Results of the live survey in Las Vegas, 2008, and the response of the AAGL

Influence of Tubal Patency on Endometriosis Recurrence: A Retrospective Matched Case-control Study

Neutens S et al., 2026·Journal of Minimally Invasive Gynecology

To study whether bilateral nonpatency of fallopian tubes is correlated with a lower recurrence rate of endometriosis. Retrospective 2:1 matched case-control study. University hospital with a tertiary referral center for fertility and endometriosis surgery in Leuven, Belgium. All patients undergoing complete laparoscopic excision of any revised system of the American Society of Reproductive Medicine-stage endometriosis between 2010 and 2014 (n = 896). Comparison between patients with bilateral nonpatent or absent fallopian tubes and matched controls with at least 1 patent fallopian tube. MAIN Primary outcome was the recurrence rate, which was analyzed on 4 overall recurrence, symptom recurrence, recurrence on imaging, and need for reintervention. Of 896 patients, 49 had bilateral nonpatent or absent fallopian tubes. These cases were compared with 98 matched controls with at least 1 patent fallopian tube. Symptoms recurred in 12.2% of the cases (n = 6) and 25.5% of the controls (n = 25) (p = .09). Recurrence was confirmed by imaging in 8% of the cases (n = 4) and 10.2% of the controls (n = 10) (p = .77). In 3 patients of the case group and 12 patients of the control group, there was a need for reintervention (p = .39). Within this subgroup, recurrence of endometriosis was histologically confirmed in none of the patients of the case group and 5 patients of the control group (p = .51). This study did not observe a statistically significant reduction in endometriosis recurrence in patients with bilateral occlusion/absence of the fallopian tubes after endometriosis surgery. A type II error may count for this result.

Is Vaginal Repair a Good Option for Severe Cesarean Scar Defect? Comparison of Women With or Without Residual Myometrium

Bardet L et al., 2024·J Minim Invasive Gynecol

To compare outcomes of vaginal surgery in women with moderate or severe symptomatic cesarean scar defect (with or without residual myometrium). Retrospective cohort study. Gynecology department of a teaching hospital. Fifty-three women, between January 2014 and December 2019, underwent vaginal surgery for symptomatic 20 women with moderate defect (with residual myometrium) and 33 with severe defect (without residual myometrium). Vaginal surgical approach to repair cesarean scar defect. MAIN surgery by comparing the myometrial residual thickness before and after surgery. The secondary objectives were evaluation of vaginal surgery efficacy on symptoms resolution, per and postoperative courses, and subsequent fertility. Failure rate was evaluated as the need for a second surgery. After vaginal surgery, the residual myometrium significantly increased from 2.4 mm ± 0.9 mm to 6.6 mm ± 2.4 mm (p <.01) in the moderate group and from 0 mm to 4.4 mm ± 2.2 mm (p <.01) in the severe group. The prevalence of abnormal uterine bleeding was significantly reduced after surgery in both groups (p <.01). Pelvic pain was significantly reduced only in the moderate group (p <.01). The rate of complications (5% vs 9.1%) and second surgery (15% vs 24.2%) were not significantly different between moderate and severe groups, respectively. The median time to conceive (7 months vs 12 months); pregnancy rates (84.6% vs 68.2%); and live birth rates (76.9% vs 50%) were not statistically significant in the moderate and severe groups respectively, with 90% of pregnancies occurring naturally. Women delivered by cesarean section at 38 weeks of gestation in both groups, and no uterine rupture was reported. Despite the absence of residual myometrium, vaginal repair of severe cesarean scar defect was effective in increasing myometrial thickness, in relieving bleeding symptoms, and in allowing to achieve pregnancy.

Case Series: Diagnosis and Treatment of Four Rare Cancers by a Single Surgeon Due to Systematic Mapping and Near Contact Techniques

Whittaker NM, AAGL 2024·J Minim Invasive Gynecol

No standard criteria exist for how to perform a diagnostic laparoscopy. This case series provides evidence of the importance of standardized, reproducible techniques. A single non-oncologic gynecologic surgeon used Near-Contact Laparoscopy (NCL) and Systematic Mapping of the Abdomen and Pelvis (S-MAP) techniques, resulting in the incidental finding and curative treatment of 4 rare cancers over 3 years. Three were neuroendocrine tumors of the appendix (incidence 0.95/100,000; probability of 3 0.0000000001). The fourth was a 2 mm well-differentiated papillary mesothelioma (WDPM). All 4 were cured. 3 of 3 infertile patients subsequently achieved pregnancy. The NCL technique was originally coined by Dr. Redwine (PMID: 3190209). The S-MAP method was described in the NaProTechnology textbook by Dr. Thomas Hilgers, and the S-MAP term coined by this author. Case D used robotic-assisted laser excision. Standardization should be incorporated as the gold standard.

Pregnancy Outcomes after Uterus-sparing Operative Treatment for Adenomyosis: A Systematic Review and Meta-analysis

Fu K et al., 2023·Journal of Minimally Invasive Gynecology