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Introduction: Options for preserving fertility in children and adolescents with cancer depend on patient age, the available time frame, and the treatment regimen. Ovarian stimulation with mature oocyte preservation is often the optimal method in post-menarcheal adolescents. We describe a case of a 17-year-old girl with vaginal soft-tissue Ewing sarcoma in whom transvaginal oocyte collection for fertility preservation was ruled out by the large tumor. To overcome the limitations of the transabdominal approach, we applied a novel method of laparoscopically-assisted ultrasound-guided percutaneous transabdominal oocyte collection. In this manner, we were able to both perform oophorectomy and obtain superficial and deep ovarian follicles for cryopreservation.

Objective: To examine the effect of uterosacral-cardinal ligament complex stretching prior to vaginal hysterectomy on uterine descent., Study Design: A prospective trial of 25 consecutive women undergoing vaginal hysterectomy. Pre-operative, apical, anterior and posterior wall POP-Q measurements were recorded for each patient before and after uterosacral-cardinal ligament complex stretching during general anesthesia., Results: Uterosacral-cardinal ligament complex stretching yielded a significant increase in mean stage of uterine and anterior wall descent (2.6 ± 0.6 vs. 3.2 ± 0.6 cm, p<0.001, and 2.5 ± 0.8 vs. 2.9 ± 0.8 cm, respectively, p<0.004). There was no significant change in posterior wall prolapse measurements (1.3 ± 0.7 vs. 1.4 ± 0.8 cm, p=0.05)., Conclusion: Uterosacral-cardinal ligament complex stretching prior to vaginal hysterectomy increase uterine descent., (Copyright © 2011. Published by Elsevier Ireland Ltd.)

With the increasing demand of Laparoscopic surgery, many departments are considering the development of surgical skills centers. The authors describe their hospitaLs endoscopic training program which includes a theoretical curriculum and an inexpensive laparoscopic simulator The system is designed in order to improve basic skills of laparoscopic surgery. Other systems available elsewhere are discussed.

Uterine fibroids (leiomyoma) are the most common benign tumors in women. Better understanding of the pathophysiology, as well as recent technical advancements opened the gates for new options for women who suffer from symptomatic uterine fibroids. Treatments are categorized in four groups: surgical removal, minimally invasive or noninvasive approach causing damage to cellular viability, medical treatments to reduce volume and relieve symptoms, and complementary medicine. This review may assist in tailoring the type of treatment according to age, desire for future fertility, size and location of the fibroids.