Jin Hwa Hong

Does conventional or single port laparoscopically assisted vaginal hysterectomy affect female sexual function

Objective. To investigate the effects of conventional and single port laparoscopically assisted vaginal hysterectomy (LAVH) on sexual function in premenopausal women. Design. A prospective case‐control study. Setting. University teaching hospital. Population. A total of 95 premenopausal women having LAVH from January 2009 to December 2009. Methods. Comparison of 47 premenopausal women who had single port LAVH using trans‐umbilical GelPort access (SP‐LAVH group) and 48 premenopausal women who had conventional multiport LAVH (conventional LAVH group). Main outcome measures. Evaluation of sexual function was done prior to and six months after surgery using a validated tool, the female sexual function index (FSFI). Results. In terms of womens demographic characteristics and operative results, there was no significant difference between the two study groups, or between pre‐ and postoperative individual domain scores or total female sexual function index in women who underwent either conventional or single port LAVH. Conclusions. Neither conventional nor single port LAVH affects sexual function in premenopausal women. Women can be counseled that this type of surgery is unlikely to alter sexual function.

Laparoscopic surgical management and clinical characteristics of ovarian fibromas.

Ovarian fibromas may be misdiagnosed as uterine myoma or ovarian malignant tumor. Laparoscopic examination appears to be an effective and safe surgical approach for managing ovarian fibromas.

Clinical performance assessment of five human papillomavirus DNA tests using liquid-based cytology samples.

Aim:  To evaluate the performance of five HPV tests (Hybrid Capture 2, Linear Array [LA], DNA chip, type‐specific polymerase chain reaction [PCR], and sequencing) in detecting high‐risk (HR) HPV DNA and high‐grade cervical intraepithelial neoplasia (CIN) and cancer.

Is laparoscopic surgery safe in women over 70 years old with benign gynecological disease

Aim:  To evaluate the feasibility, efficacy, and safety of laparoscopic surgery for benign gynecological disease in women over 70 years old.

Laparoscopic incidental appendectomy during laparoscopic surgery for ovarian endometrioma.

OBJECTIVE We sought to investigate the safety and efficacy of laparoscopic incidental appendectomy during laparoscopic surgery for endometrioma. STUDY DESIGN We conducted a retrospective study of 356 patients undergoing laparoscopic surgery for endometrioma with appendectomy (appendectomy group, n = 172) or not (nonappendectomy group, n = 184). Primary outcome measures were operating time, hemoglobin change, hospital stay, return of bowel activity, and any complications. The secondary outcome was appendiceal histopathology. RESULTS There were no statistical differences between groups in operating time, postoperative changes in hemoglobin concentration, hospital stay, return of bowel activity, or complication rate. Of the 172 resected appendices, 52 had histopathologically confirmed abnormal findings including appendiceal endometriosis in 16. CONCLUSION Incidental appendectomy at the time of laparoscopic surgery for endometrioma does not increase operative morbidity, and it has considerable diagnostic and preventive value. However, a large prospective randomized study is needed in the future to confirm this conclusion.

Laparoscopic management of large ovarian tumors: clinical tips for overcoming common concerns.

Aim:  This study was performed to assess the feasibility and efficacy of laparoscopic management for patients with large ovarian tumors.

Laparoscopic Lymphadenectomy for Isolated Lymph Node Recurrence in Gynecologic Malignancies

STUDY OBJECTIVE To assess the feasibility and efficacy of laparoscopic lymphadenectomy in patients with isolated lymph node recurrences (ILNR) who underwent initial surgery because of gynecologic malignancy. DESIGN Retrospective study (Canadian Task Force classification II-3). SETTING University teaching hospital. PATIENTS Six patients with ILNR (1 cervical, 4 ovarian, and 1 peritoneal) diagnosed between March 2003 and July 2010. INTERVENTION Laparoscopic lymphadenectomy. MEASUREMENTS AND MAIN RESULTS Median (range) patient age was 59.5 (24-70) years, and body mass index was 21.7 (21.0-24.6). There was no unplanned conversion to laparotomy. Operating time was 337.5 (200-400) minutes, hemoglobin change was 0.9 (0.4-2.6) g/dL, and hospital stay was 8.5 (5-19) days. The number of harvested lymph nodes was 20 (5-27), and of positive lymph nodes was 4 (1-24). One patient had common iliac vein laceration, with complete hemostasis achieved using intracorporeal suture. Postoperative lymphedema occurred in 1 patient, and was managed conservatively. All patients received adjuvant chemotherapy after laparoscopic lymphadenectomy. CONCLUSION Laparoscopic lymphadenectomy in patients with ILNR is feasible and might be an alternative therapeutic strategy.

Clinical efficacy on laparoscopic management of genitourinary tract injuries in gynecological surgery

Methods We conducted a retrospective study of 38 patients undergoing laparoscopic surgery to treat genitourinary tract injury which occurred during gynecologic surgery in Kangbuk Samsung Hospital from March 2003 to February 2010. We analyzed the demographic and clinical characteristics including history of previous abdominal surgery, the type of injury, type of repair procedure, and any complications.