- Email: [email protected]
AAGLEndoIssues: A unique and valuable resource in minimally invasive gynecology
Journal of Minimally Invasive Gynecology (2006) 13, 362–364
Clinical opinion
AAGLEndoIssues: A unique and valuable resource in minimally invasive gynecology Gary N. Frishman, MD From the Division of Reproductive Medicine, Women and Infants’ Hospital, and the Department of Obstetrics and Gynecology, Brown Medical School, Providence, Rhode Island The practice of medicine and, specifically, the field of minimally invasive gynecology (MIG) is constantly evolving. A number of resources exist to help a practitioner to keep up to date, as well as to address specific questions. However, each has its limitations. Textbooks may be quickly outdated and, along with journals, may not address a specific question in addition to the difficulty in obtaining and reading through all of the available texts and journals. Websites of organizations such as and the American Association of Gynecologic Laparoscopists (AAGL) and the American College of Obstetrics and Gynecology (http:// www.aagl.com/; http://www.acog.org/) have resources but also are unlikely to be able to address a specific question. Although society meetings and courses are an ideal forum for this interchange, these occur at relatively infrequent intervals and take time and money to attend. In addition, they occur sporadically and are unlikely to take place when a specific question or issue arises. Although there are many experts in the field, it may be difficult to both locate and approach one. Independent of their ability to answer questions specific to surgical techniques, none of the above resources are likely to address questions such as how to obtain the name of a referral physician for a patient who is moving, how to code for a specific procedure, how to invite colleagues to participate in a textbook, etc. Although these types of issues are not surgical in nature, they are certainly important to a surgeon’s practice and the field of MIG. A list serve or mailing list is a list of people’s names and Corresponding author: Gary N. Frishman, MD, Department of Obstetrics and Gynecology, Women and Infants’ Hospital, 101 Dudley St., Providence, RI 02905. E-mail: [email protected] Submitted December 22, 2005. Accepted for publication March 12, 2006.
1553-4650/$ -see front matter © 2006 AAGL. All rights reserved. doi:10.1016/j.jmig.2006.03.011
e-mail addresses that is used to facilitate sending a common message or announcement via e-mail to all the people on the list at one time. Each list usually has a central theme, and participants typically share a common interest. Countless electronic mailing lists exist throughout the world, and they have proven to be an ideal system for instantaneously and simultaneously communicating with a large number of people. Each list serve is typically managed by the list “owner” who creates the overall rules or guidelines for their specific list serve and is responsible for organizing the day-to-day operation. A moderated list is one in which the submitted messages are screened by the list moderator (who may or may not be the owner). The moderator acts as a filter rejecting inappropriate postings such as “spam” (the e-mail equivalent of junk mail) and helps members to post submissions to the list. Once a message is posted and e-mailed, members can delete, read, and respond to the posting. All responding e-mails are then compiled, edited, and distributed by the list editor in a subsequent e-mail. List serves differ from web-based forums such as bulletin boards or chat rooms in that they deliver the message (via e-mail) to the subscriber rather than requiring the participant to repeatedly go to a specific website to access new items. Both forums typically have web-based archives that are able to be searched for specific content (using text words) of old material. List serve sites are increasingly recognized to be a valuable resource for the practicing physician to discuss clinical cases.1 Previous literature has highlighted list serves and internet resources for physicians specializing in pediatric surgery,2 orthopedics,3 and pain management.4 Although there are obstetric and gynecologic–related list serves, these focus on general clinical practice (http://forums.obgyn.net/
Frishman Table 1
AAGLEndoIssues
363
Participation in the AAGLEndoIssues ListServ
First 6 months Second 6 months
No. of topics
No of postings
6 37
118 407
Table 2 Countries other than the United States and number of contributions
ob-gyn-l/listcmds.html) or subspecialties such as reproductive medicine’s Embryo Mail (http://www.lpsi.barc.usda. gov/EmbryoMail/default.htm). No nationwide list serve exists to address the unique needs of MIG. A decision was made to begin a list serve addressing issues surrounding topics in this field.
Methods Moderators and managers of other academic and medical list serves were contacted about the setup of their specific mailing list concerning their infrastructure and monitoring systems, as well as to avoid any overlap in mission statement or content (for obstetrics and gynecology–related sites). Suggestions regarding structure and format were incorporated during the design of the current list serve. The stated goal of the new list serve, entitled AAGLEndoIssues, is to “Facilitate communication and exchange of ideas, experience, and topics specific to the field of Minimally Invasive Gynecology.” In investigating resources, the author’s institution (Brown University) maintains a computer server for list serves and provides information services support at no charge to faculty. Hundreds of list serves are managed on its server for a variety of groups with diverse membership and interests. The actual structure and format for the list serve, AAGLEndoIssues, was developed in the summer of 2004 in coordination with the Brown University Computing and Information Systems Department and Programmers and the AAGL. Membership is an AAGL benefit at no charge to subscribers. The Society’s e-mail membership list was used to launch the ListServ.
Results The list serve had its first clinical posting in September 2004. Postings are edited using the University-based server, which is accessed via the web. This editing process permits the moderator to refine the content of the posting and put the topic discussed in the subject line of the posting rather than just the name of the e-mail posting (e.g., “Non-hysterectomy options for 24 week fibroid uterus” vs “re: Re: AAGLENDOISSUES Digest - 1 Dec 2005 to 4 Dec 2005 (#2005-213)”). This facilitates both scanning the table of contents of the digest and identifying how many submissions there are for any one topic.
Country
No.
Australia Belgium Brazil Canada China Colombia Egypt England France Greece Guatemala Hong Kong India Israel Italy Japan Malaysia Mexico Netherlands New Zealand Norway Peru South Africa Spain
4 1 1 14 1 1 2 1 1 1 1 1 7 3 8 1 1 3 5 3 1 1 2 2
There are currently more than 2450 subscribers, making AAGLEndoIssues one of the most popular list serves among the hundreds on the Brown University server. In the year since the list serve was formed, there have been more than 40 different topics discussed. With time, there has been a dramatic increase in contributions (Table 1). In addition, the participation reflects the international membership of the AAGL, with postings from members in 25 countries on 5 continents (Table 2). Canada, India, Italy, The Netherlands, and the United States have the most active participants. The most common theme relates to technical issues and management questions (Table 3). Questions have also been posted relating to more philosophical topics such as why close the vaginal cuff at all. The most popular thread to date, with 46 postings, concerned how the individual practitioner makes a diagnosis of endometriosis. Lastly, topics relating
Table 3
Most popular topics and number of postings
Instruments for TLH Hyperplasia on ablation pathology Endometritis status after Novasure ablation Fluid management for hysteroscopy Vault infection status after TLH Non-hysterectomy option with fibroids Left upper quadrant trocar insertion Energy sources for laparoscopic BSO Healing of vaginal cuff after TLH
43 37 29 29 28 27 26 25 17
BSO ⫽ bilateral salpingoophorectomy, TLH ⫽ total laparoscopic hysterectomy
364
Journal of Minimally Invasive Gynecology, Vol 13, No 4, July/August 2006
to academic issues have been posted, including questions relating to credentialing residents in hysteroscopy and a request for authors to participate in a Board Review Book. Minimal spam or advertising has been submitted, and all has been screened out successfully. Authors who have been acerbic in their submissions have uniformly been willing to modify their comments at the request of the moderator. Indeed, the role of the moderator has been mainly to facilitate the posting of questions, edit submissions to minimize the total amount of material posted by preventing repetitive material, and ensure that the correct name of the topic matter is posted in the subject line of the submission. The list serve follows an open format, and the moderator does not screen submissions for accuracy. Beginning in November 2005 a disclaimer was used at the end of all e-mail digests notifying users of this, as well as the fact that the content does not necessarily reflect the viewpoints of the AAGL or the ListServ Editor.
and moderate the day to day activity of the list serve is greatly improved. Spam e-mails and advertising are able to be screened out by the list moderator. The format allows for content to be delivered directly to the membership rather than requiring visiting a website. The number of postings and responses has paralleled the interest in the ListServ. It is anticipated the ListServ will play an increasingly important role in serving as a forum for the discussion of issues related to MIG. Interested members of the AAGL may view the archives and post submissions at no charge by going to the following URL: http://listserv.brown.edu/archives/AAGLEndoIssues. html or contact the Editor directly at Gary_Frishman@ Brown.edu.
Acknowledgment Special thanks to Peter DiCamillo for his invaluable assistance in setting up the list serve and helping with ongoing management.
Comment AAGLEndoIssues is a potentially valuable and practical resource for the rapid communication and sharing of information concerning a wide range of issues involving MIG. Topics include technical and management questions, as well as referral questions and academic issues. The theme of the list serve is unique and different than other existing list serves, including those already serving the obstetrics and gynecology community. By choosing an e-mail system that allows submitted postings to be edited, the ability to control
References 1. Angelo SJ. An electronic survey of physicians using online clinical discussion groups: a brief report. Conn Med. 2001;65:135–139. 2. Lugo-Vicente H. Internet resources and web pages for pediatric surgeons. Sem Ped Surg. 2000;9:11–18. 3. Callanan I. The Internet and an orthopaedic discussion group. J Telemed Telecare. 1999;5(Suppl 1):S42–S44. 4. Steckner K. On-line resources for the Pain Medicine physician. Reg Anesth Pain Med. 2000;25:291–295.
Clinical opinion
AAGLEndoIssues: A unique and valuable resource in minimally invasive gynecology Gary N. Frishman, MD From the Division of Reproductive Medicine, Women and Infants’ Hospital, and the Department of Obstetrics and Gynecology, Brown Medical School, Providence, Rhode Island The practice of medicine and, specifically, the field of minimally invasive gynecology (MIG) is constantly evolving. A number of resources exist to help a practitioner to keep up to date, as well as to address specific questions. However, each has its limitations. Textbooks may be quickly outdated and, along with journals, may not address a specific question in addition to the difficulty in obtaining and reading through all of the available texts and journals. Websites of organizations such as and the American Association of Gynecologic Laparoscopists (AAGL) and the American College of Obstetrics and Gynecology (http:// www.aagl.com/; http://www.acog.org/) have resources but also are unlikely to be able to address a specific question. Although society meetings and courses are an ideal forum for this interchange, these occur at relatively infrequent intervals and take time and money to attend. In addition, they occur sporadically and are unlikely to take place when a specific question or issue arises. Although there are many experts in the field, it may be difficult to both locate and approach one. Independent of their ability to answer questions specific to surgical techniques, none of the above resources are likely to address questions such as how to obtain the name of a referral physician for a patient who is moving, how to code for a specific procedure, how to invite colleagues to participate in a textbook, etc. Although these types of issues are not surgical in nature, they are certainly important to a surgeon’s practice and the field of MIG. A list serve or mailing list is a list of people’s names and Corresponding author: Gary N. Frishman, MD, Department of Obstetrics and Gynecology, Women and Infants’ Hospital, 101 Dudley St., Providence, RI 02905. E-mail: [email protected] Submitted December 22, 2005. Accepted for publication March 12, 2006.
1553-4650/$ -see front matter © 2006 AAGL. All rights reserved. doi:10.1016/j.jmig.2006.03.011
e-mail addresses that is used to facilitate sending a common message or announcement via e-mail to all the people on the list at one time. Each list usually has a central theme, and participants typically share a common interest. Countless electronic mailing lists exist throughout the world, and they have proven to be an ideal system for instantaneously and simultaneously communicating with a large number of people. Each list serve is typically managed by the list “owner” who creates the overall rules or guidelines for their specific list serve and is responsible for organizing the day-to-day operation. A moderated list is one in which the submitted messages are screened by the list moderator (who may or may not be the owner). The moderator acts as a filter rejecting inappropriate postings such as “spam” (the e-mail equivalent of junk mail) and helps members to post submissions to the list. Once a message is posted and e-mailed, members can delete, read, and respond to the posting. All responding e-mails are then compiled, edited, and distributed by the list editor in a subsequent e-mail. List serves differ from web-based forums such as bulletin boards or chat rooms in that they deliver the message (via e-mail) to the subscriber rather than requiring the participant to repeatedly go to a specific website to access new items. Both forums typically have web-based archives that are able to be searched for specific content (using text words) of old material. List serve sites are increasingly recognized to be a valuable resource for the practicing physician to discuss clinical cases.1 Previous literature has highlighted list serves and internet resources for physicians specializing in pediatric surgery,2 orthopedics,3 and pain management.4 Although there are obstetric and gynecologic–related list serves, these focus on general clinical practice (http://forums.obgyn.net/
Frishman Table 1
AAGLEndoIssues
363
Participation in the AAGLEndoIssues ListServ
First 6 months Second 6 months
No. of topics
No of postings
6 37
118 407
Table 2 Countries other than the United States and number of contributions
ob-gyn-l/listcmds.html) or subspecialties such as reproductive medicine’s Embryo Mail (http://www.lpsi.barc.usda. gov/EmbryoMail/default.htm). No nationwide list serve exists to address the unique needs of MIG. A decision was made to begin a list serve addressing issues surrounding topics in this field.
Methods Moderators and managers of other academic and medical list serves were contacted about the setup of their specific mailing list concerning their infrastructure and monitoring systems, as well as to avoid any overlap in mission statement or content (for obstetrics and gynecology–related sites). Suggestions regarding structure and format were incorporated during the design of the current list serve. The stated goal of the new list serve, entitled AAGLEndoIssues, is to “Facilitate communication and exchange of ideas, experience, and topics specific to the field of Minimally Invasive Gynecology.” In investigating resources, the author’s institution (Brown University) maintains a computer server for list serves and provides information services support at no charge to faculty. Hundreds of list serves are managed on its server for a variety of groups with diverse membership and interests. The actual structure and format for the list serve, AAGLEndoIssues, was developed in the summer of 2004 in coordination with the Brown University Computing and Information Systems Department and Programmers and the AAGL. Membership is an AAGL benefit at no charge to subscribers. The Society’s e-mail membership list was used to launch the ListServ.
Results The list serve had its first clinical posting in September 2004. Postings are edited using the University-based server, which is accessed via the web. This editing process permits the moderator to refine the content of the posting and put the topic discussed in the subject line of the posting rather than just the name of the e-mail posting (e.g., “Non-hysterectomy options for 24 week fibroid uterus” vs “re: Re: AAGLENDOISSUES Digest - 1 Dec 2005 to 4 Dec 2005 (#2005-213)”). This facilitates both scanning the table of contents of the digest and identifying how many submissions there are for any one topic.
Country
No.
Australia Belgium Brazil Canada China Colombia Egypt England France Greece Guatemala Hong Kong India Israel Italy Japan Malaysia Mexico Netherlands New Zealand Norway Peru South Africa Spain
4 1 1 14 1 1 2 1 1 1 1 1 7 3 8 1 1 3 5 3 1 1 2 2
There are currently more than 2450 subscribers, making AAGLEndoIssues one of the most popular list serves among the hundreds on the Brown University server. In the year since the list serve was formed, there have been more than 40 different topics discussed. With time, there has been a dramatic increase in contributions (Table 1). In addition, the participation reflects the international membership of the AAGL, with postings from members in 25 countries on 5 continents (Table 2). Canada, India, Italy, The Netherlands, and the United States have the most active participants. The most common theme relates to technical issues and management questions (Table 3). Questions have also been posted relating to more philosophical topics such as why close the vaginal cuff at all. The most popular thread to date, with 46 postings, concerned how the individual practitioner makes a diagnosis of endometriosis. Lastly, topics relating
Table 3
Most popular topics and number of postings
Instruments for TLH Hyperplasia on ablation pathology Endometritis status after Novasure ablation Fluid management for hysteroscopy Vault infection status after TLH Non-hysterectomy option with fibroids Left upper quadrant trocar insertion Energy sources for laparoscopic BSO Healing of vaginal cuff after TLH
43 37 29 29 28 27 26 25 17
BSO ⫽ bilateral salpingoophorectomy, TLH ⫽ total laparoscopic hysterectomy
364
Journal of Minimally Invasive Gynecology, Vol 13, No 4, July/August 2006
to academic issues have been posted, including questions relating to credentialing residents in hysteroscopy and a request for authors to participate in a Board Review Book. Minimal spam or advertising has been submitted, and all has been screened out successfully. Authors who have been acerbic in their submissions have uniformly been willing to modify their comments at the request of the moderator. Indeed, the role of the moderator has been mainly to facilitate the posting of questions, edit submissions to minimize the total amount of material posted by preventing repetitive material, and ensure that the correct name of the topic matter is posted in the subject line of the submission. The list serve follows an open format, and the moderator does not screen submissions for accuracy. Beginning in November 2005 a disclaimer was used at the end of all e-mail digests notifying users of this, as well as the fact that the content does not necessarily reflect the viewpoints of the AAGL or the ListServ Editor.
and moderate the day to day activity of the list serve is greatly improved. Spam e-mails and advertising are able to be screened out by the list moderator. The format allows for content to be delivered directly to the membership rather than requiring visiting a website. The number of postings and responses has paralleled the interest in the ListServ. It is anticipated the ListServ will play an increasingly important role in serving as a forum for the discussion of issues related to MIG. Interested members of the AAGL may view the archives and post submissions at no charge by going to the following URL: http://listserv.brown.edu/archives/AAGLEndoIssues. html or contact the Editor directly at Gary_Frishman@ Brown.edu.
Acknowledgment Special thanks to Peter DiCamillo for his invaluable assistance in setting up the list serve and helping with ongoing management.
Comment AAGLEndoIssues is a potentially valuable and practical resource for the rapid communication and sharing of information concerning a wide range of issues involving MIG. Topics include technical and management questions, as well as referral questions and academic issues. The theme of the list serve is unique and different than other existing list serves, including those already serving the obstetrics and gynecology community. By choosing an e-mail system that allows submitted postings to be edited, the ability to control
References 1. Angelo SJ. An electronic survey of physicians using online clinical discussion groups: a brief report. Conn Med. 2001;65:135–139. 2. Lugo-Vicente H. Internet resources and web pages for pediatric surgeons. Sem Ped Surg. 2000;9:11–18. 3. Callanan I. The Internet and an orthopaedic discussion group. J Telemed Telecare. 1999;5(Suppl 1):S42–S44. 4. Steckner K. On-line resources for the Pain Medicine physician. Reg Anesth Pain Med. 2000;25:291–295.