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Introduction: Hybrid total laparoscopic hysterectomy combines conventional laparoscopic surgery and robot‐assisted devices: the camera and assistant forceps are operated by a robotic device, whereas the surgeon performs laparoscopic procedures, enabling surgery with a completely fixed field of view and significantly reducing errors in forceps grasping and needle misalignment. Here, we examined whether using two arms of the Hugo™ robot‐assisted surgery system, one for the camera and one for the assistant, would improve surgical accuracy compared with conventional total laparoscopic hysterectomy. Materials and Surgical Technique: The surgical system reduced surgeon errors in grasping the forceps during training and stabilized forceps operation. Compared with conventional laparoscopic surgery, the use of the surgical system did not result in different operative durations. The stable surgical procedure was considered a major advantage. Discussion: This new technique involving new equipment can improve surgeon training and performance. In the future, we will develop new techniques to improve surgical performance. [ABSTRACT FROM AUTHOR]

Background: The da Vinci surgical systems (X and Xi) are fourth‐generation systems marketed by Intuitive Inc. The X system is less expensive than the Xi system. This study compared the surgical outcomes of patients who underwent hysterectomy using the X and Xi systems. Methods: Data from 172 patients who underwent robot‐assisted total hysterectomies by four surgeons between April 2019 and March 2023 were retrospectively analyzed in a single‐center study. The patients were divided into two groups based on the surgical system used. Approval was granted by the Institutional Review Board of the Tottori University Hospital (22A134). All patients provided opt‐out consent in accordance with the institutional guidelines. Results: Operative time (126.6 ± 29.5 for X, 138.2 ± 38.5 for Xi, p =.227) and console time (92.9 ± 27.0 for X, 105.5 ± 34.7 for Xi, p =.089) were insignificantly shorter in group X than in group Xi after propensity score matching for age, body mass index, nulliparity, previous history of abdominal or pelvic surgery, preoperative diagnosis, and surgical approach. No significant differences between X and Xi were observed in a subgroup analysis of patients who underwent robot‐assisted total laparoscopic hysterectomy without lymphadenectomy (operative time: 199.0 ± 26.5 for X, 221.5 ± 45.1 for Xi, p =.227; console time: 162.1 ± 25.0 for X, 178.3 ± 0.314 for Xi, p =.314). Conclusion: Perioperative outcomes for the X and Xi da Vinci surgical systems were equivalent. The cost‐effective X system may allow the widespread use of robotic surgeries. [ABSTRACT FROM AUTHOR]

Basal cell nevus syndrome (BCNS) is a rare neurocutaneous syndrome characterized by tumorigeneses such as basal cell carcinomas, jaw cysts, ovarian fibromas, and cardiac fibromas. We present a 24-year-old female with calcified ovarian fibromas associated with BCNS. She had a surgical history of the maxillary cyst and was diagnosed with BCNS due to the cutaneous pits. Magnetic resonance imaging indicated an 8-cm mass and a 4-cm mass, which had been suspected to be a subserosal myoma and a fibroma, respectively. GnRH agonist was preoperatively administered; however, the size of the masses did not change. In laparoscopy, a tumor consisting of 8- and 5-cm masses in the right ovary was identified, and tumorectomy was performed. Because both tumors were extraordinarily rigid and could not be morcellated with scalpels or scissors, we removed them by the Luer Bone Rongeurs with minilaparotomy. The histopathological diagnosis was the ovarian fibromas with marked calcification. [ABSTRACT FROM AUTHOR]

Aims: Dydrogesterone is a retro‐progesterone preparation widely used for over a half century. We sought to evaluate the efficacy and safety of dydrogesterone in Japanese women with dysmenorrhea. Methods: This study was conducted as an open‐label, single‐arm, multicenter study. One dydrogesterone 5‐mg tablet (Duphaston) was administered orally twice daily for 21 days from the 5th to 25th day of each menstrual cycle. A total of 44 (safety analysis) and 31 patients (efficacy analysis) were enrolled. Total dysmenorrhea score, dysmenorrhea subscale scores, dysmenorrhea visual analog scale, severity of menstruation‐related lower abdominal pain, low back pain, headache, and nausea/vomiting, basal body temperature, and serum estradiol and progesterone levels were evaluated. Results: Baseline of the total dysmenorrhea score was 4.61, which went down over time following the administration of dydrogesterone, and the decrease was statistically significant at and after 2nd cycle of menstruation. Mean change from baseline at the final evaluation point was −1.84 (P < 0.001). Severity of menstruation‐related lower abdominal pain, low back pain, headache, and nausea/vomiting, in the evaluated menstruation cycles tended to decrease over time. Basal body temperature showed a biphasic pattern in 70% at baseline, 50% in 2nd menstruation cycle, and 61% in 5th menstruation cycle, and at least half of the patients may have had ovulation during the treatment. Incidence of adverse drug reactions was 31.8%, and the most common adverse event was metrorrhagia. Conclusion: Dydrogesterone is efficacious, safe, and clinically beneficial in patients with dysmenorrhea, thereby indicating that dydrogesterone can be considered as a treatment option for patients with dysmenorrhea. [ABSTRACT FROM AUTHOR]

Aims: We investigated the potential of gonadotropin-releasing hormone (GnRH) agonists and GnRH antagonists to inhibit cell proliferation in endometriotic and endometrial stromal cells. Methods: Twenty patients with ovarian endometriomas and 18 patients with uterine fibromas were recruited. Endometriotic and endometrial stromal cells were obtained from the ovarian chocolate cyst linings and the eutopic endometria of premenopausal women with uterine fibromas, respectively. Results: GnRH agonist or antagonist treatment attenuated tumor necrosis factor (TNF)-α-induced cell proliferation in the endometrial stromal cells, whereas endometriotic stromal cells did not respond to treatment. The endometriotic stromal cells exhibited a decreased expression of the type I GnRH receptor compared with the endometrial stromal cells. GnRH agonists or antagonists did not repress TNF-α-induced IL-8 production in endometriotic stromal cells. Conclusion: GnRH agonists and antagonists have similar effects in slowing the growth of endometrial stromal cells. Endometriotic stromal cells resist the antiproliferative effect of GnRH agonists and antagonists. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]