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Objectives: This study aims to evaluate the safety, efficacy, and cost-effectiveness of the Laparoscopic Organ Suspension (OS) sec. Angioni, an innovative approach to transient OS in laparoscopic gynecological procedures. Recognizing the need to enhance surgical site access and overcome limitations of existing organ retraction methods, the study investigates a novel, in-theater constructed OS device. Design: This retrospective observational study was conducted from March 2019 to May 2021 and included 330 patients who underwent multiport or single-site-port laparoscopic surgery employing Angioni's technique for transient pelvic OS. Participants/Materials, Setting, Methods: Participants included individuals undergoing surgery for conditions such as endometriosis, ovarian cancer, endometrial cancer, pelvic prolapse, and benign ovarian cysts. The Laparoscopic OS sec. Angioni utilizes a segment of a Foley catheter connected to a Polyglactin suture to provide adjustable tension, minimizing the need for reconfiguration during surgery. Results: The application of this OS technique resulted in an average suspension time of 1.9 min, with no significant difference between senior and junior surgeons. The method proved more time-efficient for posterior peritoneum suspension than other published methods and showed no additional risks of organ damage, bleeding, conversion to laparotomy, or OS-related complications. The secondary outcomes revealed reduced hospital stays and minimal blood loss, highlighting the procedure's overall efficiency. Limitations: Given its retrospective and single-center nature, the study's results may not be widely generalizable. Prospective multicentric comparative studies are recommended to further validate Angioni's technique. Conclusions: Laparoscopic OS sec. Angioni is introduced as a straightforward, safe, and cost-effective method that significantly streamlines the surgical process. Its adaptability and ease of use suggest that it could be a valuable addition to current gynecological surgical practices, with potential implications for increasing efficiency and reducing procedural costs. Future studies are required to confirm these results across diverse clinical environments. Plain Language Summary: Our study investigates a new, simple method for holding organs in place during laparoscopic gynecological surgery. Typically, this surgery is minimally invasive, but surgeons can face difficulties in moving and securing organs out of the way for clear access and visibility. Laparoscopic Organ Suspension sec. Angioni uses a small segment of a commonly available catheter attached to a suture with a needle to lift and hold the organs gently. This technique is easy to implement, reduces the time needed for such procedures, and minimizes the risk of organ damage. It also shows promise in making surgeries more cost-effective by avoiding the need for expensive equipment. Our findings suggest that this approach could be widely adopted and improve the efficiency and safety of surgical procedures in this field. [ABSTRACT FROM AUTHOR]

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The aim of this narrative review is to offer an overview about the role of progesterone levels on pregnancy outcome in patients undergoing assisted reproductive technologies (ARTs). A detailed computerized search of the literature was performed in the main electronic databases (MEDLINE, EMBASE, Web of Science) to determine the importance of elevated progesterone levels at different stages of the cycle for pregnancy rates in the in vitro fertilization (IVF) cycle. Our review also provides information on the differences between elevated progesterone levels and their interpretation in normal and in poorly responding women. After careful evaluation, our search strategy yielded a total of 15 included articles, showing the possible factors that may have had an impact on the increased progesterone level before human chorionic gonadotropin (HCG) injection and the different thresholds above which the pregnancy rate was lower. Furthermore, increased progesterone on cycle day 2 or 3 could serve as a marker for increased progesterone in the late follicular phase, which is associated with a lower pregnancy rate. Despite the literature data that support the negative effect of elevated progesterone on fresh cycles, due to lack of randomized controlled trials, the value of measuring progesterone in daily practice is questionable. Available evidence supports the detrimental effect of elevated progesterone in different subgroups of women, although there is still the need for defining different thresholds and durations of high progesterone exposure. The need for various thresholds for different cohorts of women, the inter-assay variability is making this decision harder. [ABSTRACT FROM AUTHOR]

In this evolving scenario, we read with great interest the recent cross-sectional study by Kaya et al. [[7]], who compared surgical outcomes following laparoscopic hysterectomy and vNOTES hysterectomy in obese patients. Vaginally assisted Natural Orifice Transluminal Endoscopic Surgery (vNOTES) is a recent and newly introduced technique which has a wide application in gynecologic surgery and other medical specialties [[1]]. [Extracted from the article]

Fanfani et al. [[7]] in 2013 performed a trial in which 68 women who were undergoing hysterectomy were randomized to single-port robotic surgery (performed through a multichannel single trocar inserted in the umbilicus) versus mini-laparoscopy (performed through one optical trans umbilical 5-mm trocar and three 3-mm suprapubic ancillary ports). From the first pioneering experiences of Kurt Semm with gynecological laparoscopy and the first laparoscopic hysterectomy performed by Harry Reich in 1989 [[1]], the technique standardization has radically reduced the use of open surgery and increased the use minimally invasive approaches. In this scenario, technological enhancements with the development of 3-mm laparoscopic instruments (mini-laparoscopy) allowed for further improvement in outcomes, such as cosmetics, compared with conventional laparoscopy [[5]]. [Extracted from the article]

Objective Methods Results Conclusion To assess the quality, reliability, and level of misinformation in TikTok videos about hysteroscopy.A cross‐sectional analysis of TikTok videos retrieved using “hysteroscopy” as search term was performed. Patient education materials assessment tool for audio‐visual content (PEMAT A/V), the modified DISCERN (mDISCERN), global quality scale (GQS), video information and quality index (VIQI) and misinformation assessment were used.Of three hundred videos captured, 156 were excluded and 144 were included. Most videos were partially accurate or uninformative (43.8% and 34.7%, respectively). Non‐healthcare providers produced more inaccurate or uninformative videos than healthcare workers (51.1% vs 4.0%; P < 0.001). Compared to content by professionals, content by patients showed increased distrust towards gynecologists (11.7% vs 0%; P = 0.012) and increased incidence of anxiety and concern towards hysteroscopy (25.5% vs 2%; P < 0.001). PEMAT A/V scores for understandability and actionability were low at 42.9% (interquartile range [IQR]: 11.1–70) and 0% (IQR: 0–0), respectively. Understandability (P < 0.001) and actionability (P = 0.001) were higher for professionals' created content relative to patients' videos. Similarly, median mDISCERN score was low (1 [IQR 0–2]), with significantly higher score for healthcare professionals compared to patients (P < 0.001). Overall video quality was also low, with median VIQI and GQS score of 7 (IQR 4–11) and 1 (IQR 1–3), respectively, and significantly higher scores for healthcare workers' captions compared to patients' for both (P < 0.001 and P = 0.001, respectively).TikTok videos' quality on hysteroscopy seems unsatisfactory and misinformative, with low understandability and actionability scores. Videos recorded by healthcare workers show higher quality and less misinformation than those by patients. Raising the awareness regarding the low quality of medical information on social media is crucial to increase future reliability and trustworthiness. [ABSTRACT FROM AUTHOR]