1
|
Castaldi MA, Cobellis L, Fraternali F, Ardovino M, Ardovino I, Colacurci N. Biomechanical features of bidirectional-barbed suture: a randomized laboratory analysis. Surg Technol Int 2014; 24:45-48. [PMID: 24700213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of the current prospective study was to evaluate the biomechanical stability of barbed suture vs. conventional suture. Biomechanical stability of a 14x14-cm PDO/polydioxanone, with a half circle and 36-mm needle, bidirectional barbed 0-Quill suture (Angiotech, Vancouver, British Columbia, Canada) vs. 1-Poliglecaprone 25 (Monocryl, Ethicon, Inc, Somerville, NJ) suture was evaluated on biological specimens. The 1-Monocryl suture was chosen because it is widely used by gynecological surgeons in the repair either of the vaginal cuff or the uterine wall defects. Forty specimens of aponeurotic muscle, obtained from abdominal wall of a lamb, were prepared, and randomly assigned to 1 of 2 repair groups: Group A (n = 20) classic repair with 1-Monocryl suture; Group B (n = 20) 0-Quill barbed suture. Each specimen was transected at the midpoint and then repaired. Biomechanical stability of the repaired specimen was verified on a CMT6000 electromechanical universal testing machine (SANS, MTS SYSTEMS, China Co., Ltd., Shenzhen, China), with a 1kN cell. Biomechanical tests showed that maximum force was similar for 1-Monocryl and 0-Quill respectively (p = non-significant). This randomized laboratory study shows that biomechanical stability of the sutures is comparable.
Collapse
Affiliation(s)
- Maria Antonietta Castaldi
- Department of the Woman, the Child, and General and Specialized Surgery Second University of Naples Naples, Italy
| | - Luigi Cobellis
- Department of the Woman, the Child, and General and Specialized Surgery Second University of Naples Naples, Italy
| | - Fernando Fraternali
- Department of Civil Engineering, Laboratory of Biomechanics University of Salerno Salerno, Italy
| | - Mario Ardovino
- Department of the Woman, the Child, and General and Specialized Surgery Second University of Naples Naples, Italy
| | - Italo Ardovino
- Department of the Woman and the Child, Operative Unit of Obstetrics and Gynaecology A.O.R.N. S.G. Moscati Avellino, Italy
| | - Nicola Colacurci
- Department of the Woman, the Child, and General and Specialized Surgery Second University of Naples Naples, Italy
| |
Collapse
|
2
|
Ardovino M, Castaldi MA, Fraternali F, Ardovino I, Colacurci N, Signoriello G, Cobellis L. Bidirectional Barbed Suture in Laparoscopic Myomectomy: Clinical Features. J Laparoendosc Adv Surg Tech A 2013; 23:1006-10. [DOI: 10.1089/lap.2013.0103] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mario Ardovino
- Department of the Woman, the Child and General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Maria Antonietta Castaldi
- Department of the Woman, the Child and General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Fernando Fraternali
- Laboratory of Biomechanics, Department of Civil Engineering, University of Salerno, Salerno, Italy
| | - Italo Ardovino
- Operative Unit of Obstetrics and Gynaecology, A.O.R.N. San Giuseppe Moscati, Avellino, Italy
| | - Nicola Colacurci
- Department of the Woman, the Child and General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Giuseppe Signoriello
- Section of Statistics, Department of Public Medicine, Second University of Naples, Naples, Italy
| | - Luigi Cobellis
- Department of the Woman, the Child and General and Specialized Surgery, Second University of Naples, Naples, Italy
| |
Collapse
|
3
|
Ardovino M, Castaldi MA, Fraternali F, Ardovino I, Mosca L, Colacurci N, Signoriello G, Cobellis L. Bidirectional barbed suture in total laparoscopic hysterectomy and lymph node dissection for endometrial cancer: technical evaluation and 1-year follow-up of 61 patients. J Laparoendosc Adv Surg Tech A 2013; 23:347-50. [PMID: 23573880 DOI: 10.1089/lap.2012.0079] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE This randomized clinical study compared the feasibility and safety of the shortest suture for bidirectional knotless barbed versus standard sutures, with either extracorporeal or intracorporeal knots, for vaginal cuff closure following total laparoscopic hysterectomy (TLH) and lymph node dissection for early endometrial cancer. SUBJECTS AND METHODS The study design was Canadian Task Force Classification I. In tertiary-care university-based teaching hospitals, 61 women underwent TLH and lymph node dissection. In accord with randomization, the vaginal cuff in TLH was closed with either extracorporeal or intracorporeal knots (1-Monocryl(®); Ethicon Inc., Somerville, NJ) and a bidirectional knotless barbed suture (0-Quill™; Angiotech Pharmaceuticals, Inc., Vancouver, BC, Canada). All patients were evaluated at 3-month, 6-month, and 1-year follow-up. RESULTS Time required to suture was significantly lower in the group treated with bidirectional suture than in groups with traditional sutures (P<.001). No significant difference was observed in the operative time between the study groups. The degree of surgical difficulty was significantly lower in the bidirectional barbed suture group than in the other groups. At 1-year follow-up all patients presented no wound dehiscence, no bleeding, dyspareunia, and other potential major complications such as ureteric, bladder, or bowel injury. CONCLUSIONS Use of a barbed suture reduces the time required to repair the vaginal cuff during TLH. At follow-up of patients, carried out 3 months, 6 months, and 1 year after the surgery, no wound dehiscence, no bleeding, or no other potential major surgical complications had occurred.
Collapse
Affiliation(s)
- Mario Ardovino
- Department of Gynaecology, Obstetrics, and Reproductive Science, Second University of Naples, Naples, Italy
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Ardovino M, Ardovino I, Castaldi MA, Trabucco E, Colacurci N, Cobellis L. Minilaparoscopic Myomectomy: A Mini-invasive Technical Variant. J Laparoendosc Adv Surg Tech A 2013; 23:871-5. [DOI: 10.1089/lap.2013.0037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mario Ardovino
- Operative Unit of Obstetrics and Gynaecology, Highly Specialized National Hospital “San Giuseppe Moscati,” Avellino, Italy
- Department of Woman, Child, and of General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Italo Ardovino
- Operative Unit of Obstetrics and Gynaecology, Highly Specialized National Hospital “San Giuseppe Moscati,” Avellino, Italy
| | - Maria Antonietta Castaldi
- Department of Woman, Child, and of General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Elisabetta Trabucco
- Department of Woman, Child, and of General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Nicola Colacurci
- Department of Woman, Child, and of General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Luigi Cobellis
- Department of Woman, Child, and of General and Specialized Surgery, Second University of Naples, Naples, Italy
| |
Collapse
|
5
|
Ardovino M, Ardovino I, Castaldi MA, Monteverde A, Colacurci N, Cobellis L. Laparoscopic myomectomy of a subserous pedunculated fibroid at 14 weeks of pregnancy: a case report. J Med Case Rep 2011; 5:545. [PMID: 22054171 PMCID: PMC3225401 DOI: 10.1186/1752-1947-5-545] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 11/05/2011] [Indexed: 11/15/2022] Open
Abstract
Introduction Uterine leiomyomas are seen in 1.6% to 4% of pregnancies. With the increasing age of obstetric patients, more cases are being encountered during pregnancy. Case presentation We report the case of a 31-year-old Caucasian woman with acute recurrent abdominal pain due to a subserous fundic myoma, measuring 48 × 52 × 63 mm, with an implantation base of 22 × 18 mm, which was successfully treated by laparoscopy at 14 weeks of pregnancy. At a gestational age of week 40, the patient spontaneously delivered a healthy 3216 g girl baby. Conclusion As far as we know, this is the first reported case of laparoscopic myomectomy this early during a pregnancy. Our experience together with an analysis of cases reported in the literature suggests that myomectomy during pregnancy may be considered safe, but only in the hands of experienced laparoscopic surgeons. There are a few reports in the literature about laparoscopic myomectomy during the first half of pregnancy that demonstrate its feasibility in selected cases. Some technical tools could improve the procedure with a minimum of risk for the ongoing pregnancy.
Collapse
Affiliation(s)
- Mario Ardovino
- Department of Gynaecology, Obstetrics and Reproductive Science, Second University of Studies of Naples, Largo Madonna delle Grazie 1, 80138, Naples, Italy.
| | | | | | | | | | | |
Collapse
|
6
|
Abstract
OBJECTIVE The present study was undertaken to evaluate the pattern of serum cytokine production in postmenopausal women and the relationship with the hormonal status. A group of fertile women served as controls. METHODS Eighty-two women in apparent good health, non-smokers and without a history of hormone replacement therapy, were enrolled for the study. The women were divided in two groups according to their hormonal status: fertile women (n=34, age 32 +/- 7 years) and postmenopausal women (n=48, age 54 +/- 8 years). Blood samples were withdrawn in the morning, after an overnight fast. RESULTS Sex hormones (LH, FSH, Estradiol, Progesterone, DHEA, DHEA-S), as well as GH and IGF-1 levels, were significantly higher in the serum of fertile women as compared with their postmenopausal counterparts. Unlike IL-2, IL-4, IL-5, IL-10, IL-12 and IFN-gamma, significant differences were observed in serum IL-6, IL-18, TNFalpha and TNFbeta between groups: both IL-6 and IL-18 were higher in postmenopausal women, while TNFalpha and TNFbeta were significantly lower. There was an inverse relationship between serum DHEA and DHEA-S levels and both IL-6 (r= -0.46, P<0.02) or IL-18 (r= -0.38, P<0.05) serum concentrations. CONCLUSIONS Compared with fertile counterparts, women in postmenopause present an alteration in serum cytokine profile suggesting a prevalence of Th2 lymphocytes.
Collapse
Affiliation(s)
- Michele Cioffi
- Patologia clinica, Dipartimento di Patologia Generale, Facoltà di Medicina e Chirurgia, Seconda Università degli Studi di Napoli, Via S. Andrea delle Dame, 2-80138, Naples, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Abstract
BACKGROUND The Cerebro-Ocular-Facio-Skeletal (COFS) syndrome is an autosomal recessive condition characterized by neurogenic arthrogryposis, severe facial anomalies and brain maldevelopment. We describe here the first case of prenatal diagnosis of this syndrome in a 21-week fetus. CASE The woman was referred to our unit on suspicion of fetal microphthalmia. On trans-abdominal ultrasound, severe bilateral microphthalmia was confirmed. Micrognathia, multiple joint contractures and rockerbottom feet were also detected. On the basis of these findings, the diagnosis of COFS syndrome was hypothesized. After termination of pregnancy, necropsy confirmed all prenatal findings. Histology showed severe architectural derangement of the eye and brain together with cerebellar anomalies compatible with the diagnosis of COFS syndrome. CONCLUSIONS To the best of our knowledge, this represents the first case of prenatal diagnosis of COFS syndrome. This case demonstrates the feasibility of such a diagnosis by ultrasound and identifies the malformations already present and detectable at mid-gestation.
Collapse
Affiliation(s)
- D Paladini
- Department of Gynecology and Obstetrics, University Federico II of Naples, Italy
| | | | | | | |
Collapse
|
8
|
Parazzini F, Di Cintio E, Chatenoud L, Moroni S, Ardovino I, Struzziero E, Falsetti L, Bianchi A, Bracco G, Pellegrini A, Bertulessi C, Romanini C, Zupi E, Massobrio M, Guidetti D, Troiano L, Beretta P, Franchi M. Estroprogestin vs. gonadotrophin agonists plus estroprogestin in the treatment of endometriosis-related pelvic pain: a randomized trial. Gruppo Italiano per lo Studio dell'Endometriosi. Eur J Obstet Gynecol Reprod Biol 2000; 88:11-4. [PMID: 10659911 DOI: 10.1016/s0301-2115(99)00131-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This is a randomized clinical trial comparing estroprogestin (E/P) pill given for 12 months vs. gonadotrophin releasing hormone agonist (GNRHa) given for 4 months followed by E/P pill treatment for 8 months in the relief of endometriosis-related pelvic pain. METHODS Eligible for the study were women with laparoscopically confirmed endometriosis and pelvic pain lasting 3-12 months after diagnosis. Eligible women were randomly assigned to treatment with E/P pill (gestroden 0.75 mg and ethynlestradiol 0.03 mg) for 12 months (47 patients) vs. tryptorelin 3.75 mg slow release every 28 days for 4 months followed by E/P pill for 8 months (55 patients). RESULTS At baseline, dysmenorrhea was reported in 46 women allocated to E/P pill only (97.9%), and in all the 55 women allocated to GNRHa+E/P pill. The corresponding value at the 12 months follow-up visit was 14 subjects (35.9%) and 16 subjects (34.8%). The baseline median values of the multidimensional and analog scale were for dysmenorrhea 4 and 6 in the EP only and 3 and 6 in the GNRHa+E/P group. The corresponding value at the 12 months follow-up visit were 2 and 6 and 0 and 5. Non-menstrual pain was reported, respectively, at baseline and 12 month visit by 46 (97.9%) and 15 (38.5%) subjects in the E/P pill group and 49 (89.1%) and 17 (37.0%) of the GNRHa+E/P pill one. The baseline median values of the multidimensional and analog scale were for non-menstrual pain 3 and 5 in the E/P only and 2 and 6 in the GNRHa+E/P group. The corresponding values at the 12 month follow-up visit were 0 and 4 and 0 and 4. These differences between the two groups were not statistically significant. CONCLUSIONS 1 year after randomization, the two treatment schedules show similar relief of pelvic pain in women with endometriosis.
Collapse
Affiliation(s)
- F Parazzini
- Prima Clinica Ostetrico Ginecologica, Università di Milano, Milan, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Izzo S, Ardovino I. [Neodymium-Yag laser in the treatment of benign endometrial pathology after preparation by slow-release triptorelin]. Minerva Ginecol 1994; 46:417-22. [PMID: 7970078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Twenty-one patients with uterine bleeding who failed to respond to pharmacological treatment underwent Nd-Yag endometrial photocoagulation following preparation with slow-release triptorelin. All patients were carefully selected after a complete clinical, echographic, hormonal, hysteroscopic and histological screening. Subjects with menometrorrhagia due to high-risk endometrial pathologies and various causes were excluded from the study. The technique uses a modified urological resectoscope which enables the Nd-Yag laser optic fibre to be inserted and to move the tip by 30 degrees. The entire endometrial cavity was treated using a power of between 40 and 60 watts and in all cases analogs were administered preparatively for 3 months prior to surgery (slow-release triptorelin). No complications arose during treatment. Operating times were between 40 and 90 minutes. Fourteen of the patients currently do not report cyclical bleeding; 7 have modified periodic bleeding (3 with algomenorrhea which is overcome using bland oral analgesics). In conclusion the authors affirm that the technique is of considerable value, but requires lengthy training for operators and undoubtedly a high initial cost of equipment which is only justified by multidisciplinary use.
Collapse
Affiliation(s)
- S Izzo
- Divisione di Ostetricia e Ginecologia, Ospedale Sacro Cuore di Gesù
| | | |
Collapse
|
10
|
Struzziero E, Corbo M, Ardovino I. [Laparoscopy in the diagnosis of pelvic pain. Clinico-statistical study]. Minerva Ginecol 1987; 39:329-31. [PMID: 2957615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
11
|
Struzziero E, Corbo M, Ardovino I. [Echographic monitoring of the ovarian follicle]. Minerva Ginecol 1986; 38:465-8. [PMID: 3526198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
12
|
Struzziero E, Corbo M, Ardovino I. [The role of echography in cervico-segmental incontinence]. Minerva Ginecol 1985; 37:597-600. [PMID: 3908983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
13
|
Corbo M, Struzziero E, Zeppa P, Ardovino I. [A rare case of Krukenberg's tumor. Echographic evaluation and surgical treatment]. Minerva Ginecol 1985; 37:389-92. [PMID: 2999646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
14
|
Struzziero E, Corbo M, Delli Veneri G, Recce R, Ardovino I. [Fetal long bones. The problem of their correct visualization and echographic biometry]. Minerva Ginecol 1984; 36:339-41. [PMID: 6472729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
15
|
Struzziero E, Delli Veneri G, Corbo M, Ardovino I. [Combined maternal urogenital malformations in pregnancy. Echographic observations and comments on a clinical case]. Minerva Ginecol 1984; 36:325-9. [PMID: 6472727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
16
|
Struzziero E, Corbo M, Recce R, Ardovino I. [Echographic aspects of placental maturity]. Minerva Ginecol 1982; 34:707-9. [PMID: 7145209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|