Gynaecological robotic surgery at a state hospital — our own experience

Objectives: In recent years, the rapid development of minimally invasive surgical methods, including robotic surgery, has resulted in a marked decline of the traditional methods in gynaecological surgery. The aim of the study was to share our experience with robotic surgery at a state hospital. Material and methods: A total of 40 patients, who underwent robotic gynaecological surgery (GS) between 2015 and 2017, were included. Age, BMI, previous abdominal operations (PAO), operation indications (OI), operative time (OT), pathological evaluation, uterine weight (UW), blood loss during surgery (BL), complications, and duration of the hospitalization (DoH) were analyzed. The Da Vinci XI was used during surgery. Results: A total of 40 patients were analyzed. Mean values were as follows: age — 48 years, BMI — 28, and PAO — 12%. The most common OI included uterine fibroids (52%) and abnormal uterine bleeding (45%). Mean OT, docking time and console time values were 166 min, 15 min, and 123 min, respectively. Mean BL was 93 mL. Mean UW was 256 gr, and DoH was 4 days. Perioperative and postoperative complications were observed in 10% and 20% of the cases, respectively. Conclusions: Robotic-assisted surgery is invaluable in gynaecology, especially in the case of endometriosis, extensive adhesion, and in some oncological patients, as it allows for better visualization and higher maneuverability. In order for a surgeon to prepare for such cases, the use of the robot in benign cases is necessary to complete the learning curve and gain speed

Comparison of the harmonic scalpel with scissors in women who experience obturator nerve injury during lymph node dissection for gynaecological malignancies

Objectives: Lymphadenectomy is crucial for accurate staging in most gynecological malignancies. Serious complications can occur during the surgery. The present study aimed to present the early and late findings associated with obturator nerve injury, which is rarely observed during lymphadenectomy but can result in serious sequela if not noticed. Material and methods: The files of the patients who underwent lymphadenectomy at our clinic between 2012 and 2018 were examined. Patients with obturator nerve incisions were identified retrospectively. Results: In total, 287 women patients underwent lymphadenectomy at our clinic between 2012 and 2018. Examination of surgical notes revealed that nine patients underwent obturator nerve incisions using a scissor or a harmonic scalpel (energy- activated ultrasonic scissors). With respect to management of obturator nerve damage, no significant difference was found between the use of a harmonic scalpel and scissors (p < 1.000) and the trendelenburg and lithotomy positions (p < 0.167). In addition, no significant difference was found between laparoscopy and laparotomy in terms of surgical type (p < 0.167). At 6 months post-operatively, sensory-motor examinations and EMG findings of the patients were completely normal. Conclusions: Surgeries performed for gynaecological malignancies have high mortality and morbidity rates. Moreover, in the event of a complication such as nerve damage during laparoscopy, successful management of the complication before the patient undergoes laparotomy allows the patient to continue benefitting from the advantages of the laparoscopy. The results of our study show that these high-risk surgeries should be performed in advanced and well-equipped medical centres by teams experienced in gynaecological oncology

A Rare Case Report: A Malignant Histiocytic Tumor in the Form of Ovarian Mass

Histiocytic cell malignancies are very rare. Hence, the information about this disease in hematology is limited. In this case report, we present a case of malignant histiocytic tumor affecting the ovary of a 40-year-old virgin female. Primary ovarian malignancy was not considered for the patient who was approached as if she had ovarian malignancy, since there was an indication of a mass in the ovary. Therefore, an aggressive surgery was not performed. Since our patient was in the reproductive age, fertility-preserving surgery was performed. Our patient was then treated systemically by medical oncology. In conclusion, the rare malignancy group was investigated in the present study along with an evaluation of the current literature

Spontaneous Ovarian Hyperstimulation Syndrome with FSH Receptor Gene Mutation: Two Rare Case Reports

Development of ovarian hyperstimulation syndrome (OHSS) is very rare in a spontaneous ovulatory cycle and it is usually seen during pregnancy. In the etiology of OHSS, higher hCG (molar pregnancies or multiple pregnancies) and thyroid-stimulating hormone (TSH) levels have been accused. In recent years, some follicle-stimulating hormone (FSH) receptor (FSHR) gene mutations have been described in patients with OHSS in the first trimester with normal hCG levels. Herein, we report two cases of FSHR gene mutation during the investigation of the etiology of spontaneous OHSS. Although OHSS is typically associated with ovulation induction, it should be kept in mind that this condition may also develop in spontaneous pregnancies

High serum HTATIP2/TIP30 level in serous ovarian cancer as prognostic or diagnostic marker

bayir, yasin/0000-0003-3562-6727WOS: 000321015600001PubMed: 23800048Background: Human HIV-1 TAT interactive protein 2 (HTATIP2/TIP30) is an evolutionarily conserved gene that is expressed ubiquitously in human tissues and some tumor tissues. This protein has been found to be associated with some gynecological cancers; as such, this study aimed to investigate blood HTATIP2/TIP30 levels in patients with ovarian cancer. Methods: Twenty-three women with ovarian cancer and 18 patients with various non-cancerous gynecological complaints (for example, dysfunctional uterine bleeding, fibroids, and urinary incontinence) were included in the study. The pathological diagnosis of ovarian cancer was adenocarcinoma. HTATIP2/TIP30 concentration in the patients' blood samples was determined using ELISA kits. Results: The HTATIP2/TIP30 level was significantly higher in the cancer group than in the control group (1.84 +/- 0.82 versus 0.57 +/- 0.13 ng/ml, mean +/- SD). Conclusions: We demonstrated the potential role of HTATIP2/TIP30 in ovarian cancer for the first time, thereby enlightening future studies targeting HTATIP2/TIP30 in ovarian cancer treatment, diagnosis, and prevention.Ataturk University Scientific Research Projects Coordination Commission (ATAUNI-BAP)Ataturk University ['2011/1']This research has been supported by Ataturk University Scientific Research Projects Coordination Commission (ATAUNI-BAP) with project number '2011/1'