomy ctors with OB/GYN, Mount counseling Sinai Beth Israel, New York, New York York, New New York; York; conservative therapy after detailed be aNew option. Lapx conservative therapy after detailed counseling can be aaafter option. This video Moon HS, Kim SG, Choi JK, Park GS, Koo JS. Good Moonhwa with noncompliance (n=5) or misinterpretation of the confirmation Was Ileal Associates, Alpharetta, Georgia conservative therapy after detailed counseling can be option. This video absenteeism due to fibroid symptoms and pain scores surgery. There Hospital, Busan, Korea was Patients: Women presenting with AUB and/or requesting sterilization. Miklos JR,University Moore RD, Chinthakanan O. International Urogynecology Hospital, University of Toronto, Toronto, Mississauga, Ontario, Canada describes aaa case case of of stage stage IA IA endometrial endometrial adenocarcinoma adenocarcinoma treated treated with with of Mississauga, Ontario, Canada Hospital, Korea Hospital, Busan, Korea contraception, unintended pregnancies afterwards been The for Indications 7Chr re describes describes case of stage IA endometrial treated with myomectomy SCH Total Subscale Baseline (Mean) 3between months p value Hospital, Busan, Korea UFS-QoL VAS scores at baseline and 3 adenocarcinoma months post surgery test Benign (n=9).Busan, Time of conception was estimated to behave more thanreported. three months satis describes aand case of stage IAdifference endometrial adenocarcinoma treated with was no statistically significant inbe scores 3(mean) and 6 months. trial Ileal Intervention: Pelvic examination determined the size, shape, tenderness, Associates, Alpharetta, Georgia targeted hysteroscopic resection. The patient subsequently conceived using Sentinel lymph node (SLN) mapping may an acceptable surgical strategy aim of this study toD, factors that contribute tosling the and occurrence of Sentinelhysteroscopic lymph node (SLN) mapping may be an acceptable conceived surgical strategy was requ Mahnert N, Morgan Johnston C, As-Sanie S. of Obstetrics targeted resection. The patient subsequently using targeted hysteroscopic resection. The patient subsequently conceived using after placement in ismost cases (n=26). Obturator neuralgia is aaidentify rare complication ofwomen suburethral placement but M€ ullerian llerian agenesis is rare congenital anomaly the female genital tract Lapa targeted hysteroscopic resection. The patient subsequently conceived using trial Conclusion: This is the first prospective study looking at quality of life Objective: To demonstrate a new surgical technique in minimal invasive satis mobility, and position of the uterus. All had pre-operative Pap Subscale Baseline (Mean) 3 months (mean) p value M€ u agenesis is a rare congenital anomaly of the female genital tract assisted reproductive technology and had a successful pregnancy with Objective: To demonstrate a new surgical technique in minimal invasive M€ u llerian agenesis is a rare congenital anomaly of the female genital tract between a complete lymphadenectomy and no nodal evaluation in patients betweenreproductive aseverity complete lymphadenectomy and no nodal patients unintended pregnancies after Essure trial M€ unormally llerian agenesis ainrare congenital anomaly ofMichigan the female genital tract fibro Myoma 316 208 in \0.001 524 assisted technology and had aaa successful pregnancy with Symptom score 70.78 32.66evaluation assisted reproductive technology and had successful pregnancy with Gynecology, University of Michigan, Ann Arbor, it associated with transobturator (TOT) We present Stud Conclusion: The results of this study sterilization. show the incidence of pregnancies with an incidence ofis 4000 female births and accounts forapproximately approximately urete assisted reproductive technology and had successful pregnancy with measures inoutcome. women undergoing hysteroscopic myomectomy. Women with Obturator neuralgia is ain rare complication of suburethral sling placement buta infra renal para aortic lymphadenectomy compared toslings. standard techniques. Lapa smear, transvaginal tothat assess uterine cavity and with an incidence of 1sono(hystero)graphy in 4000 female births and accounts for infra renal para aortic compared tothe standard techniques. excellent Two casemost series where focal hysteroscopic resection with an incidence of 111lymphadenectomy 4000 female births and accounts for approximately with cancer. The recent National Comprehensive Cancer with endometrial endometrial cancer. The most recent National Comprehensive Cancer Design: Retrospective case-series analysis. trial with an incidence of in 4000 female births and accounts for approximately norm excellent outcome. Two case series where focal hysteroscopic resection excellent outcome. Two case series where focal hysteroscopic resection Adenomyosis 5 26 31 Concern 9.0 59.75 \0.001 patient with a case of obturator neuralgia and gait disturbance after a follo after Essure sterilization is low. Most pregnancies were related to incorrect 10% of primary amenorrhea. Affected individuals have absence of the intra excellent outcome. Two case series where focal hysteroscopic resection rred submucous fibroids have significantly poorer quality of life indicators it normally associated with transobturator (TOT) slings. We present a urete Method: Retrospective data collection for all cases with high risk pelvic organs, and endometrial biopsy to determine ease of insertion, Symptom severity score 70.78 32.66 \0.001 10% of primary amenorrhea. Affected individuals have absence of the was used to manage stage IA endometrial carcinoma with subsequent 10% of primary amenorrhea. Affected individuals have absence of the Network guidelines includes recommendations and techniques for SLN Method: Retrospective data collection for all cases with high risk Network techniques for SLN Study To define the incidence of karyotype, unexpected uterine sarcoma Setting: National multicenter. 10% ofObjective: primary Affected individuals have absence of the was used to manage stage IA endometrial carcinoma with was used to manage stage IA endometrial carcinoma with subsequent Con Myoma +surgery Adenomyosis 4 96 onsubsequent 100 Activities 17.5 67.32 \0.001 tension free vaginal tape type retropubic sling. The patient’s levo positioning of a amenorrhea. device or(TVT) unilateral placement, and seem therefore vagina and uterus with normal 46XX female functional ovaries with was used to manage stage IA endometrial carcinoma with subsequent was prior to compared to the published literature fibroids. patient with a case of obturator neuralgia and gait disturbance after a intra endometrial cancer and ovarian cancer that required a full staging. cavity length, patient tolerance, and obtain endometrial sample. All Concern 9.0 59.75 \0.001 vagina and uterus with normal 46XX female karyotype, functional ovaries attempts at pregnancy among thetreated treated patients arealso alsoreviewed. reviewed. Key vagina and uterus normal 46XX female karyotype, ovaries mapping for endometrial cancer. pericervical injectionKey of endometrial cancerwith andpregnancies ovarian cancer that required athe fullfunctional staging. mappingwith The95use of 70.71 pericervical injection of and other gynecologic malignancies among women whotheadhering underwent rred vagina andwas uterus with normal 46XX female karyotype, functional ovaries Patients: Thirty-five were reported incharacteristics. Netherlands after attempts at pregnancy among the patients are attempts at pregnancy among the treated patients are also reviewed. Key and Myoma degeneration 31 126 Energy 25.71 \0.001 condition remedied after complete TVT removal from obturator preventable. We want to emphasize the importance of strictly to and normal development of secondary sexual Various Des hyst attempts at pregnancy among the treated patients are also reviewed. Key Hysteroscopic myomectomy is associated with significantly improved S6 Abstracts / Journal of Minimally Invasive Gynecology 21 (2014) S1–S44 tension free vaginal tape (TVT) type retropubic sling. The patient’s with procedures were under general anesthesia. Patients werethe assessed at Result: total ofdone 23patients patients were included, tencases cases without the use and normal development of secondary sexual characteristics. Various points tosuccessful successful hysteroscopic management ofearly early stageendometrial endometrial and normal development of secondary sexual characteristics. Various fluorescent indocyanide green17.5 dye, infrared camera and Activities 67.32 \0.001 Result: AAtotal of 23 were included, ten without use ofofV-Vfluorescent combined of with infrared camera and hysterectomy for benign indications. was and normal development of secondary sexual characteristics. Essure sterilization from 2002 through 2013 out neovagina ofnerve an estimated 12,000 points to hysteroscopic management stage points to successful hysteroscopic management of early stage plac internus muscle and resection from the obturator using combined placement and follow-up protocols, as well as excluding aVarious luteal Myoma with degeneration +and 0 post surgery. 7 endometrial 7 Control 25.25 67.50 \0.001 surgical techniques have been suggested for formation in trans Sett points to successful hysteroscopic management of early stage endometrial and quality of life measures at 3 6 months condition was remedied after complete TVT removal from the obturator hyst baseline, 3, 6, 12 months and annually thereafter. lock (group 1), and 13 with the use of V-lock suture (group 2). Comparing surgical techniques have been suggested for neovagina formation in cancer are using a multi-disciplinary approach, thorough counseling of the surgical techniques have been suggested for neovagina formation in the laparoscopic approach can aid in identification, isolation, and removal lock (group 1), and 13 with the use of V-lock suture (group 2). Comparing Energy 25.71 70.71 \0.001 the laparoscopic isolation, and removal surgical techniques have been suggested for neovagina formation in Design: Retrospective chart review of aThe Michigan multi-center prospective placements. cancer are using aaa multi-disciplinary approach, thorough counseling of the cancer are using multi-disciplinary approach, thorough counseling of the vaginal and laparoscopic approach. pregnancy before placement. Unilateral placement without prior history patients with m€ u llerian agenesis. most widely used surgical crea adenomyosis 16 Open Communications 1 Robotics accurately predict overall lymph node status in 92% of cases when used Self-consciousness 27.92 67.08 \0.001 Pati cancer are using multi-disciplinary approach, thorough counseling of the all 3 internus muscle and resection from the obturator nerve using combined trans group 1 to group 2, they had an average age 60 to 63, BMI 28.5 to 29, length Measurements and Main Results: The mean(SD) Age (years), BMI patients m€ uuuthey llerian agenesis. most widely patient and availability availability of of aaa25.25 surgical team team 67.50 skilled in in hysteroscopic hysteroscopic patients with m€ llerian agenesis. The most widely used surgical of group 1 towith groupJanuary 2, had2012 an average age 60 to 63,procedure, BMI 28.5used to 29,surgical length of SLNs. SLNs. Control \0.001 and patients with m€ llerian agenesis. The most widely used surgical database 1st through December 8th 2013. patient and surgical skilled patient and availability of surgical skilled hysteroscopic Intervention: Data regarding Essure placement confirmation of salpingectomy should always be considered ascomplication unsuccessful 2 and The purpose of this video: 1) present an extremely rare of was techniques McIndoe operation, laparoscopic Davydov procedure, as part offrom ainclude comprehensive protocol. Single port laparoscopy has been Normal 0 team 18 (11:54 AMthere - 11:59 AM) Sexual function 57.50 \0.001 IUD patient and availability of a24.34 surgical team guidelines skilled in in18 hysteroscopic tage vaginal laparoscopic approach. crea of stay (LOS) 1 to 1, EBL 140 to 120, operative time 233 to 251 minutes, ), Uterine Sound (cm) and Parity for Thermablate alone vs (m/kg techniques include McIndoe operation, laparoscopic Davydov procedure, resection. Finally, is a need for consensus for management techniques include McIndoe operation, laparoscopic Davydov procedure, of stay (LOS) 1 to 1, EBL 140 to 120, operative time 233 to 251 minutes, 493 Self-consciousness 27.92 67.08 \0.001 all 3 techniques include McIndoe operation, laparoscopic Davydov procedure, resection. Finally, there is need for guidelines for Setting: were abstracted from an all-payer quality and safety resection. Finally, there is need for consensus guidelines for management tests, and Cases pregnancy outcome were obtained andconfirmation analyzed of the reported sterilization. Furthermore, interpretation of the tests should TVT retropubic slings 2)7but present symptoms and signs ofpresent obturator nerve satis andlaparoscopic laparoscopic Vechietti procedure. We would likerare to present apossible simple described for use in EC has not been widely adopted despite Dec Atypical endometrial 0young women 1 management 1 resection. Finally, therehyperplasia is aaacarcinoma need for consensus consensus guidelines for management Total HRQL 20.15 66.16 desiring \0.001 e IB The purpose of this video: 1) present an extremely complication of was number of lymph node to 13, post operative complication 0 to 1, and Thermablate + Essure was 43.1(5.1), 30.4(8.4), 8.9(1.0) and 2.0(1.1) vs and Vechietti procedure. We would like to a simple of early stage endometrial in fertility. and laparoscopic Vechietti procedure. We would like to present a simple number of lymph node 7 to 13, post operative complication 0 to 1, and Sexual function 24.34 in 57.50desiring fertility. \0.001 Learning Curve Analysis of Intracorporeal Cuff tage and laparoscopic procedure. We would like toadvancement present a simple 22 Video Session 1Analysis -carcinoma Oncology of stage endometrial database byofnormal the Michigan Surgical Quality Collaborative of early stage endometrial carcinoma in women cases to identify aVechietti cause failure. 22early Video be done by trained physicians, and with caution. compression 3) show the and the actual position of thisonly patient’s had method ofmaintained neovaginoplasty using labial and vestibular flap. advantages. Robotic surgery can potentially overcome counterintuitive 10-Year Retrospective excl of early stage endometrial carcinoma inyoung youngwomen women desiring fertility. Endometrial carcinoma 0young 2 fertility. 2 ease VAS score 68.4of Unintended 25.2 desiring 0.004 495 TVT retropubic slings 2) groups. present symptoms and signsthe of obturator nerve satis readmission rate 0 in both groups. 36.1(6.4), 29.4(8.2), 8.6(1.0) and 2.1(1.2) respectively with age method of neovaginoplasty using labial and vestibular advancement flap. method of neovaginoplasty using labial and vestibular advancement flap. readmission rate 0 in both Total HRQL 20.15 66.16 \0.001 e IB Suturing during Robotic Single-Site Total method ofMSQC neovaginoplasty using labialThe and vestibular advancement flap. (11:35after AM - 11:41 AM) (MSQC). is aMain statewide group ofthat 52 hospitals that voluntarily Measurements and Results: main causes of failure were TVT sling 4) describe the the laparoscopic removal of the TVT sling 5)a The Thisopposite simple technique is safe, minimally invasive and effective while and hand-instrument movements have contributed topatient’s awhile steep outp Pregnancies e in Atypical(11:35 myoma Essure Sterilization11in the 5 16 compression 3) show the normal and the actual position of this had being statistically different between groups (unpaired t-test). At 1 year This simple technique is safe, minimally invasive and effective Conclusion: The new technique using the V-lock suture yields to This simple technique is safe, minimally invasive and effective while Conclusion: The new technique using the V-lock suture yields to a Higher the symptom severity of life. ease 23NB:score VideoSession Session 1---Oncology Oncology This simple technique is safe, minimally invasive and effective while VAS 68.4 score, the poorer 25.2 the quality 0.004 Hysterectomy report perioperative surgical outcomes. Specially trained, dedicated nurses Imp perforation (n=10), expulsion (n=7), and unilateral placement (n=7). Another as well ascurve present the postoperative course and resolution of the patient’s more minimizing the morbidity associated with other grafting techniques learning in laparoscopic single site surgery. We present the first 23 Video 1 23 Video Session 1 Oncology Inte died Netherlands TVT sling 4) describe the the laparoscopic removal of the TVT sling 5) The 494 Successful Pregnancy after Targeted Hysteroscopy for follow-up, the combined amenorrhea/hypomenorrhea and overall minimizing the morbidity associated with other grafting techniques significantly higher lymph node count with similar operative time, LOS, minimizing the morbidity associated with other grafting techniques Successful 23 Video 1 Ozgurel - Oncology 1 Session 1 2 1 significantly higher lymph node count with similar operative time, LOS, e in minimizing the pregnancy morbidity associated with other grafting techniques The higher HRQL scores, the B, better the quality of life F.1 1Obstetrics (11:42 AM---B, 11:48 AM) Zeybek Oztekin MK, Sendag Akdemir A,the End cause was luteal (n=2). The occurrence of most pregnancies was pain. lapa commonly used insingle practice. case of site hysterectomy with SLN biopsy near AM 11:48 AM) gene (11:42 AM 11:48 AM) NB: (11:42 Higher the symptom severity score, the poorer the quality of life. Veersema S, Hitzerd E. Obstetrics & Gynecology, St. Antonius Hospital, as well asrobotic present the postoperative course and resolution of theand patient’s more satisfaction rates where 66% and 68% for Thermablate alone vs 77% commonly used in practice. EBL, and readmission rate. commonly used in practice. Endometrial Adenocarcinoma EBL, and readmission rate. Endometrial (11:42 AM 11:48 AM) died commonly used inguidance practice. 1553-4650/$ - seeEge front matter School 2014 AAGL. All rights reserved. Two Minute Thermal Balloon Endometrial Ablation related toimaging physician noncompliance (n=14). Thein other cases were associated and Gynecology, University of Medicine, Izmir, Bornova, Men infrared performed inrespectively EC an effort tonodemonstrate 1Laparoscopic 1 2 1the 11 11 Mea The higher HRQL scores, the better the quality of life pain. lapa Nieuwegein, Utrecht, Netherlands Complete Cytoreduction in Advance and 77% for Thermablate + Essure with statistical Ibrahim Al-Dossary M, NA. Obstetrics Arendas K, Leader A, Leyland NA. Obstetrics Arendas K, 2 Laparoscopic Complete Cytoreduction in Advance Complete Laparoscopic Cytoreduction in Advance http://dx.doi.org/10.1016/j.jmig.2014.08.016 with patientnode noncompliance or misinterpretation of the confirmation (Thermablate EAS) with and without Concomitant Department of Actuarial Sciences, Yasar University, Izmir, Turkey; Was that lymph sampling is(n=5) feasible this platform. Complete Laparoscopic Cytoreduction in Advance inclu UFS-QoL and VAS scores at University, baseline and 6 months after surgery Women requiring re-intervention difference between the groups (X2).with Fallopian Tube Adenocarcinoma Stage IIIC: Case and Gynecology, McMaster Ontario, Canada; and Gynecology, Hamilton, Ontario, Canada; Fallopian Tube Adenocarcinoma Stage IIIC: Case Fallopian Tube Stage IIIC: test TimeSession of conception was estimated to (Essure) be more than three months Hysteroscopic Fallopian Tube Micro-Inserts Bornova, Turkey 26 (n=9). Video 2 --Urogynecology Urogynecology Chri Fallopian Tube Adenocarcinoma Adenocarcinoma Stage IIIC: Case Caseincreasingly popular 2Report Study Objective: Essureand sterilization is becoming levo 2 26 Video were considered not satisfied. In total, there were 9 re-interventions 26 Video Session 2 Urogynecology 25 Video Session 2 Urogynecology 25 Session 2 Urogynecology Obstetrics, Gynecology Medicine Univerity of Obstetrics, (Endocrinology), Univerity of 26 Video Session 2 - Urogynecology Subscale Baseline (Mean) months (Mean) p value Report UFS-QoL and VAS scores atthough baseline and 66is months after surgery Report after placement in most (n=26). Placement (11:07 AM 11:13 AM) Report in the Netherlands. Even Essure a npermanent method of was 18 Video Session 1cases - Oncology within the firstAM year,-----11:06 all in the Thermablate alone group. They included (11:07 11:13 AM) (11:07 AM 11:13 AM) (11:00 AM 11:06 AM) (11:00 Tejerizo A, Marqueta L, L� o pez G, Alvarez C, Mu~ oz L, Mu~ n oz JL, se 3 Ottawa, Ottawa Fertility Centre, Ottawa, Canada Ottawa, Ottawa Ontario, Canada (11:07 AM 11:13 AM) Study Objective: To analyze the learning curve of intracorporeal cuff Tejerizo A, Marqueta L, L� o pez G, Alvarez C, Mu~ n oz L, Mu~ n oz JL, Tejerizo A, Marqueta L, L� oopez Alvarez C, nnhave oz Mu~ nnreported. oz Stud Conclusion: results of study show that theH,incidence of pregnancies A,(11:07 VilosThe G, Marks J, this Oraif A, Abduljabar Doulaverakis The contraception, unintended pregnancies afterwards been The levo Tejerizo A, Marqueta L,Baseline L� pez G, G, Alvarez C,6 Mu~ Mu~ oz L, L, Mu~ ozdeJL, JL, AM - 11:13 AM) Subscale (Mean) months (Mean) p value 7Vilos repeat hysteroscopic ablations, 1 subtotal hysterectomy and 1 C. woman Jim� e nez J. Gynecology Oncology and Endoscopy, Hospital 12 Octubre, Robotic-Assisted Vesicovaginal Fistula Repair Symptom severity 70.78 39.58 \0.001 suturing during robotic single-site total hysterectomy. follo after Essure sterilization is low. Most pregnancies wereofrelated to incorrect Jim� eeeof nez J. Gynecology Oncology and Endoscopy, Hospital 12 de Octubre, Jim� nez J. Gynecology Oncology and Endoscopy, Hospital 12 de Octubre, Robotic-Assisted Vesicovaginal Fistula Repair Robotic-Assisted Vesicovaginal Fistula Repair se 3 Neovaginoplasty Using Labial and Vestibular Neovaginoplasty Using Labial and Vestibular Fertility Clinic, LHSC, Division of REI, Department Obstetrics and aim this study is to identify factors that contribute to the occurrence of levo Jim� nez J. Gynecology Oncology and Endoscopy, Hospital 12 de Octubre, Robotic-Assisted Vesicovaginal Fistula Repair requiring COC. The surgical pathology was adenomyosis in 2 women, Endometrial women under the age of 40 in 3-5% Endometrial carcinoma can affect young age of 40 in 3-5% Madrid,Spain Spain SamuelSA, SA,Patel Patel N, Vakili B.Department Department ofIntraWomen’s Health, Christiana Concern 9.0 49.71 0.002 Laparoscopic Anterior Exenteration with levo positioning of a N, device or unilateral placement, and seemChristiana therefore Design: Retrospective design. Madrid, Madrid, Spain Samuel Vakili of Health, Samuel SA, N, Vakili B. Department of Women’s Health, Christiana Advancement Flap Patients with u llerian Agenesis Advancement Flap in Patients with uwoman. llerian Agenesis Gynecology, Schulich School of Medicine and Dentistry, Western unintended pregnancies after Essure sterilization. Prio Symptom severity 70.78 39.58and refuse \0.001 Madrid, fibroids in Patel 1Patel woman andB. in M€ 1M€ All other women had Samuel SA, N,in Vakili B.both Department of Women’s Women’s Health, Christiana of cases. cases.Spain fertility of In patients who desire future refuse hysterectomy, hysterectomy,

2014 Award Oral Winning Abstracts & Videos Presentations

Golden Hysteroscope Award

Golden Laparoscope Award

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scores were \70% correct despite New the intervention. Thus, the gain, while practice surgeons (mean experience= 3.2) earned $247, 969 (range= Gynecology, University, York, New York suspicion of Columbia endometrial tuberculosis. Targeted biopsies were taken from (2:57 PM - There 3:02 PM) statistically significant, was relatively small and indicates that resident 100,000-860,000). was no significant difference between salaries the region of the whitish deposits and endometrial tuberculosis was training should be supplemented to increase the baseline level Study Objective: To assess the value and usability of ofthesurgical three (p=.654) or yearsControlled in practiceTrial (p=.358) among these groups. A Randomized Comparing Traditional confirmed by BACTEC culture. It appears that the methylene blue vital skills. commercially available robotic surgical simulators: the daVinci Skills Conclusion: Compensation of FMIGS graduates varied significantly. As the stain was not taken up by the caseous tubercular deposits while it was with Simulation Resident Surgical Laparoscopic Simulator (dVSS), the Mimic dV-Trainer, and Simulated Surgical demand for specialized gynecologic surgeons increases, it will be important taken up by the surrounding endometrium. As a result the unstained Salpingectomy Training Systems’ RoSS. to have guideposts on compensation of these physicians for both prospective caseous tubercular deposits reflected white light in contrast to the Patel NR,1 Makai G,2 Sloan N,2 Della Badia C.1 1Department of 102 Open Communications 5study. - Education Design: Prospective randomized employers and employees. However, It is important to recognize these surrounding dark blue endometrium and thereby helped in raising a Obstetrics and Gynecology, Drexel University School of Medicine, (3:03 PM surgical - 3:08 PM) Setting: Robotic courses and at conferences. salary data represent current 2compensation and market trends, but not the suspicion of endometrial tuberculosis hysteroscopy. Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology, current worth and value of the skilled gynecologic surgeon. Additional Patients: Medical students, fellows, andof attending surgeons werea Conclusion: VitalSimulators: staining residents, withAn methylene blue dye is helpful in raising Robotic Surgical Assessment Christiana Care Health System, Newark, Delaware studies must be performed to evaluate productivity of this type of surgical recruited suspicion(n=105). of endometrial tuberculosis at hysteroscopy. Usability and Preferences specialist to determine a fair market-driven compensation. Intervention: Subjects were assigned a specific order in which they used Study Objective: To evaluate the effectiveness of the porcine training Tanaka ADS,1 Truong MD,2 Graddy CB,1 Smith RD.1 1The Nicholson Excellence in Education Bestsimulator. AbstractThey by athen Resident each completedora Fellow demographic questionnaire. model for obstetrics-gynecology residents in laparoscopic salpingectomy. Center, Florida Hospital, Celebration, Florida; 2Obstetrics and Participants performed one exercise on the three simulators and 94 Open Communications 5 Education 101 Open Communications 5 Education Design: Randomized controlled single blinded trial. Gynecology, Columbia University, New York, New York completed a second questionnaire (2:15 PMAM - 2:20 PM)AM) regarding their experience with the PMtertiary - 3:02 PM)AM) 101 AM - 8:30 94 (8:30 - 8:45 Setting:(2:57 A (8:15 large care hospital. device. After using all systems, they completed a final questionnaire, Study Objective: To assess theGynecologic value and Surgery usability of the three Patients: Twenty-two PGY-1 through PGY-4Traditional OB GYN residents were Impactdetailed of a Minimally-Invasive A Randomized Controlled Trial Comparing which their comparative preferences. The performance metrics commercially available robotic surgical simulators: the daVinci Skills enrolled. Department on Rates Laparoscopic with Simulation Resident Surgical Laparoscopic were also collected fromofeach simulator. Hysterectomy: Simulator (dVSS),(2014) the S1–S44 Mimic dV-Trainer, and Simulated Surgical Intervention: in /blocks of two stratified Invasive Abstracts Journal of Minimally Gynecology S27 2004 to 2012 21and SalpingectomyResidents Trainingwere randomly assigned, Measurements Main Results: Data confirmed face, content, and Systems’ RoSS. by intervention control All participants 2 1 Loring M,validity Morris SN,the Isaacson KB. MIGS Department, Sloan N,2 DellaorBadia C.1 group. Department Patelexperience, NR,1 MakaitoG,the construct for dV-Trainer and DVSS. SimilarNewton-Wellesley validities could Abstracts / Journal of of Minimally Invasive Gynecology 21 (2014) S1–S44 S27 Design: Prospective randomized study. (Seprafilm,an=7) or 3) test article groupskills (LABS, n=8). Attest day 42 animals underwent pre-intervention objective assessment in Invasive Abstracts / Journal of(OSAT), Minimally Gynecology 21 (2014) S1–S44 S27 not be confirmed for theinvestigate RoSS. Greater than 80% of participants chose Hospital, Newton, Massachusetts Obstetrics and Gynecology, Drexel University School of Medicine, Study Objective: To the impact of a minimally-invasive Abstracts / Journal of Minimally Invasive Gynecology 21 (2014) S1–S44 S27 Setting: Robotic surgical courses and conferences. were humanely euthanized and werelaparoscopic scored. which the participant live (human) salpingectomy 2 adhesions (Seprafilm, n=7) or 3)performed test article group (LABS, n=8). At day 42 animals the DVSS in terms of ergonomics, and overallonchoice, however 55% Department of Obstetrics andday Gynecology, Philadelphia, Pennsylvania; gynecologic surgery (MIGS) department the rates of only outpatient (Seprafilm, n=7) or 3)Main test article group (LABS, n=8). At 42 animals Patients: Medical students, residents, fellows, and attending surgeons were which was video-recorded. A subjective survey assessed participants’ Measurements and Results: At day14, prior to group assignment, Study Objective: To investigate the impact of a minimally-invasive were humanely euthanized and adhesions were scored. thought it washysterectomy worthTotheinvestigate investment. Seventy one of participants Study Objective: the impact of percent a minimally-invasive Christiana Care Health System, Newark, Delaware (Seprafilm, n=7) or 3) intervention test article group (LABS, n=8).simulation At day 42 animals laparoscopic at andepartment academic community hospital without a were humanely were scored. recruited (n=105). comfort levels. The consisted of session the severity (S),euthanized extent (E),and andadhesions total adhesion for assignment, each group gynecologic surgery (MIGS) on of the a rates of outpatient Study Objective: To(MIGS) investigate the cost impact minimally-invasive Measurements and Main Results: At(T) day14, priorascores to group agreed that thesurgery dV- Trainer had the best value. gynecologic department on the rates of outpatient were humanely euthanized and adhesions were scored. da Vinci robot. Measurements and Main Results: Atfrom day14, prior to groupnon-treatment assignment, involving pre-session reading, a lecture, viewing a procedural video, and were not significantly different each other: Intervention: Subjects were assigned a specific order in which they useda laparoscopic hysterectomy at an academic community hospital without gynecologic surgery can (MIGS) on and the commitment rates of outpatient the severity (S), and extent (E),Results: andthe total (T) adhesion for assignment, each group Study Objective: ToMain evaluate effectiveness ofscores thegroup porcine training Conclusion: Usability affect the consistency of usersa laparoscopic hysterectomy at andepartment academic hospital without Measurements day14, prior to Design: Retrospective study.acommunity the severitylaparoscopic (S), extent (E), and totalAt (T) adhesion scores for The eachcontrol group practicing salpingectomy on a porcine cadaver. (S=3.90.3, E=3.30.8, T=7.21.1), LABS (S=3.31.5, E=3.01.5, each simulator. They observational thenat completed demographic questionnaire. da Vinci robot. laparoscopic hysterectomy an academic community hospital without a were not significantly different from each other: non-treatment model for obstetrics-gynecology residents in laparoscopic salpingectomy. to robotic surgical simulators. In conjunction with previously published da Vinci robot. the severity (S), extent (E),different and totalAll (T)E=3.30.4, adhesion scores for eacha group Setting: Academic community hospital. were not significantly from each other: non-treatment group received traditional training. participants underwent postT=6.32.9), and Seprafilm (S=3.90.2, T=7.10.6). Participants performed one exercise on the three simulators and Design: Retrospective observational study. da Vinci robot. (S=3.90.3, E=3.30.8, T=7.21.1), LABS (S=3.31.5, E=3.01.5, work comparing the systems capabilities, this for work will indications offer end users Design: Randomized controlled single blinded trial. Design: Retrospective observational study. were not significantly different from each other: non-treatment Patients: All patients undergoing hysterectomy benign from (S=3.90.3, E=3.30.8, LABS were (S=3.31.5, E=3.01.5, intervention OSAT and T=7.21.1), a(S=3.90.2, second adhesions subjective survey. recorded Four weeks later following treatment, scored All again with the completed a secondcommunity questionnaire regarding their experience with the Setting: Academic hospital. Design: Retrospective observational T=6.32.9), and Seprafilm E=3.30.4, T=7.10.6). and potential buyers a comparison ofstudy. the perceived value and preferences Setting: A large tertiary care hospital. E=3.30.4, Setting: Academic community hospital. (S=3.90.3, E=3.30.8, T=7.21.1), (S=3.31.5, E=3.01.5, January 2004 to December 2012 as identified by in hospital T=6.32.9), and Seprafilm (S=3.90.2, T=7.10.6). salpingectomies (OSATs) scoredadhesions by LABS a E=0.61.0, single blinded evaluator. following results: LABSwere (S=0.60.9, T=1.31.9), and device. After using all systems, they completed a finalcode questionnaire, Patients: All patients undergoing hysterectomy for ICD-9 benign indications from Four weeks later following treatment, were scored again with the Setting: Academic community hospital. of robotic simulators. Suggestions for future research include a Patients: Twenty-two PGY-1 through PGY-4 OB GYN residents were T=6.32.9), and Seprafilm (S=3.90.2, E=3.30.4, T=7.10.6). Patients: All patients undergoing hysterectomy for benign indications from operating room records were included. Four weeks later following treatment, adhesions were scored again with the Seprafilm (S=0.71.1, E=0.71.1, T=1.42.2) significantly (P\0.01) which detailed their comparative preferences. The performance metrics Measurements and Main Results: Nine OSAT surgical skills and 10 January 2004 to December 2012 as identified by ICD-9 code in hospital following results: LABS treatment, (S=0.60.9, E=0.61.0, T=1.31.9), and Patients: All patients undergoing hysterectomy for benign indications from comparative evaluation of the transfer of training effect of the devices. enrolled. Four weeks later following adhesions were scored again with the January 2004 to December 2012 as identified by ICD-9 code in hospital Intervention: or laparoscopic hysterectomy (both total hysterectomy following results: (S=0.60.9, E=0.61.0, T=1.31.9), and reduced themeasures severityLABS andE=0.71.1, extent of reformed following lysis as were also collected from eachincluded. simulator. subjective were assessed using a adhesion Likert Scale of 1(P\0.01) -5 (for operating roomOpen records were Seprafilm (S=0.71.1, T=1.42.2) significantly January 2004 December as identified by ICD-9 code in hospital Intervention: Residents were randomly assigned, insignificantly blocks of two stratified following (S=0.71.1, results: (S=0.60.9, E=0.61.0, T=1.31.9), and operating roomtorecords were2012 included. or supracervical hysterectomy included). Seprafilm E=0.71.1, T=1.42.2) (P\0.01) compared to the LABS non-treatment group (S=3.01.3, E=2.61.6, Measurements and Main Results: Data confirmed content, and Intervention: Open or laparoscopic hysterectomy (bothface, total hysterectomy reduced the severity and extent of reformed adhesion following lysis as operating room records were included. by experience, the or control group. All participants Seprafilm E=0.71.1, T=1.42.2) significantly (P\0.01) Intervention: Open laparoscopic hysterectomy total hysterectomy reduced the(S=0.71.1, severity andintervention extent of reformed adhesion following lysis as Measurements and Main Results: outcome was route of T=5.62.9). Theto LABS and Seprafilm groups had significantly (P\0.05) construct validity fororthe dV-Trainer andPrimary DVSS. (both Similar validities could or supracervical hysterectomy included). compared to the non-treatment group (S=3.01.3, E=2.61.6, 103 Open Communications 5 Education Intervention: Open or laparoscopic hysterectomy (both total hysterectomy underwent a pre-intervention objective skills assessment test (OSAT), in reduced the severity and extent of reformed adhesion following lysis as or supracervical hysterectomy included). compared to theof animals non-treatment (S=3.01.3, E=2.61.6, hysterectomy, either open or laparoscopic. Secondary ofroute interest higher percentage adhesiongroup free (63% and 57%, respectively) not be (3:09 confirmed for the RoSS. GreaterPrimary than 80% ofoutcomes participants chose Measurements and Main Results: outcome was of T=5.62.9). The LABS and Seprafilm groups had significantly (P\0.05) PM 3:14 PM) or supracervical hysterectomy included). which the participant performed live (human) laparoscopic salpingectomy compared to the non-treatment group (S=3.01.3, E=2.61.6, Measurements Main Results: Primary outcome was only route55% of T=5.62.9). The LABS and Seprafilm groups had significantly (P\0.05) included ofand stay andorfactors associated with an open procedure. as compared to the non-treatment group (11%). the DVSSlength in terms ofopen ergonomics, and overall choice, however hysterectomy, either laparoscopic. Secondary outcomes ofroute interest higher percentage of animals adhesion free (63% and 57%, participants’ respectively) Measurements and Main Results: Primary outcome was of which was video-recorded. A subjective survey assessed T=5.62.9). The LABS and Seprafilm groups had significantly (P\0.05) hysterectomy, either open or laparoscopic. Secondary outcomes of interest higher percentage of animals adhesion free (63% and effectively 57%, respectively) In 2004,itonly 12% of hysterectomies Newton-Wellesley hospital Positioning Yourself for Success: Teaching Conclusion: a sprayable adhesion barrier, reduced thought was worth the investment. Seventyatwith one percent of participants included length of (24/194) stay and factors associated an open procedure. as compared toLABS, theof non-treatment group (11%). hysterectomy, either open laparoscopic. Secondary outcomes of interest comfort levels. intervention consisted of and a adhesion simulation session higher percentage animals adhesion free (63% 57%, respectively) included length of stay andorhad factors associated with an open procedure. as compared to theThe non-treatment group (11%). (NWH) were done laparoscopically. This increased to over 50% (156/296) adhesions as compared to a commercially available barrier in a agreed that the dVTrainer the best cost value. Laparoscopic Positioning Using Didactics and In 2004, only 12% (24/194) of hysterectomies at Newton-Wellesley hospital Conclusion: LABS, a sprayable adhesion barrier, effectively reduced included length of(24/194) stay and of factors associated an open were procedure. involving pre-session reading, a lecture, viewing a procedural video, and as compared to the non-treatment group (11%). In 2004, only 12% atwith Newton-Wellesley hospital by 2007 were and in 2012, 91.5% orhysterectomies (315/344) of hysterectomies via a Conclusion: LABS, a sprayable adhesion barrier, effectively reduced preclinical adhesion reformation model. Conclusion: Usability can affect the This consistency andtocommitment of users Simulation (NWH) done laparoscopically. increased over 50% done (156/296) adhesions laparoscopic as compared tosprayable a commercially available adhesion barrier in a In 2004, only 12% (24/194) of hysterectomies at Newton-Wellesley hospital practicing salpingectomy on a porcine cadaver. The control Conclusion: LABS, a adhesion barrier, effectively reduced (NWH) were done laparoscopically. This increased to over 50% (156/296) traditional laparoscopic approach. adhesions as compared to a commercially available adhesion barrier in a to robotic surgical simulators. In conjunction with previously published Tang NZ, Haughton M, Gabbur N. OBGYN, SUNY Downstate Medical by 2007 were and in 2012, 91.5% or (315/344) of hysterectomies were done via a preclinical adhesion reformation model. (NWH) laparoscopically. Thisof increased to overwere 50% done (156/296) group received traditional All participants underwent a postadhesions as compared to atraining. commercially available adhesion barrier in a by 2007 and indone 2012, 91.5% or capabilities, (315/344) hysterectomies via a preclinical adhesion reformation model. work comparing the systems this work will offer end users Center, New91.5% York traditional laparoscopic approach. by 2007Brooklyn, and in 2012, or (315/344) of hysterectomies were done via a intervention OSAT and a second subjective survey. All recorded preclinical adhesion reformation model. traditional laparoscopic approach. 93 Open Communications 4 - Research and potential buyers a comparison of the perceived value and preferences traditional laparoscopic approach. salpingectomies (OSATs) were scored by a single blinded evaluator. (3:09 PM - 3:14 PM) 4 - Research of robotic simulators. for future research include Study Objective: Proper Suggestions patient positioning is paramount to both patienta 93 Open Communications Measurements and Main Results: Nine OSAT surgical skills and 10 93 Open Communications 4 - Research comparative evaluation of the transfer of training effect of the devices. safety and surgical efficacy, and is often overlooked during residency (3:09 PM - 3:14 PM) Hysteroscopic Images from 16 4Cases Related to Vital subjective measures were assessed using a Likert Scale of 1 -5 (for 93 Open Communications - Research (3:09 PM - 3:14 PM) training. In teaching this key component to a laparoscopy curriculum, we Staining in Endometrial Tuberculosis (3:09 PM - 3:14from PM) Hysteroscopic Images 16 Cases Related to Vital developed a workshop integrating classical didactics with a simulation Hysteroscopic Images from 16 Cases Related to Vital Kumar A.inHysteroscopic Surgery Division, Woman’s Health Centre, 103 Open 5 - Education Staining Endometrial Tuberculosis component forCommunications residents to experience firsthand the importance of proper Hysteroscopic Images from 16 Cases Related to Vital Staining in Endometrial Tuberculosis Jaipur, Rajasthan, India Surgery Division, Woman’s Health Centre, (3:09 positioning. PM - 3:14 PM) laparoscopic Kumar A.inHysteroscopic Staining Endometrial Tuberculosis Kumar A. Hysteroscopic Surgery Division, Woman’s Health Centre, Jaipur, Rajasthan, India S1–S44 Kumar A. Hysteroscopic Woman’s Health Centre, high Invasive Gynecology 21 (2014) Positioning Yourself for Success: Teaching Study Objective: The Surgery purpose Division, of this study is to demonstrate Jaipur, Rajasthan, India Jaipur, Rajasthan, India images of endometrial tuberculosis after vital resolution hysteroscopic Laparoscopic Positioning Using Didactics and Study Objective: The purpose of this study is to demonstrate high OSATs 1=low score,The for blue subjective score). group OSAT Study Objective: purpose of1=high this study is Control to demonstrate high staining with methylene dye. Simulation resolution hysteroscopic images of endometrial tuberculosis after The vital Study Objective: Thestudy. purpose of endometrial this post: study 26.210.1, istuberculosis to demonstrate high scores did not change (pre: 26.610.8, p=.65). resolution images of after vital Design: A hysteroscopic prospective Tang NZ, Haughton M, Gabbur N. OBGYN, SUNY Downstate Medical staining with methylene blue dye. resolution hysteroscopic images of endometrial tuberculosis after vital intervention grouphysteroscopic showed significant improvement in two-handed staining methylene blue dye. Setting:with A prospective private surgery centre. Center, Brooklyn, New York Design: A study. staining (pre: with methylene blue dye. surgery 2.81.6, study. post: 3.51.3, p=.004) and use of energy (pre: Design: A prospective Patients: Sixteen selected cases surgery of infertility in which hysteroscopy was Setting: A A private hysteroscopic centre. 2.91.3, post: 3.61.0, p=.01), contributing to the overall score change Design: prospective study. Setting: private hysteroscopic surgery test centre. Study Objective: Proper patient positioning is paramount to both patient indicatedAalong with chromopertubation and endometrial tuberculosis Over 85% of hysterectomies at NWH were done as outpatient surgeries in Patients: Sixteen selected cases surgery of infertility in which hysteroscopy was (pre: 26.710.6, post:29.99.8, Setting: ASixteen private hysteroscopic centre. Patients: selected casesp%.001). of infertility in which hysteroscopy was safety and surgical efficacy, and is often overlooked during residency was diagnosed. 2012. indicated along with chromopertubation test and endometrial tuberculosis The control group experienced no change in comfort levels. The Over 85% of hysterectomies at NWH were done as outpatient surgeries in Patients: Sixteen selected cases of infertility in which hysteroscopy was indicated alongInwith test 16 andselected endometrial training. this key atcomponent to done a laparoscopy curriculum, Intervention: thischromopertubation study we demonstrate cases tuberculosis of infertility Over 85%Inofteaching hysterectomies NWH were as outpatient surgerieswe in was diagnosed. intervention group experienced both increases (anatomy, steps tuberculosis of surgery, 2012.85% of indicated along with chromopertubation test and endometrial Over hysterectomies at NWH were done as outpatient surgeries in was diagnosed. developed a workshop integrating classical didactics with a simulation wherein we performed hysteroscopy and the16endometrium was 2012. Intervention: In this and study we of demonstrate selected cases of examined infertility two-handed surgery, use energy) 16 andselected decreases and was diagnosed. 2012. component for residents to experience firsthand the importance of proper Intervention: Indeposits this study we demonstrate cases(reading of infertility for any whitish suggestive of tuberculosis. The initial hysteroscopy wherein we performed hysteroscopy and the16endometrium was examined learning in in this comfort levels. Intervention: In study we demonstrate selected cases infertility laparoscopic positioning. wherein weOR) performed hysteroscopy and endometrium wasof examined wasany followed by chromopertubation all the cases. After the chromopertubafor whitish deposits suggestive ofinthat tuberculosis. The initial hysteroscopy Conclusion: This study demonstrates simulation can improve surgical wherein we performed hysteroscopy and the endometrium examined for any whitish depositswas suggestive of tuberculosis. The initialwas hysteroscopy tion the hysteroscope reintroduced and the endometrium was again was followed bydeposits chromopertubation in all cases. After the chromopertubatechnique. However, of 45 possibleofin OSATs points, both groups’ average for any whitish suggestive tuberculosis. The initial hysteroscopy was followed all cases. After the chromopertubaevaluated for by anychromopertubation whitish High resolution hysteroscopic tion the hysteroscope was deposits. reintroduced and the After endometrium wasimages again scores were \70% correct despite the intervention. Thus, the gain, while was followed by chromopertubation in all cases. the chromopertubation the hysteroscope was reintroduced and the endometrium was again were takenfor in all bothdeposits. prior andHigh after the chromopertubation. evaluated anycases whitish resolution hysteroscopic images statistically significant, was relatively small and indicates that resident tion the hysteroscope was reintroduced and the endometrium was again evaluated for anyand whitish deposits. HighInresolution hysteroscopic images Measurements Main Results: allchromopertubation. 16 cases whitish deposits were taken in all cases both prior and after the training should becases supplemented to increase the baseline level of surgical evaluated for any whitish deposits. High resolution hysteroscopic images were taken in all bothtuberculosis prior and after the chromopertubation. suggestive of endometrial were not seen at initial hysteroscopy Measurements and both Mainprior Results: In allchromopertubation. 16 cases whitish deposits skills. were taken in all cases and chromopertubation after Measurements Results: In the all 16 cases and whitish deposits done prior of to endometrial theand vitalMain staining with hysteroscopic suggestive tuberculosis were not 16 seen at initial hysteroscopy Measurements and Main Results: In all deposits suggestive of endometrial tuberculosis were notHowever seencases at initial hysteroscopy findings were unremarkable forwith tuberculosis. inwhitish these 16 cases done prior to the vital staining chromopertubation and hysteroscopic suggestive of endometrial tuberculosis were not seen at initial hysteroscopy done prior to the vital staining with chromopertubation and hysteroscopic after vital staining with chromopertubation the hysteroscopy revealed findings were unremarkable for tuberculosis. However in these 16 cases 102 Open 5 - Education done prior to Communications the vital staining chromopertubation andthe hysteroscopic findings were unremarkable forwith tuberculosis. However in these 16 cases glistening white highly reflective whitish deposits background after vital staining with chromopertubation the against hysteroscopy revealed (3:03 PM 3:08 PM) findings were unremarkable for tuberculosis. However in these 16 cases after vitalblue staining with chromopertubation the hysteroscopy revealed of a dark stained endometrium. The reflective whitishthe deposits raised glistening white highly reflective whitish deposits against background after vital staining with chromopertubation the hysteroscopy revealed glistening white highly reflective whitish deposits against the background suspicion of endometrial tuberculosis. Targeted biopsies were takenraised from Robotic Simulators: An Assessment of of a darkSurgical blue stained endometrium. The reflective whitish deposits By 2011 and 2012, surgeon preference or lack of surgeon expertise was glistening white highly reflective whitish deposits against the background of a dark stained endometrium. The reflective whitish deposits raised the regionblue of the whitish deposits and endometrial tuberculosis was Usability and Preferences suspicion of endometrial tuberculosis. Targeted biopsies were taken from rarely cited as 2012, a factor leadingpreference to an openorhysterectomy. of a dark of blue stained endometrium. The whitish deposits raised 1endometrial 2 1 reflective 1methylene 1 were suspicion tuberculosis. Targeted biopsies taken from By 2011 and surgeon lack of surgeon expertise was confirmed by BACTEC culture. It appears that the blue vital MD, Graddy Smith RD. The Nicholson was Tanaka ADS,ofTruong the region the whitish depositsCB, and endometrial tuberculosis By 2011 and 2012, surgeon preference or lack surgery of surgeon expertise was Conclusion: A large, diverse gynecologic department can suspicion of endometrial tuberculosis. Targeted biopsies were taken from 2 the region of taken the whitish deposits and endometrial tuberculosis was rarely cited as a factor leading to an open hysterectomy. stain was not up by the caseous tubercular deposits while it was Obstetrics and Center, Florida Hospital, Celebration, Florida; By 2011 and 2012, surgeon preference or lack ofopen surgeon expertise was confirmed byofBACTEC culture. It appears that the methylene blue vital rarely citedits as asurgical factor leading to from an open hysterectomy. transform practice primarily hysterectomies to the region thesurrounding whitish deposits and endometrial tuberculosis was confirmed BACTEC culture. It appears that the methylene blue vital taken up by the endometrium. As a result the unstained Conclusion: A large, diverse gynecologic surgery department can rarely cited as a factor leading to an open hysterectomy. Gynecology, Columbia New York, Newthe York stain was not taken upUniversity, by the caseous tubercular deposits while it vital was Conclusion: A large, diverse gynecologic surgery department can performing over 90% of hysterectomies via a traditional laparoscopic confirmed by BACTEC culture. It appears that methylene blue stain was not taken up by the caseous tubercular deposits while it was caseousup tubercular deposits reflected white As light in contrast to the transform its A surgical practice from primarilysurgery open hysterectomies to Conclusion: large, diverse gynecologic can taken by the surrounding endometrium. a result the unstained transform its surgical practice primarily open to route in less than eight yearsfrom without the ause of hysterectomies dadepartment Vinci robotic stain was notdark taken up by the endometrium. caseousand tubercular while it wasa taken up by the surrounding As usability a deposits result the unstained surrounding blue endometrium thereby helped in the raising performing over 90% of hysterectomies via traditional laparoscopic Study Objective: To assess the value and of transform itsover surgical practice from primarily open hysterectomies to caseous tubercular deposits reflected white light in contrast tothree the performing 90% of hysterectomies via a traditional laparoscopic taken up by the surrounding endometrium. As a result the unstained technology. This paradigm shift was fueled by patient demand and by caseous tubercular deposits reflected white light in toSkills the suspicion of endometrial tuberculosis at and hysteroscopy. route in less than eight years without via the ausetraditional of da Vinci robotic commercially available robotic surgical simulators: the contrast daVinci performing of hysterectomies laparoscopic surrounding dark blue endometrium thereby helped in raising a route in department lessover than90% eight yearsmentorship without theforuse of da Vinci robotic caseous tubercular deposits reflected white light in contrast to the MIGS surgical generalist obstetrician/ surrounding dark blue endometrium and thereby helped in raising a technology. This paradigm shift was fueled byusepatient demand and by Conclusion: Vital staining with methylene blueand dye isSimulated helpful in Surgical raising a Simulator the tuberculosis Mimic dV-Trainer, route in less than eight years without theby of dademand Vinci and robotic suspicion of(dVSS), endometrial at and hysteroscopy. technology. This paradigm shift was fueled patient by surrounding dark blue tuberculosis endometrium thereby helped in raising a gynecologists. suspicion of atathysteroscopy. MIGS department surgicalshift mentorship for generalist obstetrician/ suspicion of endometrial endometrial tuberculosis hysteroscopy. Systems’ RoSS. technology. This paradigm was fueled by patient demand and by Conclusion: Vital staining with methylene blue dye is helpful in raising a MIGS department surgical mentorship for generalist obstetrician/ suspicion of endometrial tuberculosis at hysteroscopy. Conclusion: Vital staining with methylene blue dye is helpful in raising a gynecologists. Design: Prospective randomized study.at hysteroscopy. MIGS department surgical mentorship for generalist obstetrician/ suspicion of endometrial tuberculosis gynecologists. Conclusion: Vital staining with methylene blue dye is helpful in raising a suspicionRobotic of endometrial hysteroscopy. 95 Open Communications 5 - Education Setting: surgical tuberculosis courses and at conferences. gynecologists. suspicion of endometrial tuberculosis at hysteroscopy. 94 Open Communications 5 - Education (2:21 PM - 2:26 PM) 5 - Education Patients: Medical students, residents, fellows, and attending surgeons were 95 Open Communications

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Endometriosis and 2,131 (34) 4 (26.7) and 6,563 were performed for benign indications. AUB +/- Fibroids Measurements and Main Results: Unexpected cancer was defined as Surgical Approach malignancy confirmed on pathology specimen, without a preoperative Abdominal 1,562 (24.9) 8 (53.3) 0.03 surgical indication for cancer. The incidence of unexpected gynecologic 13.56 (3.29) 318.96 (302.57) 3.38 (3.04) Vaginal 775 (12.4) 0 cancer was 3.2% (n=208) and included uterine sarcoma (n=15,0.23%), Laparoscopic 3,938 cancer (62.7) (n=12,0.18%) 7 (46.7) and ovarian/ endometrial cancer (n=80,1.2%), cervical 13.97 (5.05) 586.12 (1089.03) NA Specimen weight (grams) 231 +/401 520 +/-no 972 0.01 in peritoneal/fallopian tube cancer (n=100,1.5%). There was difference Estimate 178 +/-sarcoma 239 405 +/- 452 \0.00 the mean blood age ofloss women with unexpected compared to those with Length of stay 1.6 2sarcoma +/- 2.3 were younger \0.00 Here we describe several tools to minimize blood loss during laparoscopic benign pathology; however, women 1.7 with+/unexpected Preoperative bloodatransfusion 41 (0.65) of cancer 1 (6.7)and sarcoma \0.00on management of advanced ectopic pregnancy: development of the avascular than those with preoperative diagnosis spaces to allow temporary ligation of all major contributory blood supplies, Postoperative blood transfusion 149 (2.3)The most 3 (20) \0.00 pathology (48.710.7vs.61.911.1,p=.01). common indications Best Paper on Minimally Invasive Gynecology injection of vasopressin, and judicious use of vessel sealing devices. forData surgical intervention fibroids and AUB, and therespecified. was no are n (%) or mean were standard deviation unless otherwise difference in preoperative indications between sarcoma and benign disease. by a Fellow Conclusion: Unexpected uterine and cervical cancers, found in 1.6% of 3 Plenary 1 - Laparoscopy Table 1 hysterectomies performed for benign indications are important (11:16 AM - 11:25 3 (8:45 AM - 9:00AM) AM) Demographic and characteristics undergoing considerations for clinical perioperative planning ofofwomen minimally invasivehysterecsurgery. tomy for a benign indication We recommend including a discussion of the risks and benefits associated Unexpected Uterine Sarcoma and Other Gynecologic with morcellation to remove specimens a minimally invasive Malignancies Diagnosed after Hysterectomy Performed Characteristics Benign during Sarcoma p value approach. We did not identify preoperative characteristics that were for Benign Indications significantly associated with uterine46.8+/-10.7 sarcoma. Age 48.7+/-12.5 0.49 Mahnert N, Morgan D, Johnston C, As-Sanie S. Obstetrics and Surgeon Type Gynecology, University of Michigan, Ann Arbor, Michigan 4Non-gyn Plenary 1 - Laparoscopy 5,912 (94.2) 12 (80) oncologist .02 Study Objective: To define the incidence of unexpected uterine sarcoma (11:26 AM - 11:32 AM) 363 (5.8) Gyn Oncologist 13 (20) and other gynecologic malignancies among women who underwent Surgical Indication Best Paper in JMIG An AAGL TaskPublished Force Consensus Statement: A hysterectomy for benign indications. Pelvic Mass 323 (5.2) 1 (6.6) 0.54 Standardized Approach to LESS Hysterectomy Design: Retrospective chart review of a Michigan multi-center prospective (September 2013 – August Prolapse 667 2014) (10.6) 0 Stepp KJE. Department of Obstetrics and Gynecology, Carolinas S2 Abstracts /8th Journal Gynecology 21 (2014) S1–S44 567 (9) database from January 1st 2012 through December 2013. of Minimally Invasive Endometriosis 1 (6.7) Healthcare System, Charlotte, North Carolina Setting: Cases were abstracted from an all-payer quality and safety AUB +/Fibroids 2,587 (41.2) 9and (60) (9:00 AM - 9:05 AM) given the abstracted patient characteristics and perioperative data. Women with a LESS has been questioned, above factors need for advanced database maintained by the Michigan Surgical Quality Collaborative Endometriosis and 2,131 (34) 4 (26.7) Single incision gynecologic laparoscopy was first described in role 1991, preoperative surgical indication of cancer, cervical dysplasia or laparoscopic skills. More importantly, it may play an essential in but the (MSQC). MSQC is a statewide group of 52 hospitals that voluntarily S2 Abstracts / Journal of Minimally Invasive Gynecology 21 (2014) S1–S44 AUB +/- Fibroids Feasibility and Dosage of Indocyanine Green did not really emerge until 2007 as an advanced laparoscopic approach. endometrial hyperplasia excluded. indicationsnurses for reproducibility and Optimal diffusion of LESS. Information about training and report perioperative surgical were outcomes. SpeciallyBenign trained, dedicated Surgical Approach This approach isfor known my many different names and acronyms. hysterectomy included pelvic mass, endometriosis, abnormal Fluorescence Lymph Using education on LESS is Sentinel scarcegiven in the literature. of abstracted patient characteristics and prolapse, perioperative data. Women with a LESS has been questioned, thecurrent aboveNode factorsDetection andWith needthe forsupport advanced Abdominal 1,562 (24.9)is surgeons (53.3)andacronym 0.03 to Laparoendoscopic single site of (LESS) surgery the8 accepted uterine bleeding (AUB) or fibroids. AAGL, a working group expert LESS educators Robotic Single-Site Instrumentation: Preclinical Study preoperative surgical indication of cancer, cervical dysplasia or laparoscopic skills. More importantly, it may play an essential role in the Vaginal this 775 (12.4) describe approach. The feasibility LESS forfor complex developed andadvanced described standardized consensus0of technique Patients: During the study period, women Benign underwentindications a hysterectomy endometrial hyperplasia were 7,469 excluded. for reproducibility and diffusion of LESS. Information about trainingLESS and Levinson KL, Mahdi H, aEscober PF. Division ofthe Gynecologic surgical procedures is no longer an 3,938 issue; however, generalizability of Laparoscopic (62.7) 7 (46.7) supracervical hysterectomy that can be easily understood, replicated, and and 6,563 were performed for benign indications. hysterectomy included pelvic mass, prolapse, endometriosis, abnormal education on LESS is scarce in the current literature. With the support of Oncology, Cleveland Clinic, Cleveland, Ohio Specimen weight (grams) 231 +/401 520 +/972 0.01 is useful in LESSoftechnique. Measurements and Main Results: Unexpected cancer was defined as uterine bleeding (AUB) or fibroids. AAGL, a learning working the group expert LESS surgeons and educators Estimate blood loss 178 +/-consensus 239 405 +/- 452 for\0.00 malignancy confirmed on period, pathology without aa hysterectomy preoperative developed and described a standardized technique LESS Patients: During the study 7,469specimen, women underwent The present was performed to+/determine optimal dosage of staystudy 1.6 understood, 2 the +/- 2.3 \0.00 surgical for cancer. The incidence of unexpected gynecologic 5Length Plenary 1 - Laparoscopy supracervical hysterectomy that can1.7 be easily replicated, and and 6,563indication were performed for benign indications. cancer was 3.2%and (n=208) included uterine sarcoma (n=15,0.23%), Preoperative blood 41 (0.65) differentiate 1 (6.7) the sentinel \0.00 ofuseful indocyanine (ICG) to accurately is in learning the LESS technique. (11:33 AMgreen -transfusion 11:42 AM) Measurements Main and Results: Unexpected cancer was defined as endometrial (n=80,1.2%), cervicalspecimen, cancer (n=12,0.18%) and ovarian/ Postoperative blood transfusion 3 (20) node from surrounding tissue 149 and (2.3) then to test this dosage\0.00 using malignancy cancer confirmed on pathology without a preoperative Pelvic Spindle Cell Neoplasms Following Laparoscopic peritoneal/fallopian tubecancer. cancer The (n=100,1.5%). There was no difference in novel single-port robotic instrumentation. surgical indication for incidence of unexpected gynecologic Data Plenary are n (%) or mean  standard deviation unless otherwise specified. 5Hysterectomy 1 Laparoscopy or Myomectomy with Power the mean age3.2% of women withand unexpected compared(n=15,0.23%), to those with cancer was (n=208) included sarcoma uterine sarcoma The study wasAM performed in healthy female pigs. (11:33 - 11:42 AM) Morcellation benign pathology; women with unexpected sarcoma were Conclusion: Unexpected uterine and cervical cancers, found in 1.6% of endometrial cancerhowever, (n=80,1.2%), cervical cancer (n=12,0.18%) and younger ovarian/ After induction of anesthesia, allTA. pigs 1 2 2 1 underwent exploratory lapJ, Harrison and Gynecology, than those with a tube preoperative diagnosis ofThere cancer sarcoma on Hartzell KA, Tan-Kim Pelvic Spindle Cell Neoplasms Laparoscopic hysterectomies performed forFollowing benign Obstetrics indications are2 important peritoneal/fallopian cancer (n=100,1.5%). wasand no difference in arotomy, dissection of the bladder, and colpotomy to Obstetrics reveal the pathology (48.710.7vs.61.911.1,p=.01). The most common University of California, San Diego, Diego, California; Hysterectomy or Myomectomy withSan Power considerations for perioperative planning of minimally invasive surgery. the mean age of women with unexpected sarcoma compared to indications those with cervical os. With use of a 21-gauge needle, 0.5 mL normal saline for surgical intervention were fibroids and AUB, and there was no and Gynecology,including Kaiser Permanente, Diego, We recommend a discussionSan of the risksCalifornia and benefits associated Morcellation benign pathology; however, women with unexpected sarcoma were younger 1 injected at 2 the 3- and 29-o’ 1 clock positions as control. difference in preoperative indications between sarcoma and benign disease. solution was with morcellation to remove specimens during a minimally invasive than those with a preoperative diagnosis of cancer and sarcoma on Hartzell KA, Tan-Kim J, Harrison TA. Obstetrics and Gynecology, Study Objective: Toofdescribe theconstituted riskof for 2 factors Four concentrations ICGDiego, were forand doses 1000, 500, approach. WeCalifornia, did not identify preoperative that were pathology (48.710.7vs.61.911.1,p=.01). The most common indications Obstetrics University of San Sanincidence, Diego,characteristics California; Table 1 development ofmg spindle cellmL. neoplasms, including parasiticat leiomyomas significantly associated with uterine sarcoma. 250, and 175 per 0.5 ICG was then injected the 3and for surgical intervention were fibroids and AUB, and there was no and Gynecology, Kaiser Permanente, San Diego, California Demographic and clinical characteristics of women undergoing hysterecand uterine sarcoma, at the time of laparoscopic hysterectomy or difference in preoperative indications between sarcoma and benign disease. 9-o’clock positions on the cervix. tomy for a benign indication myomectomy with power morcellation. Study Objective: To describe the incidence, factors for camera was used to track ICG intoand the risk sentinel nodes 4The SPY Plenary 1 - Laparoscopy Design: Retrospective chart review. Table 1 development of spindle cell neoplasms, includingSPY parasitic leiomyomas Characteristics Benign Sarcoma p value (11:26 AMthe - 11:32 AM) and to quantify intensity of light emitted. technology uses Setting: Kaiser Permanente Medical San Diego. hysterectomy or Demographic and clinical characteristics of women undergoing hysterecand uterine sarcoma, at the time Center, of laparoscopic an intensity scale of 1 to 256; this scalelaparoscopic wasAused tohysterectomy determine the Patients: women who underwent or An AAGL3523 Task Force Statement: tomy myomectomy with powerConsensus morcellation. Age for a benign indication 46.8+/-10.7 48.7+/-12.5 0.49 difference in intensity between the sentinel node and surrounding myomectomy from 2000 to 2012. Standardized Approach to LESS Hysterectomy Design: Retrospective chart review. Surgeon Type Characteristics Benign Sarcoma p value tissues. Intervention: Univariate were conducted to identify potential risk Stepp KJE. Department ofanalyses Obstetrics and Gynecology, Carolinas Setting: Kaiser Permanente Medical Center, San Diego. Non-gyn oncologist 5,912 (94.2) 12 (80) .02 factors for 3523 parasitic leiomyomas andusing uterine sarcoma. Significant values The optimal dosage was single-port robotic instruHealthcare System, Charlotte, North Carolina Patients: women whotested underwent laparoscopic hysterectomy or Gyn Oncologist 363 (5.8) 13 (20) Age 46.8+/-10.7 48.7+/-12.5 0.49 (p\0.1) andwith those characteristics thattechniques. were biologically plausible risk mentation the same injection A sentinel node was myomectomy from 2000 to 2012. Surgical Indication Surgeon Type factors wereatput into a multivariate logistic regression model. Single incision gynecologic laparoscopy was firsttodescribed in 1991, but Intervention: Univariate analyses were conducted identify potential identified all doses except 175 mg, at which ICG stayed in risk the Pelvic Mass 323 (5.2) 1 (6.6) 0.54 Non-gyn oncologist 5,912 (94.2) 12 (80) .02 did not for really emerge until 2007 as an advanced laparoscopic approach. Measurements andleiomyomas Main Results: 941 sarcoma. patients underwent power factors parasitic and uterine Significant values Prolapse 667 (10.6) 0 cervix and vasculature only. For both the 500and 250-mg doses, Gyn Oncologist 363 (5.8) 13 (20) This approach is known many namesorand acronyms. morcellation the time of my laparoscopic hysterectomy myomectomy. (p\0.1) and at those characteristics that different were biologically plausible risk Endometriosis 567 (9) 1 (6.7) thethese, sentinel node was identified before reaching maximum intensiSurgical Indication Laparoendoscopic single site (LESS) surgery is the accepted acronym to Of 10/941 (1.1%) were diagnosed with spindle cell neoplasms. For factors were put into a multivariate logistic regression model. AUB +/Fibroids 2,587 (41.2) 9 (60) Pelvic Mass 323 (5.2) 1 (6.6) 0.54 ty. At maximum intensity, the difference between the surrounding describe this advanced approach. The of LESS for complex parasitic leiomyomas (n=4), median agefeasibility was 35 years (range 32-40), and Measurements and Main Results: 941 patients underwent power Endometriosis and 2,131(10.6) (34) Prolapse 667 04 (26.7) tissue and node was 207 (251 vswas 44) the dose and surgical procedures is no longer an issue; however, the500-mg generalizability of median timethe presentation 5foryears (range 4-11). On morcellation attothesecond time of laparoscopic hysterectomy or myomectomy. AUB +/- Fibroids Endometriosis 567 (9) 1 (6.7) multivariate analysis, younger age (OR 0.7, p=0.001, CI 0.54-0.90) and 159 (251 vs 92) for the 250-mg dose. Of these, 10/941 (1.1%) were diagnosed with spindle cell neoplasms. For Surgical AUB +/- Approach Fibroids 2,587 (41.2) 9 (60) uterine weight >350g (OR 13, p=0.046, CI 1.05-163.74) were associated Sentinel lymph node (SLN) biopsy performed usparasitic leiomyomas (n=4), median agewas wassuccessfully 35 years (range 32-40), and Abdominal 1,562 (34) (24.9) 48 (26.7) (53.3) 0.03 Endometriosis and 2,131 with higher risk of developing parasitic leiomyomas. The incidence of ing single-port robotic technology with both the 250and 500-mg median time to second presentation was 5 years (range 4-11). On Vaginal 775 (12.4) 0 AUB +/- Fibroids uterine sarcoma was 0.6% (6/941) with a0.7, median age of 47 years (range multivariate analysis, younger age (OR p=0.001, CIto 0.54-0.90) and doses. For SLN detection, the dose of ICG is related the ability to Laparoscopic 3,938 (62.7) 7 (46.7) 41-52). weight Thirty three percent were menopausal at the time of morcellation. Surgical Approach uterine >350g (OR 13, p=0.046, CI surrounding 1.05-163.74) were associated differentiate the sentinel node from the tissue. Specimen weight (grams) 231 401 520 +/- 972 0.01 Multivariate analysis revealed that menopausal status was associated with Abdominal 1,562+/-(24.9) 8 (53.3) 0.03 with higher riskofof developing leiomyomas. The of An ICG dose 250 to 500 mgparasitic enables identification ofincidence a SLN Fifty with Estimate blood loss 178 239 auterine higher risk forwas uterine p=0.04,age CI of 1.05-32.56). Vaginal 775 +/(12.4) 0405 +/- 452 \0.00 sarcoma 0.6%sarcoma (6/941) (OR with a6, median 47 years (range more distinction from the surrounding tissues, and this procedure Length of stay 1.7 +/-(62.7) 1.6 +/- 2.3 \0.00 percent Thirty of patients uterine sarcoma had sarcoma diagnosed on initial Laparoscopic 3,938 72 (46.7) 41-52). threewith percent were menopausal at the time of morcellation. Pathology and 50% hadthat recurrence of uterine with benign is feasiblereport, using single-port robotics instrumentation. Preoperative blood(grams) transfusion 41 1520 (6.7) Specimen weight 231(0.65) +/- 401 +/- 972 \0.00 0.01 Multivariate analysis revealed menopausal statussarcoma was associated with Pathology at initial procedure; median to second 6 Postoperative 149 +/(2.3)239 3 (20) \0.00 Estimate bloodblood loss transfusion 178 405 +/- 452 \0.00 a higher risk for uterine sarcoma (ORtime 6, p=0.04, CI presentation 1.05-32.56).was Fifty years (range 2-7). Length of stay 1.7 +/1.6 2 +/2.3 \0.00 percent of patients with uterine sarcoma had sarcoma diagnosed on initial Data are n (%) or mean  standard deviation unless otherwise specified. Conclusion: Younger age and uterine weight >350gsarcoma are riskwith factors for Pathology report, and 50% had recurrence of uterine benign Preoperative blood transfusion 41 (0.65) 1 (6.7) \0.00 parasitic leiomyomas after power morcellation, and menopause is was a risk Conclusion: uterine and Pathology at initial procedure; median time to second presentation 6 Postoperative Unexpected blood transfusion 149cervical (2.3) cancers, 3 (20)found in 1.6% \0.00of factor for uterine hysterectomies performed for benign indications are important years (range 2-7). sarcoma. Patients should be counseled about these Data are n (%) mean  standard deviation unless otherwise potential complications undergoing power are morcellation, considerations fororperioperative planning of minimally invasivespecified. surgery. Conclusion: Younger ageprior and to uterine weight >350g risk factors and for consideration should beafter givenpower to avoiding morcellation in these populations. We recommend including a discussion of the risks and benefits associated parasitic leiomyomas morcellation, and menopause is a risk Conclusion: Unexpected uterine and cervical cancers, found in 1.6% of with morcellation to remove specimens during a minimally invasive factor for uterine sarcoma. Patients should be counseled about these Mean Pre-op uterine size in weeks, (SD)

Mean Mass of the specimen in grams (SD)

Mean Number of myomas (SD)

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