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40 records – page 1 of 4.

Analysis of robotic performance times to improve operative efficiency.

https://arctichealth.org/en/permalink/ahliterature119082
Source
J Minim Invasive Gynecol. 2013 Jan-Feb;20(1):43-8
Publication Type
Article
Author
Elizabeth J Geller
Feng-Chang Lin
Catherine A Matthews
Author Affiliation
Division of Female Pelvic Medicine and Reconstructive Pelvic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7570, USA. egeller@med.unc.edu
Source
J Minim Invasive Gynecol. 2013 Jan-Feb;20(1):43-8
Language
English
Publication Type
Article
Keywords
Canada
Efficiency
Female
Humans
Hysterectomy - methods
Learning Curve
Pelvic Organ Prolapse - surgery
Retrospective Studies
Robotics - methods
Surgical Mesh
Task Performance and Analysis
Time Factors
Abstract
To estimate the efficiency of procedural steps in robotic sacrocolpopexy and concomitant hysterectomy.
Retrospective study (Canadian Task Force classification II-2).
University hospital.
One hundred forty-seven patients who underwent robotic-assisted procedures from November 2007 through December 2010.
Robotic-assisted sacrocolpopexy. Sixty patients (40.8%) underwent concomitant hysterectomy; 37 (25.2%), mid-urethral sling placement; and 7 (4.8%), concomitant colporrhaphy.
Comparison of the first 20 procedures with the subsequent 127 demonstrated that there was considerable improvement in time of cuff closure (p = .04); sacral dissection (p = .004); anterior (p = .006), posterior, (p = .003), and sacral (p = .003) mesh attachment; peritoneal closure (p
PubMed ID
23141423 View in PubMed
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Attitudes to mode of hysterectomy--a survey-based study among Swedish gynecologists.

https://arctichealth.org/en/permalink/ahliterature89890
Source
Acta Obstet Gynecol Scand. 2009;88(3):267-74
Publication Type
Article
Date
2009
Author
Persson Pär
Hellborg Thomas
Brynhildsen Jan
Fredrikson Mats
Kjølhede Preben
Author Affiliation
Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, Faculty of Health Sciences, University Hospital, 581 85 Linköping, Sweden. par.persson@akademiska.se
Source
Acta Obstet Gynecol Scand. 2009;88(3):267-74
Date
2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Attitude of Health Personnel
Cross-Sectional Studies
Female
Gynecology
Humans
Hysterectomy - methods - statistics & numerical data
Hysterectomy, Vaginal - utilization
Laparoscopy - utilization
Logistic Models
Male
Middle Aged
Physicians - psychology
Questionnaires
Sex Factors
Sweden
Abstract
OBJECTIVE: To determine gynecologists' attitudes to mode of hysterectomy on benign indication. DESIGN: Cross-sectional study. SETTING: Sweden. POPULATION: Members of the Swedish Society of Obstetrics and Gynecology. METHODS: A postal questionnaire. Questions examined attitudes to mode of hysterectomy based on three clinical scenarios with different conditions of the uterus. Gynecologists were also asked to estimate how the distribution of the different modes of benign hysterectomy should be overall. The modes to choose were total abdominal, subtotal abdominal, laparoscopic or vaginal hysterectomy (VH). Analyses were performed with multiple logistic regression and multivariate analysis of covariance. MAIN OUTCOME MEASURES: Preferred mode of hysterectomy in the three scenarios and distribution of modes of hysterectomy. RESULTS: VH was the most preferred method in general as well as when the uterus was of normal size, whereas subtotal and total abdominal hysterectomy were the most favored methods when the uterus was enlarged. VH was more often preferred by male compared to female gynecologists as a personal preference. The choice and distribution of mode varied significantly between place of work, seniority and in the quantity of yearly performed hysterectomies. The minimal invasive methods, vaginal and laparoscopic hysterectomy, were recommended in more than 50% of the overall suggested distribution. CONCLUSION: Personal choice of mode of hysterectomy does not seem to strictly follow evidence-based recommendations, but varies significantly between gynecologist's gender, type of clinical setting in which the gynecologist works, seniority and by how many hysterectomies the gynecologist does annually.
PubMed ID
19241224 View in PubMed
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Changing hysterectomy technique from open abdominal to laparoscopic: new trend in Oslo, Norway.

https://arctichealth.org/en/permalink/ahliterature79168
Source
J Minim Invasive Gynecol. 2007 Jan-Feb;14(1):74-7
Publication Type
Article
Author
Istre Olav
Langebrekke Anton
Qvigstad Erik
Author Affiliation
Department of Obstetrics and Gynecology, Ullevål University Hospital, University of Oslo, Oslo, Norway. post@oistre.com
Source
J Minim Invasive Gynecol. 2007 Jan-Feb;14(1):74-7
Language
English
Publication Type
Article
Keywords
Female
Hospitals, University - statistics & numerical data
Humans
Hysterectomy - methods - trends - utilization
Laparoscopy - trends - utilization
Myoma - surgery
Norway
Retrospective Studies
Uterine Neoplasms - surgery
Abstract
STUDY OBJECTIVE: To evaluate the change in hysterectomy technique. DESIGN: Retrospective study (Canadian Task Force classification XXX). SETTING: University tertiary referring center in Norway. PATIENTS: A total of 1963 women treated with hysterectomy over a 5-year period in Oslo. INTERVENTIONS: The operative records and techniques were investigated in all treated patients. MEASUREMENTS AND MAIN RESULTS: A total of 1963 hysterectomies were performed from 2001 through 2005. The operative patient records were investigated with the main focus on indication for surgery and the technique used in the operative procedure. In 2001, 62 (17.7%) laparoscopic hysterectomies were performed, while 256 (73.1%) of the hysterectomies were done with laparotomy. The operative technique has gradually changed during the last 5 years. In 2005, 220 (53.5%) of the surgical procedures were laparoscopic, 177 (43.1%) were done by laparotomy, while the vaginal approach in all these years was less than 10%. CONCLUSION: From 2001 to 2005, a trend shift of the operative technique has been observed in Oslo, increasing the endoscopic hysterectomy rate from approximately 18% to 54%. During the same time, enlarged uteri with myomas equivalent to 10 to 12 weeks' gestation and endometrial cancer were more often treated by laparoscopic hysterectomy instead of open abdominal hysterectomy. With modern equipment and trained staff, more routine hysterectomies can be managed with laparoscopy.
PubMed ID
17218234 View in PubMed
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Clamping compared to cauterization for subcutaneous hemostasis in Pfannenstiel incision.

https://arctichealth.org/en/permalink/ahliterature101862
Source
Acta Obstet Gynecol Scand. 2011 Apr;90(4):405-7
Publication Type
Article
Date
Apr-2011
Author
Enis Ozkaya
Vakkas Korkmaz
Tuncay Kucukozkan
Author Affiliation
Department of Obstetrics and Gynecology, Dr. Sami Ulus Maternity & Women's Health Teaching and Research Hospital, Ankara, Turkey. enozkaya1979@gmail.com
Source
Acta Obstet Gynecol Scand. 2011 Apr;90(4):405-7
Date
Apr-2011
Language
English
Publication Type
Article
Keywords
Cautery - methods
Chi-Square Distribution
Constriction
Female
Hemostasis, Surgical - methods
Humans
Hysterectomy - methods
Middle Aged
Postoperative Complications - etiology
Abstract
We compared subcutaneous clamping and cauterization for hemostasis at laparotomy with Pfannenstiel incision with reference to surgical site infection, postoperative fever and time taken for incision. A total of 214 patients with consecutive hysterectomies were alternately assigned to incisional hemostasis by clamping (n= 107) or cauterization (n= 107). The groups were similar in terms of age, gravidity, parity, body mass index, uterine size and mean hemoglobin drop. Rates of surgical site infection, postoperative fever and time from skin incision to peritoneal cavity entry were significantly higher in the group with cauterization (p
PubMed ID
21306335 View in PubMed
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Clinical outcome and complications of laparoscopic surgery compared with traditional surgery in women with endometrial cancer.

https://arctichealth.org/en/permalink/ahliterature185544
Source
Arch Gynecol Obstet. 2004 Jul;270(1):25-30
Publication Type
Article
Date
Jul-2004
Author
Tapio Kuoppala
Eija Tomás
Pentti K Heinonen
Author Affiliation
Department of Obstetrics and Gynecology, Tampere University Hospital and Medical School, University of Tampere, Finland. tapio.kuoppala@pshp.fi
Source
Arch Gynecol Obstet. 2004 Jul;270(1):25-30
Date
Jul-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Case-Control Studies
Endometrial Neoplasms - surgery
Fallopian Tubes - surgery
Female
Finland
Humans
Hysterectomy - methods
Laparoscopy - utilization
Lymph Node Excision
Middle Aged
Outcome Assessment (Health Care)
Ovariectomy
Postoperative Complications
Abstract
The purpose of this study was to evaluate the feasibility, clinical outcome and complications of laparoscopic surgery in women with endometrial cancer and to compare surgical outcome and postoperative early and late complications with results of traditional laparotomy.
Forty women with endometrial cancer underwent laparoscopic hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Each patient operated by laparoscopy was matched by age, preoperative clinical stage and histology of the endometrial cancer with a patient treated by the same operation but using traditional laparotomy. Half of these patients underwent total pelvic lymphadenectomy and half had pelvic lymph node sampling. The groups were compared in clinical characteristics, surgical outcomes, recoveries and early and late postoperative complications.
The patients in the laparoscopy group had less blood loss, more lymph nodes removed, shorter hospital stay but longer operation time than those treated by laparotomy. Only one (2.5%) laparoscopy was converted to laparotomy due to pelvic adhesions. There were no intraoperative complications in either group. Postoperative complications were more common (55.0%) in the laparotomy than in the laparoscopy group (37.5%). Only one major complication (2.5%) occurred among patients undergoing laparoscopy as compared with three (7.5%) major complications in the laparotomy group. Superficial wound infection was the most common (20%) infection in laparotomy patients while vaginal cuff cellulitis occurred in 10% of laparoscopy patients. Late (>42 days) postoperative complications were almost equally frequent (20.0 and 22.5%) in both groups. Lower extremity lymph edema or pelvic lymph cyst was found in 12.5% of all cases. As a result of surgical staging the disease of 6 women (15%) in both groups was upgraded.
Laparoscopic surgery is a viable alternative to traditional surgery in the management of endometrial cancer. The surgical outcome is similar in both cases. In laparoscopic procedures the operation time is longer but the postoperative recovery time shorter than in laparotomy. Severe complications were limited in both groups, while wound infections can be avoided using laparoscopy.
PubMed ID
12728326 View in PubMed
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Depressive symptoms before and after elective hysterectomy.

https://arctichealth.org/en/permalink/ahliterature127649
Source
J Obstet Gynecol Neonatal Nurs. 2011 Sep-Oct;40(5):566-76
Publication Type
Article
Author
Amanda Digel Vandyk
Ingrid Brenner
Joan Tranmer
Elizabeth Van Den Kerkhof
Author Affiliation
Department of Anesthesiology & Perioperative Medicine, Kingston General Hospital, 76 Stuart Street, Kingston, Ontario, Canada. ev5@queensu.ca
Source
J Obstet Gynecol Neonatal Nurs. 2011 Sep-Oct;40(5):566-76
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Cohort Studies
Confidence Intervals
Depression - diagnosis - epidemiology - etiology
Female
Follow-Up Studies
Humans
Hysterectomy - methods - psychology
Incidence
Middle Aged
Odds Ratio
Ontario
Postoperative Period
Preoperative Period
Quality of Life
Questionnaires
Retrospective Studies
Severity of Illness Index
Stress, Psychological
Surgical Procedures, Elective
Abstract
To examine the factors associated with depressive symptoms before and after surgery in women who undergo elective hysterectomy.
A secondary analysis of longitudinal data from a prospective cohort study designed to understand chronic postsurgical pain in women.
One acute care hospital in southeastern, Ontario, over a 4-year period (2006-2010).
Three hundred eighty-four (384) English-speaking women, age 18 years or older, who presented for elective hysterectomies.
Data were gathered preoperatively in the same-day admission center and six months postoperatively using validated web-based or mailed questionnaires.
Thirty six percent (36%) of participants reported depressive symptoms before surgery, 22% reported symptoms afterwards, 15% reported symptoms at both time points, and 6% developed new onset depressive symptoms postoperatively. Younger (odds ratio [OR] = 2.5, 95% confidence interval [CI], [1.7, 5.0]) women, those with higher levels of anxiety (state: OR = 8.6, 95% CI [5.2, 14.0]), or who experienced pain that interfered with their daily functioning (OR = 2.8, 95% CI [1.7, 4.7]) were more likely to report depressive symptoms prior to hysterectomy. Preoperative pain (OR = 2.0, 95% CI [1.1, 3.6]), trait anxiety (OR = 2.4, 95% CI [1.2, 4.6]), and depressive symptoms (OR = 3.9, 95% CI [2.1, 7.5]) increased the risk of depressive symptoms 6 months postoperatively.
Young women who exhibit high levels of anxiety and pain and who require a hysterectomy are at risk of experiencing psychological distress prior to and following their surgery.
PubMed ID
22273413 View in PubMed
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[Documentation problems in anesthesiology and gynecology?].

https://arctichealth.org/en/permalink/ahliterature193151
Source
Ugeskr Laeger. 2001 Sep 3;163(36):4871-4
Publication Type
Article
Date
Sep-3-2001
Author
L. de Lasson
J. Blaakaer
Author Affiliation
Arhus Universitetshospital, Skejby Sygehus, anaestesiologisk afdeling og gynaekologisk obstetrisk afdeling.
Source
Ugeskr Laeger. 2001 Sep 3;163(36):4871-4
Date
Sep-3-2001
Language
Danish
Publication Type
Article
Keywords
Adult
Anesthesia Department, Hospital - standards - utilization
Denmark
Documentation
Female
Humans
Hysterectomy - methods - utilization
Length of Stay - statistics & numerical data
Medical Record Linkage
Medical Records - standards
Obstetrics and Gynecology Department, Hospital - standards - utilization
Patient Admission - statistics & numerical data
Patient Discharge - statistics & numerical data
Patient Education as Topic
Physician's Practice Patterns
Postoperative Care
Questionnaires
Abstract
The number of beds in surgical wards is declining. Whether the reason is more outpatient surgery or quicker recovery, owing to better perioperative care is unknown.
A questionnaire was sent to all gynaecological and anaesthetic departments in Denmark concerning the treatment of women who had had a hysterectomy for non-malignant disease. The following questions were asked: What were the numbers of patients operated on in 1998, the methods of operation, duration of admission, the surgeon in charge, information about admission and postoperative management of patients, choice of anaesthesia and treatment of postoperative pain.
The chief surgical method was abdominal hysterectomy. There were relatively few vaginal or laparoscopically assisted hysterectomies. The duration of admission varied considerably. Patients mostly were given written information about admission and the postoperative course. Postoperative follow-up was relatively uncommon. The duration of admission was not influenced by the anaesthetic method. Seventeen of 31 anaesthetic departments knew the number of patients anaesthetised for hysterectomy in 1998 and the anaesthetic methods.
This study cannot answer the question: How does the method of operation, choice of anaesthesia, postoperative analgesia, and information to the patient affect the duration of admission? Data allowing a discussion of the quality of the treatment were not available. There is a serious lack of registration.
PubMed ID
11571863 View in PubMed
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Does self-administered vaginal misoprostol result in cervical ripening in postmenopausal women after 14 days of pre-treatment with estradiol? Trial protocol for a randomised, placebo-controlled sequential trial.

https://arctichealth.org/en/permalink/ahliterature85767
Source
BJOG. 2008 Jun;115(7):917-e10
Publication Type
Article
Date
Jun-2008
Author
Oppegaard K S
Lieng M.
Berg A.
Istre O.
Qvigstad E.
Nesheim B-I
Author Affiliation
Department of Gynaecology, Helse Finnmark, Klinikk Hammerfest, Hammerfest, Norway.
Source
BJOG. 2008 Jun;115(7):917-e10
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Administration, Intravaginal
Ambulatory Surgical Procedures
Cervical Ripening - drug effects
Clinical Protocols
Double-Blind Method
Drug Administration Schedule
Drug Therapy, Combination
Estradiol - administration & dosage - pharmacology
Estrogens - administration & dosage - pharmacology
Female
Humans
Hysterectomy - methods
Misoprostol - administration & dosage - pharmacology
Oxytocics - administration & dosage - pharmacology
Patient satisfaction
Postmenopause
Pregnancy
Preoperative Care
Self Administration
Tablets
Abstract
OBJECTIVE: To compare the impact of 1000 micrograms of self-administered vaginal misoprostol versus self-administered vaginal placebo on preoperative cervical ripening after pre-treatment with estradiol vaginal tablets at home in postmenopausal women prior to day-care operative hysteroscopy. DESIGN: Randomised double-blind placebo-controlled sequential trial. The boundaries for the sequential trial were calculated on the primary outcomes of a difference of cervical dilatation > or = 1 millimetre, with the assumption of a type 1 error of 0.05 and a power of 0.95. SETTING: Norwegian university teaching hospital. POPULATION: Postmenopausal women referred for day-care operative hysteroscopy. METHODS: The women were randomised to either 1000 micrograms of self-administered vaginal misoprostol or self-administered vaginal placebo the evening before day-care operative hysteroscopy. All women had administered a 25-microgram vaginal estradiol tablet daily for 14 days prior to the operation. MAIN OUTCOME MEASURES: Preoperative cervical dilatation (difference between misoprostol and placebo group, primary outcome), difference in dilatation before and after administration of misoprostol or placebo, number of women who achieve a preoperative cervical dilatation > or = 5 millimetres, acceptability, complications and side effects (secondary outcomes). RESULTS: Intra-operative findings and distribution of cervical dilatation in the two treatment groups: values are given as median (range) or n (%). Difference in dilatation before and after administration of misoprostol and placebo: values are given as median (range) of intraindividual differences. Percentage of women who achieve a cervical dilatation of > or = 5 mm, percentage of women who were difficult to dilate. Acceptability in the two treatment groups: values are given as completely acceptable n (%), fairly acceptable n (%), fairly unacceptable n (%), completely unacceptable n (%). Pain in the two treatment groups: pain was measured with a visual analogue scale ranging from 0 (no pain) to 10 (unbearable pain): values are given as median (range). Occurrence of side effects in the two treatment groups. Values are given as n (%). Complications given as n (%). FUNDING SOURCES: No pharmaceutical company was involved in this study. A research grant from the regional research board of Northern Norway has been awarded to finance Dr K.S.O.'s leave from Hammerfest hospital as well as travel expenses between Hammerfest and Oslo, and research courses. The research grant from Prof B.I.N. (Helse ?st) funded the purchase of estradiol tablets, the manufacturing costs of misoprostol and placebo capsules from the hospital pharmacy, as well as the costs incurred for preparing the randomisation schedule and distribution of containers containing capsules to hospital. Prof B.I.N.'s research grant also funded insurance for the study participants. CONCLUSIONS: Estimated completion date 31 December 2008.
PubMed ID
18485172 View in PubMed
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Effect of surveillance on the number of hysterectomies in the province of Saskatchewan.

https://arctichealth.org/en/permalink/ahliterature249840
Source
N Engl J Med. 1977 Jun 9;296(23):1326-8
Publication Type
Article
Date
Jun-9-1977
Author
F J Dyck
F A Murphy
J K Murphy
D A Road
M S Boyd
E. Osborne
D. De Vlieger
B. Korchinski
C. Ripley
A T Bromley
P B Innes
Source
N Engl J Med. 1977 Jun 9;296(23):1326-8
Date
Jun-9-1977
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Female
Humans
Hysterectomy - methods
Middle Aged
Pregnancy
Saskatchewan
Sterilization, Reproductive
Uterine Diseases - surgery
Uterine Neoplasms - surgery
Utilization Review - utilization
Abstract
In 1972 the College of Physicians and Surgeons of Saskatchewan appointed a committee to study hysterectomies because the Saskatchewan Department of Health had data showing that the annual number of hysterectomies carried out in the province had increased by 72.1 per cent between 1964 and 1971, whereas the number of women over 15 years of age had increased by 7.6 per cent. The committee compiled a list of indications for hysterectomy. Any hysterectomy carried out for one of these reasons was classified as justified, and the remainder as unjustified. Five hospitals were reviewed in 1970 and a further two in 1973. In 1974, all seven hospitals were reviewed again. In these hospitals, the average proportion of unjustified hysterectomies had dropped from 23.7 per cent at the time of the first review to 7.8 per cent in 1974. The total number of hysterectomies in the province dropped by 32.8 per cent between 1970 and 1974.
PubMed ID
870826 View in PubMed
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Factors affecting the use of postincisional analgesics in dogs and cats by Canadian veterinarians in 2001.

https://arctichealth.org/en/permalink/ahliterature169091
Source
Can Vet J. 2006 May;47(5):453-9
Publication Type
Article
Date
May-2006
Author
Caroline J Hewson
Ian R Dohoo
Kip A Lemke
Author Affiliation
Sir James Dunn Animal Welfare Centre, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island.
Source
Can Vet J. 2006 May;47(5):453-9
Date
May-2006
Language
English
Publication Type
Article
Keywords
Analgesics - therapeutic use
Animals
Canada
Cats - surgery
Data Collection
Dogs - surgery
Female
Humans
Hysterectomy - methods - statistics & numerical data - veterinary
Linear Models
Logistic Models
Male
Ovariectomy - methods - statistics & numerical data - veterinary
Pain Measurement - veterinary
Pain, Postoperative - drug therapy - prevention & control - veterinary
Postoperative Care - methods - statistics & numerical data - veterinary
Risk factors
Veterinarians - psychology
Veterinary Medicine - methods - statistics & numerical data
Abstract
Factors affecting the postincisional use of analgesics for ovariohysterectomy (OVH) in dogs and cats were assessed by using data collected from 280 Canadian veterinarians, as part of a national, randomized mail survey (response rate 57.8%). Predictors of analgesic usage identified by logistic regression included the presence of at least 1 animal health technician (AHT) per 2 veterinarians (OR = 2.3, P = 0.004), and the veterinarians' perception of the pain caused by surgery without analgesia (OR = 1.5, P
Notes
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PubMed ID
16734371 View in PubMed
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40 records – page 1 of 4.