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Simple Summary: Vulvar tumors are uncommon and have a considerable impact on the functional and aesthetic well-being of those affected. Their treatment necessitates a comprehensive, multidisciplinary approach at various levels, highlighting the importance of having standardized recommendations that are aligned with the latest scientific findings. Are scientific guidelines aligning with the advancements made in this field of oncology, spanning from diagnosis to palliative care at various levels? To address this, we conducted a systematic comparison of the main European and American guidelines for vulvar cancer management to assess their current status of update. From our comparisons, many divergences emerged in management strategies. Among them, lack of reference to the most up-to-date diagnostic classification systems, indication for an integrated gyneco-oncologic and plastic surgical approach to postoperative management with the most modern advanced dressing devices and palliative setting with the use of immuno- and electrochemotherapy. Background: Vulvar carcinoma is an uncommon gynecological tumor primarily affecting older women. Its treatment significantly impacts the quality of life and, not least, aesthetics because of the mutilating surgery it requires. Objectives: The management requires a multidisciplinary team of specialists who know how to care for the patient in her entirety, not neglecting psychological aspects and reconstructive surgery. How do the guidelines address multidisciplinarity, team surgical management, passing through preoperative diagnosis, and follow-up in such a challenging rare tumor to treat? Methods: To answer these questions, we compared the main scientific recommendations to identify similarities and differences in diagnostic and therapeutic management to provide an overview of the gaps that there are currently in European and American international recommendations in providing management guidance in a cancer that is both among the rarest and most difficult to manage. In this way, we aim to encourage an update in practices based on the latest scientific evidence. Results: A review of various international guidelines, some dating back to 2014, shows significant variation in approaches, ranging from initial diagnostic procedures to managing relapses. The most recent guidelines also lacked references to the latest literature, indicating that more robust scientific evidence is needed before new treatments, such as electrochemotherapy for palliation and reconstructive surgery post exenteration, can be widely adopted. Conclusions: From the systematic comparison of the main international guidelines, a strong heterogeneity emerged in the diagnostic and therapeutic recommendations as well as for the multidisciplinary approach that today is essential. Our work certainly stimulated an update of the main guidelines. [ABSTRACT FROM AUTHOR]

Background Objective Search Strategy Selection Criteria Data Collection and Analysis Main Results Conclusions Registration Number Literature is lacking strong evidence about comparisons of efficacy and quality of life‐related outcomes between laparoscopic total and/or supracervical hysterectomy (LTH/LSCH) with laparoscopic sacrocolpopexy (LSC) and minimally invasive sacrohysteropexy (LSH).To summarize and compare available data on this topic providing a useful clinical tool in the treatment decision process.We performed a systematic research of PubMed (MEDLINE), Web of Science, and Gooogle Scholar.We included studies that compared at least one efficacy outcome (objective or subjective outcome) between LTH/LSCH with LSC and LSH. Data on surgery‐related morbidities were also extracted where available.A random‐effect meta‐analysis was conducted reporting pooled mean differences and odds ratios (OR) between groups using Review Manager V.7.9.0.We included a total of nine observational studies. LTH/LSCH with LSH was associated with a significantly higher objective success (apical compartment OR 7.95; 95% confidence interval [CI] 2.23–28.33; I2 = 0%; P = 0.001; anterior compartment OR 2.23; 95% CI 1.26–4.30; I2 = 12%; P = 0.007) and subjective success (OR 3.19; 95% CI 1.42–7.17; I2 = 39%; P = 0.005). No differences were found regarding intraoperative and postoperative complications, sexual dysfunction, and stress urinary incontinence rate after surgery. Hysteropexy showed shorter operative time and shorter hospital length with a pool mean difference of 27.37 min (95% CI 18.04–32.71; I2 = 0%; P < 0.001) and 0.7 days (95% CI 0.24–1.17; I2 = 75%; P = 0.003), respectively. Concurrent hysterectomy was not associated with a higher rate of mesh‐related complications (P = 0.53). No major differences were found regarding recurrence and reoperation rate (P = 0.10 and P = 0.93, respectively).LTH/LSCH with LSC has better objective and subjective outcomes in pelvic organ prolapse surgery than LSH alone, especially for apical and anterior compartments, and is not associated with higher postoperative sexual dysfunction and mesh‐related complications. Adequate preoperative counseling is highly recommended in patients who desire uterine preservation.CRD42024537270. [ABSTRACT FROM AUTHOR]

This video article summarizes a case study involving the use of pelvic sentinel lymph node (SLN) biopsy for endometrial cancer (EC) staging and treatment utilizing a multi-modal infrared signal technology. This innovative approach combines cervical injection of fluorescent dye indocyanine green (ICG) and near-infrared imaging to enhance SLN detection rates in early-stage EC patients. The study showcases the successful application of advanced technology in improving surgical staging procedures and reducing postoperative morbidity for patients. Multi-modal infrared signal technology consists of different modes of fluorescence imaging used to identify lymph nodes based on near-infrared signals. Each mode serves a specific purpose: overlay image combines white light and near-infrared signals in green, monochromatic visualization shows near-infrared signal in greyscale, and intensity map combines signals in a color scale to differentiate signal intensity. Yellow denotes strong near-infrared signals while blue represents weaker signals. By utilizing a multi-modal approach, surgeons can accurately identify and remove SLN, thus avoiding unnecessary removal of secondary or tertiary echelons. [ABSTRACT FROM AUTHOR]

The operating room is the environment where harm to the patient is most likely. Robotic surgery was listed as one of the top 10 health hazards as late as 2020. Taking inspiration from other fields of application, such as aeronautics, checklists have been increasingly implemented in medical practice over the years, becoming essential components of the operating theatre. In addition to checklists, simulation has taken on a fundamental importance in reducing errors. This paper aims to provide a narrative review to assess the importance of checklists and training in robotic surgery and how they improve the outcome. A comprehensive literature search from January 2000 to September 2023 was conducted. A total of 97 articles were included in the initial search. Eleven studies were deemed relevant and were considered eligible for full-text reading. Among these, ten studies focused on the analysis of training effectiveness. An article in our review assessed the benefits of introducing checklists in the operating room. Innovations created in aviation, such as checklists and simulation, have entered the medical field to prevent human error. Developing dedicated checklist and surgical teams, through theoretical and practical training, has become essential in modern medicine. Tools such as checklists, training, and simulation are among the best methods to reduce adverse medical events. [ABSTRACT FROM AUTHOR]

Simple Summary: Cervical cancer, a very aggressive gynecological malignancy that also affects young women, remains significantly prevalent despite worldwide efforts in HPV vaccination campaigns. Cervical cancer research is experiencing a period of significant change, with intense ongoing debates on issues that could potentially transform current guidelines. Therefore, in light of these changes, guidelines and protocols will soon need significant updates. Hence, this paper aims to summarize and compare the most recent recommendations published by international gynecological oncology societies for patients with cervical cancer. A comparative analysis of American, Asian, and European guidelines was conducted to evaluate the different recommendations for diagnostic, surgical, medical, and follow-up management. Cervical cancer continues to have a significant incidence, despite global efforts in HPV vaccination campaigns. Managing this condition involves a diverse team of healthcare professionals. Research in this field is undergoing a period of great revolution in multiple areas, and international guidelines will soon have to adapt to new scientific evidence. This could be true mainly in locally advanced stages, and it could also be true for minimal invasive surgery. This paper aims to summarize and compare the most recent recommendations published by international gynecological oncological societies for patients with cervical cancer. From their comparison, common aspects and disagreements emerged, especially in the diagnostic pathway and follow-up strategies. Several issues that remain to be debated in the literature were addressed and compared, highlighting similarities and differences, from the role of the sentinel lymph node in early stages to that of the adjuvant hysterectomy in locally advanced tumors. On the surgical side, for this last subset of patients, currently, a laparotomic approach is recommended. At the same time, the advent of immunotherapy has just opened up new and promising scenarios in systemic treatment for locally advanced cervical cancer, and international guidelines will soon introduce it into their algorithms. [ABSTRACT FROM AUTHOR]

Simple Summary: Endometrial cancer has a high epidemiological impact, and its management is part of everyday clinical practice. International guidelines have been arranged over the years according to major recent discoveries. The application of the guidelines released by different international gynecological societies is still matter of debate as they diverge in many issues. Authors wanted to compare them and point out the differences, aiming to both draw the attention to a need of unification and to provide a useful tool for clinicians. Endometrial cancer is the most common gynecological malignancy in Europe and its management involves a variety of health professionals. In recent years, big discoveries were made concerning the management of patients diagnosed with endometrial cancer, particularly in the field of molecular biology and minimally invasive surgery. This requires the continuous updating of guidelines and protocols over the years. In this paper, we aim to summarize and compare common points and disparities among protocols for management of patients diagnosed with endometrial cancer by leading international gynecological oncological societies. We therefore systematically report the parallel among the guidelines based on the various steps patients with endometrial cancer usually undergo. The comparison between American and European protocols revealed some relevant disparities, in particular regarding surgical staging, molecular biology application as a prognostic tool and follow up regimens. This could possibly cause differences in interpreting and applying protocols in clinical practice in small centers, leading to a lack of adherence to guidelines or even prompting a confusing mix of them. [ABSTRACT FROM AUTHOR]