Initial results in the automatic visual recognition of endometriosis lesions by artificial intelligence during laparoscopy: a proof-of-concept study.

Objective: To develop a machine learning method for the automatic recognition of endometriosis lesions during laparoscopic surgery and evaluate its feasibility and performance.

Design: Collecting and annotating surgical videos and training, validating, and testing a deep neural network.

Setting: Multicenter proof-of-concept study using surgical videos from expert centers in France, Hungary, Brazil, and Denmark.

Diagnostic laparoscopy and cytoreduction surgery in ovarian cancer FIGO III-IV: The impact on survival of one-stage versus two-stage sequence.

Objectives: This is a retrospective study designed to assess the impact of two-stage versus single-stage surgical management on survival in patients with FIGO III-IV ovarian neoplasia receiving surgical management.

Methods: This is a retrospective, multicenter study, based on the FRANCOGYN group database. Two groups were studied, the first having primary surgical management in a single operation, and the second having two-stage sequence primary surgical management.

Travel less, learn more, never attend alone! Adapting Minimally Invasive Surgery meetings to minimize the environmental impact while maintaining personal interactions.

Objective: To propose a model of international meetings of minimally invasive gynecologic surgery to decrease the carbon footprint while preserving personal interactions and the financial stability of meetings and of medical societies.

What We Know: International medical society meetings create a substantial carbon footprint, with 95% generated by air travel. Meetings may be organized virtually or in-person with distinct benefits and drawbacks of each format.

[Clinical practice guidelines for pelvic pain associated with endometriosis. A consensus-based approach by CNGOF & Convergences PP].

Objective: To develop best practice guidelines under the auspices of the CNGOF and Convergences PP for the management of pain associated with endometriosis.

Method: We organised a literature review and a formal expert consensus. A multidisciplinary steering committee composed of 14 healthcare professionals and 2 patient association representatives drafted an argument based on literature analysis, resulting in 7 proposed definitions and 59 best practice recommendations.

In vitro Effects of ABT-263, a BH3 Mimetic, on Fibrotic Phenotype in Endometriotic and Endometrial Stromal Cells.

Objectives: A recent study has shown that myofibroblasts are primed for apoptosis when survival pathways are inhibited under fibrosis. This knowledge of apoptosis priming led to the development of methods to induce apoptosis specifically in myofibroblasts by blocking specific pro-survival proteins of the BCL-2 family with small molecules that mimic the function of the BH3-only proteins, termed BH3 mimetics. The current study aimed to investigate the in vitro effects of ABT-263 (navitoclax), a BH3 mimetic, alone and in combination with oestrogen and/or progesterone, on fibrosis in endometriotic and endometrial stromal cells.

Indocyanine green in gynecologic surgery: Where do we stand? A literature review and meta-analysis.

The main objective of this study was to review and perform a meta-analysis of current literature on the use of indocyanine green for sentinel lymph node detection in pelvic gynecologic cancer. We included all studies focusing on indications and procedures associated with the use of ICG in gynecologic surgery and available on the Medline and Pubmed database. For the meta-analysis, random effect models were used for estimation of the 95 % detection rate and 95 % confidence interval, and stratified analyses by cancer type, concentration and localization of injection were performed.

Do we want to know the enormity of women's severe menstrual disorders and chronic pelvic pain?

Objective: The purpose of this paper is to call for a nationwide study to assess the prevalence and incidence of women health problems related to menstrual disorders and severe pelvic pain.

Rationale: The exact prevalence and incidence of endometriosis, adenomyosis, severe painful menstrual disorders, and of severe chronic pelvic pain are unknown. These issues severely impact women's quality of life and represent huge costs for our societies.

Endometriosis: Age at diagnosis and the severity of the disease.

Background: Endometriosis is often described as a progressive disease beginning with menarche and menstrual bleeding. However, this is controversial, as the origin of the disease remains unknown. The objective of this study was to investigate the association between the severity of endometriosis and age at initial diagnosis.

Meta-analysis of randomized clinical trials comparing robotic versus laparoscopic surgery for mid-low rectal cancers.

Introduction: Robotic surgery (RS) is experiencing major development, particularly in the context of rectal cancer. The aim of this meta-analysis was to summarize data from the literature, focusing specifically on the safety and effectiveness of robotic surgery in mid-low rectal cancers, based on the hypothesis that that robotic surgery can find its most rational indication in this anatomical location.

Method: The meta-analysis was conducted according to the PRISMA 2000 recommendations, including all randomized trials that compared robotic surgery versus laparoscopic surgery (LS) that were found in the Medline-PICO, Cochrane Database, Scopus and Google databases.

Automatic Smoke Analysis in Minimally Invasive Surgery by Image-Based Machine Learning.

Introduction: Minimally Invasive Surgery uses electrosurgical tools that generate smoke. This smoke reduces the visibility of the surgical site and spreads harmful substances with potential hazards for the surgical staff. Automatic image analysis may provide assistance.

The impact of laparoscopic gynecological surgery training on the technicity index of a developing country center.

Purpose: To compare laparoscopic gynecological surgery training between a developed country's reference center (host center) and a public reference service in a developing country (home center), and use the technicity index (TI) to compare outcomes and to determine the impact of laparoscopic gynecological surgery fellowship training on the home center's TI.

Methods: The impact of training on the home center was assessed by comparing surgical performance before and after training. TI was assessed in 2017 in the host center, and before and after training in the home center.

In the thicket of fears, doubts, and murky facts: some reflections on treatment modalities for endometriosis-associated pain.

Endometriosis-associated pain can be managed by either surgery or hormonal therapy. The final decision as to which treatment modality to take is based on efficacy and possible complications of different treatment modalities, risk of recurrence, and the patient's wishes and preferences. But in the thicket of fears, doubts, and murky facts, the choice may ultimately be the trade-off between irrational fears and ignorance versus scientific evidence.

SurgAI3.8K: A Labeled Dataset of Gynecologic Organs in Laparoscopy with Application to Automatic Augmented Reality Surgical Guidance.

Study Objective: We focus on explaining the concepts underlying artificial intelligence (AI), using Uteraug, a laparoscopic surgery guidance application based on Augmented Reality (AR), to provide concrete examples. AI can be used to automatically interpret the surgical images. We are specifically interested in the tasks of uterus segmentation and uterus contouring in laparoscopic images.

IL-10 is not anti-fibrotic but pro-fibrotic in endometriosis: IL-10 treatment of endometriotic stromal cells in vitro promotes myofibroblast proliferation and collagen type I protein expression.

Study Question: Is interleukin-10 (IL-10) anti-fibrotic in endometriosis?

Summary Answer: IL-10 is not anti-fibrotic but pro-fibrotic in endometriosis, because IL-10 treatment of endometriotic stromal cells in vitro promotes myofibroblast proliferation and collagen type I protein expression.

What Is Known Already: We previously showed that persistent activation of signal transducer and activator of transcription 3 (STAT3) via IL-6 trans-signaling promotes fibrosis of endometriosis. Studies showed marked anti-fibrotic effects of IL-10 via the STAT3 signaling pathway, which is generally considered to be anti-inflammatory, in various organs.

Surgical complications and their impact for gynecological surgeons.

Objectives: Major clinical incidents can impact the healthcare professionals involved. This is of particular relevance in surgery, with the operating room being a high-risk zone for complications; however, there is few available data on how surgeons may be affected. The current study examined the impact of surgical complications on surgeon traumatic stress levels, emotional state, job performance, and coping strategies.

Persistent activation of signal transducer and activator of transcription 3 via interleukin-6 trans-signaling is involved in fibrosis of endometriosis.

Study Question: Is activation of signal transducer and activator of transcription 3 (STAT3) via interleukin-6 (IL-6) trans-signaling involved in fibrosis of endometriosis?

Summary Answer: Persistent activation of STAT3 via IL-6 trans-signaling is involved in fibrosis of endometriosis.

What Is Known Already: Our previous study showed that sustained low-grade inflammation promotes a fibrotic phenotype in endometriotic stromal cells. However, the underlying mechanisms of the establishment of non-resolving, low-grade inflammation in endometriosis remain to be clarified.