http://www.gynecendoscopy.org/currentissue.asp J Gynec Endosc Surg 2011 - 2(1) Journal of Gynecological Endoscopy and Surgery Medknow Publications0974-1216 Rajesh Modi Editorial Journal of Gynecological Endoscopy and Surgery 2011 2(1):1-1doi:10.4103/0974-1216.85270 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85270 http://www.gynecendoscopy.org/text.asp?2011/2/1/1/85270 http://www.gynecendoscopy.org/text.asp?2011/2/1/1/8527021 1 1 http://www.gynecendoscopy.org/text.asp?2011/2/1/1/85270 Rajesh Modi

Journal of Gynecological Endoscopy and Surgery 2011 2(1):1-1

]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/1/85270 Rakesh Sinha Editorial Journal of Gynecological Endoscopy and Surgery 2011 2(1):2-2doi:10.4103/0974-1216.85271 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85271 http://www.gynecendoscopy.org/text.asp?2011/2/1/2/85271 http://www.gynecendoscopy.org/text.asp?2011/2/1/2/8527121 2 2 http://www.gynecendoscopy.org/text.asp?2011/2/1/2/85271 Rakesh Sinha

Journal of Gynecological Endoscopy and Surgery 2011 2(1):2-2

]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/2/85271 Rakesh Sinha Meenakshi Sundaram Chaitali Mahajan Shweta Raje Pratima Kadam Gayatri Rao Review Article Journal of Gynecological Endoscopy and Surgery 2011 2(1):3-10doi:10.4103/0974-1216.85272 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85272 http://www.gynecendoscopy.org/text.asp?2011/2/1/3/85272 http://www.gynecendoscopy.org/text.asp?2011/2/1/3/8527221 3 10 http://www.gynecendoscopy.org/text.asp?2011/2/1/3/85272 Rakesh Sinha, Meenakshi Sundaram, Chaitali Mahajan, Shweta Raje, Pratima Kadam, Gayatri Rao

Journal of Gynecological Endoscopy and Surgery 2011 2(1):3-10

Uterine leiomyomas are one of the most common benign smooth muscle tumors in women, with a prevalence of 20 to 40% in women over the age of 35 years. Although many women are asymptomatic, problems such as bleeding, pelvic pain, and infertility may necessitate treatment. Laparoscopic myomectomy is one of the treatment options for myomas. The major concern of myomectomy either by open method or by laparoscopy is the bleeding encountered during the procedure. Most studies have aimed at ways of reducing blood loss during myomectomy. There are various ways in which bleeding during laparoscopic myomectomy can be reduced, the most reliable of which is ligation of the uterine vessels bilaterally. In this review we propose to discuss the benefits and possible disadvantages of ligating the uterine arteries bilaterally before performing laparoscopic myomectomy.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/3/85272 Mereu Liliana Pontis Alessandro Carri Giada Mencaglia Luca Review Article Journal of Gynecological Endoscopy and Surgery 2011 2(1):11-17doi:10.4103/0974-1216.85273 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85273 http://www.gynecendoscopy.org/text.asp?2011/2/1/11/85273 http://www.gynecendoscopy.org/text.asp?2011/2/1/11/8527321 11 17 http://www.gynecendoscopy.org/text.asp?2011/2/1/11/85273 Mereu Liliana, Pontis Alessandro, Carri Giada, Mencaglia Luca

Journal of Gynecological Endoscopy and Surgery 2011 2(1):11-17

The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus and reduces morbidity of minimally invasive surgery. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. This review summarizes the history of SPAL hysterectomy (single-port access laparoscopy), and emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Specific gynecological applications of single-port hysterectomy to date are summarized. Using the PubMed database, the English-language literature was reviewed for the past 40 years. Keyword searches included scarless, scar free, single-port/trocar/incision, single-port access laparoscopic hysterectomy. Within the bibliography of selected references, additional sources were retrieved. The purpose of the present article was to review the development and current status of SPAL hysterectomy and highlight important advances associated with this innovative approach.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/11/85273 Manju Sinha Sheetal Chiplonkar Review Article Journal of Gynecological Endoscopy and Surgery 2011 2(1):18-20doi:10.4103/0974-1216.85274 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85274 http://www.gynecendoscopy.org/text.asp?2011/2/1/18/85274 http://www.gynecendoscopy.org/text.asp?2011/2/1/18/8527421 18 20 http://www.gynecendoscopy.org/text.asp?2011/2/1/18/85274 Manju Sinha, Sheetal Chiplonkar

Journal of Gynecological Endoscopy and Surgery 2011 2(1):18-20

Recent advances in the practice of anesthsiology ensure that we move closer to our goal of zero morbidity. It is of critical importance that we couple our clinical expertise with the sophisticated monitoring equipment and get the best out of them.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/18/85274 Bhaskar Pal Review Article Journal of Gynecological Endoscopy and Surgery 2011 2(1):21-24doi:10.4103/0974-1216.85275 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85275 http://www.gynecendoscopy.org/text.asp?2011/2/1/21/85275 http://www.gynecendoscopy.org/text.asp?2011/2/1/21/8527521 21 24 http://www.gynecendoscopy.org/text.asp?2011/2/1/21/85275 Bhaskar Pal

Journal of Gynecological Endoscopy and Surgery 2011 2(1):21-24

Adhesions are abnormal fibrous connections, joining tissue surfaces in abnormal locations. Adhesions form after any trauma involving the peritoneum and the injured tissue surface or directly between the injured tissue surfaces. The ideal anti-adhesion agent should be safe, efficacious, easy to use in all types of surgery, and economical. It should prevent adhesions at the site of surgery as well as throughout the peritoneal cavity. Needless to say, the ideal agent is still elusive.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/21/85275 Gopinath N Shenoy Review Article Journal of Gynecological Endoscopy and Surgery 2011 2(1):25-29doi:10.4103/0974-1216.85276 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85276 http://www.gynecendoscopy.org/text.asp?2011/2/1/25/85276 http://www.gynecendoscopy.org/text.asp?2011/2/1/25/8527621 25 29 http://www.gynecendoscopy.org/text.asp?2011/2/1/25/85276 Gopinath N Shenoy

Journal of Gynecological Endoscopy and Surgery 2011 2(1):25-29

Services provided by healthcare providers have been the subject matter of judicial review time and again. The Consumer Disputes Redressal Commissions have laid down decisively what is and what is not 'deficiency' in the services provided by a healthcare provider. 'Deficiency' means, any fault, imperfection, shortcoming or inadequacy in the quality, nature, and manner of performance that is required to be maintained by or under any law for the time being in force or has been undertaken to be performed by a person in pursuance of a contract or otherwise, in relation to any service.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/25/85276 Pravin Patel Manish Banker Sujal Munshi Aditi Bhalla Review Article Journal of Gynecological Endoscopy and Surgery 2011 2(1):30-32doi:10.4103/0974-1216.85277 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85277 http://www.gynecendoscopy.org/text.asp?2011/2/1/30/85277 http://www.gynecendoscopy.org/text.asp?2011/2/1/30/8527721 30 32 http://www.gynecendoscopy.org/text.asp?2011/2/1/30/85277 Pravin Patel, Manish Banker, Sujal Munshi, Aditi Bhalla

Journal of Gynecological Endoscopy and Surgery 2011 2(1):30-32

Compared to myomas that occur in the uterine corpus, cervical myomas are closer to other organs such as the bladder, ureter, and rectum, and the approach needs to be modified, as the organs that have to be considered differ depending on the location of the myoma. Surgical difficulties associated with these cases are, poor access to the operative field, difficulty in suturing the repairs, increased blood loss, and distortion of the anatomy of the vital neighboring structures in the pelvic cavity.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/30/85277 Nikita Trehan Review Article Journal of Gynecological Endoscopy and Surgery 2011 2(1):33-35doi:10.4103/0974-1216.85278 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85278 http://www.gynecendoscopy.org/text.asp?2011/2/1/33/85278 http://www.gynecendoscopy.org/text.asp?2011/2/1/33/8527821 33 35 http://www.gynecendoscopy.org/text.asp?2011/2/1/33/85278 Nikita Trehan

Journal of Gynecological Endoscopy and Surgery 2011 2(1):33-35

Most of the surgeons find it difficult to perform myomectomy when it bleeds during the procedure as it becomes difficult to get into the correct plane of dissection. If this bleeding or blood staining of tissues is prevented it will be easier to get into the correct plane of dissection. In several studies, it is found that bilateral uterine artery ligation, at origin, does not interfere with future fertility as the end vessels and collaterals of the uterus are not interfered with. As no energy source is used to incise the myoma once Vasopressin has been used, the myomectomy scar integrity is better, as noted by various surgeons.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/33/85278 Pankaj Desai Purvi Patel Original Article Journal of Gynecological Endoscopy and Surgery 2011 2(1):36-42doi:10.4103/0974-1216.85280 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85280 http://www.gynecendoscopy.org/text.asp?2011/2/1/36/85280 http://www.gynecendoscopy.org/text.asp?2011/2/1/36/8528021 36 42 http://www.gynecendoscopy.org/text.asp?2011/2/1/36/85280 Pankaj Desai, Purvi Patel

Journal of Gynecological Endoscopy and Surgery 2011 2(1):36-42

Objective: To review the literature and summarize the available evidence about the relationship of fibroids with infertility and to review the role of laparoscopic myomectomy in infertility. Materials and Methods: Medline, PubMed, and Cochrane Databases were searched for articles published between 1980 and 2010. Results: Fertility outcomes are decreased in women with submucosal fibroids, and myomectomy is of value. Subserosal fibroids do not affect fertility outcomes, and removal may not confer benefit. Intramural fibroids appear to decrease fertility, but the results of therapy are unclear. Although pregnancy rates for women with leiomyomata, managed endoscopically, are similar to those after laparotomy, there is a risk of uterine rupture. The risk is essentially unknown. Finally, the risk of recurrence seems higher after laparoscopic myomectomy compared to laparotomy. Conclusions: Laparoscopic myomectomy, when performed by an experienced surgeon, can be considered a safe technique, with an extremely low failure rate and good results in terms of the outcome of pregnancy.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/36/85280 Nutan Jain Original Article Journal of Gynecological Endoscopy and Surgery 2011 2(1):43-46doi:10.4103/0974-1216.85281 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85281 http://www.gynecendoscopy.org/text.asp?2011/2/1/43/85281 http://www.gynecendoscopy.org/text.asp?2011/2/1/43/8528121 43 46 http://www.gynecendoscopy.org/text.asp?2011/2/1/43/85281 Nutan Jain

Journal of Gynecological Endoscopy and Surgery 2011 2(1):43-46

Objective: To assess the feasibility and outcome of laparoscopic myomectomy and multiple layer closure of the myoma bed, for management of myomas, at a tertiary care hospital . Materials and Methods: From September 2005 to September 2010, 417 patients, with large and moderate size myomas, were managed by laparoscopic myomectomy. Indications were subfertility, menorrhagia, and abdominal mass. Preoperative evaluation included history, clinical examination, and sonographic mapping. The myomas were enucleated and retrieved laparoscopically. Myoma beds were sutured in multiple layers by endoscopic intracorporeal suturing. Results: Three hundred and fifteen patients presented with subfertility, 45 with menorrhagia, and 57 with abdominal mass. The average maximum diameter of a myoma was 9 cm. The mean duration of surgery was 120 minutes. The mean postoperative stay was 24 hours. No intraoperative complication occurred and the hospital course was uncomplicated. In one case, a minilap incision was performed for retrieval of the myoma with suturing of the bed. Two patients had minor delayed wound healing of the morcellator port site. The patients did not report any complaints during the follow-up, except one patient who developed omental hernia at the morcellator port site. There was no rupture of the scar and very low adhesion scores in the subsequent cesarean sections or second-look scopies. Conclusion : With proper multilayer closure of the myoma bed, laparoscopic myomectomy was feasible for moderate and even large myomas and had excellent outcomes.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/43/85281 Rajesh Modi New Techniques Journal of Gynecological Endoscopy and Surgery 2011 2(1):47-52doi:10.4103/0974-1216.85283 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85283 http://www.gynecendoscopy.org/text.asp?2011/2/1/47/85283 http://www.gynecendoscopy.org/text.asp?2011/2/1/47/8528321 47 52 http://www.gynecendoscopy.org/text.asp?2011/2/1/47/85283 Rajesh Modi

Journal of Gynecological Endoscopy and Surgery 2011 2(1):47-52

The objective of this study was to evaluate the efficacy of aquadissection technique to reduce the blood loss in myomectomy and to assess the benefits and feasibility of the use of barbed suture for myometrial defect closure. Vasopressin is diluted with saline as 10 units of vasopressin for every 100 ml of saline. For a fibroid of about 8 cm size, 40 units of vasopressin is diluted in 400 ml of normal saline. The whole of 400 ml of this saline is injected in the myometrium. Incision is made on the uterus with just simple scissors (no energy source is required). As the uterus is cut, instead of bleeding, saline leakage takes place. This helps to keep the field clear and it is easier to get the correct plane between the fibroid and the myometrium. The separation of the fibroid is helped due to the dissection of the correct plane by the saline injection.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/47/85283 Krishna Kavita Ramavath PP Srinivasa Murthy Case Report Journal of Gynecological Endoscopy and Surgery 2011 2(1):53-57doi:10.4103/0974-1216.85285 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85285 http://www.gynecendoscopy.org/text.asp?2011/2/1/53/85285 http://www.gynecendoscopy.org/text.asp?2011/2/1/53/8528521 53 57 http://www.gynecendoscopy.org/text.asp?2011/2/1/53/85285 Krishna Kavita Ramavath, PP Srinivasa Murthy

Journal of Gynecological Endoscopy and Surgery 2011 2(1):53-57

Although there are many studies the ongoing debate on the management of posthysterectomy vault prolapse whether it should be abdominal, vaginal, or laparoscopic still continues. However there is no clear consensus. Though the incidence of vaginal vault prolapse is said to range from 0.2 to 45%, the choice of the optimal treatment depends on the surgeon's experience, suitability for surgery, age, symptoms, quality of life impairment, and prolapse grade. Abdominal sacrocopopexy (ASCP) with mesh interposition is the traditional surgical procedure for treating pelvic organ prolapse and has been shown to have one of the highest long-term success rates for vaginal vault prolapse. The laparoscopic approach offers reduced morbidity, shorter hospitalization, and decreased post operative pain. The disadvantages of the laparoscopic approach include longer operating time and need for advanced laparoscopic surgical skills including suturing. Robot-assisted laparoscopic procedure allows the performance of complex laparoscopic maneuvers with less difficulty, and thereby simplifies the complex procedure. The aim is to describe and demonstrate the use and benefit of robot-assisted laparoscopic sacrocolpopexy in the treatment of posthysterectomy vaginal vault prolapse in obese patients along with mid-urethral sling application.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/53/85285 Rafique B Parkar MA Hassan David Otieno Richard Baraza Case Report Journal of Gynecological Endoscopy and Surgery 2011 2(1):58-60doi:10.4103/0974-1216.85287 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85287 http://www.gynecendoscopy.org/text.asp?2011/2/1/58/85287 http://www.gynecendoscopy.org/text.asp?2011/2/1/58/8528721 58 60 http://www.gynecendoscopy.org/text.asp?2011/2/1/58/85287 Rafique B Parkar, MA Hassan, David Otieno, Richard Baraza

Journal of Gynecological Endoscopy and Surgery 2011 2(1):58-60

A 43-year-old, who underwent a subtotal hysterectomy for postpartum hemorrhage following a normal delivery, 10 years ago, presented with a history of persistent vaginal discharge and post-coital bleeding. A pap smear reported moderate dysplasia, and a subsequent colposcopic biopsy reported severe dysplasia with crypt extension. The patient underwent a laparoscopic trachelectomy, and histology of the stump reported cervical squamous carcinoma in situ, with no microinvasion.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/58/85287 B Ramesh Madhuri Vidyashankar BV Bharathi Case Report Journal of Gynecological Endoscopy and Surgery 2011 2(1):61-63doi:10.4103/0974-1216.85288 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85288 http://www.gynecendoscopy.org/text.asp?2011/2/1/61/85288 http://www.gynecendoscopy.org/text.asp?2011/2/1/61/8528821 61 63 http://www.gynecendoscopy.org/text.asp?2011/2/1/61/85288 B Ramesh, Madhuri Vidyashankar, BV Bharathi

Journal of Gynecological Endoscopy and Surgery 2011 2(1):61-63

Single port laparoscopic surgery (SPLS), also called SILS is the natural extension of multi-incisional laparoscopic surgery, in the quest for reduction of traumatic insult and residual scarring to the patient. Today with the evolution of newer instruments, bidirectional self-retaining sutures, and surgical experience we are able to perform many surgeries in gynecology.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/61/85288 Palaskar Pandit Shradha Chandak Case Report Journal of Gynecological Endoscopy and Surgery 2011 2(1):64-66doi:10.4103/0974-1216.85290 Journal of Gynecological Endoscopy and Surgery 10.4103/0974-1216.85290 http://www.gynecendoscopy.org/text.asp?2011/2/1/64/85290 http://www.gynecendoscopy.org/text.asp?2011/2/1/64/8529021 64 66 http://www.gynecendoscopy.org/text.asp?2011/2/1/64/85290 Palaskar Pandit, Shradha Chandak

Journal of Gynecological Endoscopy and Surgery 2011 2(1):64-66

Two cases of true broad ligament fibroids and thirty cases of false broad ligament fibroids were operated. All were removed through the laparoscopic route, with very minimal blood loss and without a need for blood transfusion. We traced the course of the ureters in all cases. No complications were met with.]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/64/85290 Rajesh Modi Book Review Journal of Gynecological Endoscopy and Surgery 2011 2(1):67-67Journal of Gynecological Endoscopy and Surgery http://www.gynecendoscopy.org/text.asp?2011/2/1/67/85292 http://www.gynecendoscopy.org/text.asp?2011/2/1/67/8529221 67 67 http://www.gynecendoscopy.org/text.asp?2011/2/1/67/85292 Rajesh Modi

Journal of Gynecological Endoscopy and Surgery 2011 2(1):67-67

]]> Thu,22 Sep 2011http://www.gynecendoscopy.org/text.asp?2011/2/1/67/85292