ASRM: Annual Meeting Final Program

10:15 am
Introduction

10:20 am
V-1
Improvement of a Photodynamic System for Observation of Seminiferous Tubules in Microdissection-Testicular Sperm Extraction (MD-TESE)
A. Tanaka, I. Tanaka, M. Nagayoshi, S. Awata, N. Himeno
Objective: This study was conducted to three-dimensionally visualize the structure of seminiferous tubules and objectively evaluate the degree of spermatogenesis. Content: Magnification was improved by attaching a contact type lens to a surgical microscope. In addition, it was possible to clearly observe the inner structure of the testicular tubes by obtaining an appropriate lighting angle and height with an external light source. Conclusion: With this new system, it is possible to evaluate the density and characteristics of the cells in seminiferous tubules to a certain degree.

10:30 am
V-2
Microsurgical Subinguinal Variococelectomy
C. Tanrikut, M. Goldstein, R.K. Lee, P.S. Li
Varicocelectomy is the most commonly performed procedure for male infertility. This video reviews the rationale for and technique of subinguinal microsurgical varicocelectomy. Use of the operating microscope allows for: 1) identification and preservation of testicular and cremasteric arteries, optimizing testicular blood supply; 2) reliable identification and preservation of lymphatics, virtually eliminating postoperative hydrocele; and 3) ligation of all internal and external spermatic veins. Delivery of the testis assures direct visual access to all possible routes of venous return, minimizing risk of varicocele recurrence. Subinguinal microsurgical varicocelectomy is a safe, effective approach to varicocele repair that minimizes post-operative morbidities.

10:40 am
V-3
The In-Line Vasectomy with ILV Instruments
J.L. Marmar
The instruments and closure techniques for vasectomies have never been standardized. In contrast, with the In-Line Vasectomy all aspects of the vasectomy procedure have been critiqued. As a result, the In-Line Vasectomy utilizes standardized ILV instruments and a standardized method for vas occlusion to provide a rapid and reliable office procedure for permanent male birth control with reduced tissue trauma, less inflammation and less post operative discomfort. (Honorable Mention for Technical Achievement in Video: Urology Category)

10:50 am
V-4
Robotic-assisted Vasovasostomy: A Two-layer Technique in an Ex-vivo Human Vas Model
W.W. Kuang, A.J. Thomas
A two-layer vasovasostomy in an exvivo human vas model is feasible using the da Vinci robot.

11:00 am
V-5
Hemostatic Hydrodissecion of the Neurovascular Bundles During Laparoscopic Radical Prostatectomy: Technique Video
S.J. Parekattil
The video demonstrates a novel technique for nerve preservation during laparoscopic radical prostatectomy.

11:10 am DISCUSSION

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MISCELLANEOUS

11:20 am
V-6
Multidetector CT Virtual Hysterosalpingography
P. Carrascosa, M. Baronio, C. Capunay, E.M. Lopez, C. Sueldo, M. Borghi
Objective: To compare the efficacy of multidetector CT virtual hysterosalpingography (MDCT-VH) with conventional X-ray hysterosalpingography (HSG) in the evaluation of patients with the diagnosis of infertility. Content: Sixty patients with the diagnosis of infertility scheduled to undergo an HSG, were evaluated with 16-row (n=50) and 64-row (n=10) MDCT-VH. The sensitivity and specificity of MDCT-VH for the detection of uterine pathology and tubal obstruction were calculated using the exact binomial method. Conclusion: This study demonstrated the feasibility of evaluating the female reproductive system by MDCT-VH. 64-row MDCT-VH could be an alternative diagnostic technique in the infertility workup algorithm. (First Prize for Technical Achievement in Video 2007)

11:30 am
V-7
An Embryology Laboratory Tour
J. A. Barritt, R. Slifkin, M. Duke, M. Acosta-LaGreca, A. Copperman
A patient education video designed to be shown in our IVF cycle training class for patients initiating a cycle. The video shows and discusses the embryology laboratory and the procedures performed.

11:40 am DISCUSSION

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Assisted Reproductive Technology

11:45 am
V-8
Embryonic Development Following the Nuclear Transfer of In Vitro Matured Metaphase-II Oocytes into Enucleated Freshly Ovulated Metaphase-II Oocytes
A. Tanaka, I. Tanaka, M. Nagayoshi, S. Awata, N. Himeno
Objective: We conducted this study to investigate the possibility of repairing either mitochondrial diseases or female infertility due to ooplasmic deficiency and abnormalities. Content: Embryonic development following the nuclear transfer of in vitro matured metaphase-II oocytes into enucleated freshly ovulated metaphase-II oocytes was investigated. Conclusion: This technique can be applied to the treatment of mitochondrial diseases or female infertility due to ooplasmic deficiency and abnormalities.

11:50 am
V-9
Implantation of a Human Blastocyst into a Human Endometrial Epithelial Cell Monolayer: Cinematographic Observation
H. Ando
Human blastocyst implantation into a human endometrial epithelial monolayer has been recorded using time-lapse cinematography. This video provides some educational information as well as much research interest.

11:55 am DISCUSSION

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ASRM VIDEO SESSION II

Robotics, Myomas and Cerclage
Wednesday, October 17, 2007
2:30 pm-4:30 pm

Moderators:
Tomasso Falcone, M.D.
Steven F. Palter, M.D.

2:30 pm
Introduction

2:35 pm
V-10
Simple Laparoscopic Abdominal Cerclage
T. Tulandi, M. Al-Sunaidi
We describe a simple laparoscopic technique of abdominal cerclage without dissecting the uterine vessels. After many miscarriages despite the traditional cerclage, the patient in this video delivered a healthy male infant.

2:40 pm
V-11
Da Vinci Assisted Abdominal Cerclage
L. I. Barmat, G. Davis
This video reviews the indications, advantages, and disadvantages of abdominal cerclage. We will highlight the first reported use of the da Vinci Robotic system for placement of a transabdominal cerclage.

2:50 pm
V-12
Robotically Assisted Tubal Anastomosis
M.A. Bedaiwy, T. Falcone, J.M. Goldberg
The objective of this video is to describe the detailed technique of tubal reanastomosis using the da Vinci robot.

2:55 pm
V-13
The Role of Laparoscopic Assisted Myomectomy
J. Ocampo, M. Nutis, C.R. Nezhat, F. R. Nezhat, C.H. Nezhat
Laparoscopic assisted myomectomy is advocated as a technique that may lessen the concerns of prolonged time of anesthesia, increased blood loss, and possibly a higher risk of postoperative adhesion formation, while retaining the benefits of laparoscopic surgery.

3:05 pm
V-14
Conventional Laparoscopic Myomectomy with Robotic Reconstruction: A Safe Hybrid Procedure for Large Myomata
A.R. Gargiulo, S. Srouji
Robotic-assisted laparoscopic myomectomy allows uterine reconstruction that is virtually identical to that achieved at laparotomy. Very large myomata present unique challenges to robotic applications. We present a hybrid technique allowing safe utilization of robotic assistance in these cases.
(Second Prize for Technical Achievement in Video 2007)

3:15 pm
V-15
Parasitic Fibroids After Laparoscopic Myomectomy
E.J. Nejat, J. Epstein, J. Licul, T. Tsai
A 29 year old GO developed parasitic fibroids two years after undergoing a laparoscopic myomectomy. The parasitic fibroids may have been a result of shards of the original fibroids that were dispersed throughout the abdomen.

3:20 pm DISCUSSION

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3:25 pm
V-16
Ovarian Vessels Dissection for Fertility Preservation Purposes
M.A. Bedaiwy, T. Falcone
This video describes the laparoscopic and the angiographic anatomy of the ovarian vessels. It also describes techniques for ovarian transplantation and transposition.

3:35 pm
V-17
Intact Whole Ovary Allotransplantation with Microvascular Anastomosis
S.J. Silber, M. DeRosa, J. Pineda, M. Hartman, P. Patrizio, R.G. Gosden
This video demonstrates the technique for intact whole ovary transplantation with end-to-end anastomosis of ovarian artery and ovarian veins. This particular case is the first between no-twin, non-identical sisters. The purpose is to avoid egg loss due to the prolonged ischemia time associated with ovarian cortical grafts.

3:40 pm
V-18
Primate Allograph Uterus Transplantation
J. Stega, S. Schlatt, G. Del Priore
Objective: To validate our human organ donor experience in a primate model and to demonstrate a technique for uterus allograph transplantation in a primate. Content: The video contains surgical highlights. Conclusion: We believe these results offer a proof of principle for our human uterus transplant proposal.

3:45 pm DISCUSSION

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3:50 pm
V-19
Laparoscopic Amputation of a Noncommunicating Uterine Horn
J. Ocampo, M. Nutis, C.R. Nezhat, F. R. Nezhat, C.H. Nezhat
Objective: To demonstrate the laparoscopic management of a non-communicating rudimentary uterine horn. Methods: Hysteroscopic evaluation to assess the uterine cavity followed by an operative laparoscopy detailing the complete resection of a non-communicating rudimentary uterine horn. A subsequent cystoscopy was also performed to assess correct implantation of the ureters. Results: A 13 year-old female presented with onset of dysmenorrhea and pelvic pain since menarche six months prior to our consultation. Initial ultrasound evaluation showed a right adnexal mass. A subsequent diagnostic laparoscopy showed a pelvic mass, completely separate from the right adnexa. We performed a second operative laparoscopy and found a pelvic mass consistent with a non-communicating rudimentary uterine horn. The right adnexa had a normal ovary but poorly formed fallopian tube. The left ovary and tube were normal. This video demonstrates the laparoscopic management of a non-communicating rudimentary uterine horn. Conclusion: Management of congenital uterine anomalies is feasible by laparoscopy.

4:05 pm
V-20
Fertility Considerations in Patients with Bowel Endometriosis
J. Ocampo, M. Nutis, C.R. Nezhat, F. R. Nezhat, C.H. Nezhat
Objective: To demonstrate the laparoscopic treatment of endometriosis in a patient with chronic pelvic pain, proctalgia during menses and infertility. We show the technique of bowel shaving for the treatment of bowel endometriosis.

4:15 pm
V-21
Incisional Hernia on the Trocar Port Site After Laparoscopy. Prevention, Recognition and Management
J. Ocampo, M. Nutis, C.R. Nezhat, F. R. Nezhat, C.H. Nezhat
Objective: To demonstrate the laparoscopic management of an incisional hernia on the trocar port site after laparoscopy. Methods: Laparoscopic evaluation to assess the presence of an incisional hernia after robotic assisted laparoscopy detailing the complete management. Results: A 50 year-old female presented with onset of pelvic pain and left lower extremity swelling six months prior to our consultation. Initial ultrasound evaluation showed a fibroid uterus. We performed a robotic assisted hysterectomy and found a 5cm fundal uterine fibroid. This video demonstrates early recognition, prevention and laparoscopic management of a port site incisional hernia. Conclusion: Management of a port site incisional hernia is feasible by laparoscopy.

4:25 pm DISCUSSION

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AAGL FILM FESTIVAL

Wednesday, October 17, 2007
10:15 am-12:00 noon

Best Endoscopic Surgical Videos of the American Association of Gynecologic Laparoscopists (AAGL)
This session will highlight the best surgical videos from the 2006 annual meeting of the AAGL. A variety of innovative laparoscopic and hysteroscopic procedures and techniques will be presented. Topics will include techniques for reproductive surgery, myomectomy, endometriosis, hysteroscopy, and new technologies. The session is designed for all levels of gynecologic and urologic surgeons.

Moderators:
Ceana H. Nezhat, M.D.
Grace M. Janik, M.D.

VIDEO SESSION I
ENDOMETRIOSIS

10:15 am
V-1 (8 min)
Modified Virtual Colonoscopy - A New Non-Invasive Technique for the Diagnosis of Rectovaginal Septum and Deep Infiltrating Pelvic Endometriosis.
J.I. Van der Wat, M.D. Kaplan. Park Lane Clinic, Johannesburg, South Africa

10:23 am
V-2 (8 min)
Development and Use of a New Autofluorescence Based System for Endoscopy - Use in the Pelvis, Bladder and Lung.
S. F. Palter. Syosset, NY

10:35 am
V-3 (8 min)
Recto-Vaginal Endometriotic Nodule Excision and Measures to Prevent Fistula Formation.
E. Ohana, V. Frenna, A. Wattiez. Hautepierre University Hospital, Strasbourg; I.R.C.A.D./E.I.T.S., Strasbourg, Cedex, France

10:43 am DISCUSSION

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HYSTEROSCOPY

V-4
10:48 am (7:05 min)
Suprapubic-Assisted Operative Cystoscopy for Removal of Intravesical Foreign Bodies.
P. L. Rosenblatt, S.J. Pulliam, L. Hota. Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts

V-5
10:55 am (8 min)
Endoscopic Management of the Perforated IUD.
E. M. Heinberg, R.P. Pasic, T.W. McCoy. University of Louisville, Louisville, Kentucky

V-6
11:03 am (6:51 min)
Demonstration of a New Hysteroscopic Shaving Technique to Remove Intrauterine Polyps with Intrauterine Resection Blades.
B. C. Schoot, J. Jaspers, B. de Becker. Catharina Hospital, Eindhoven, Netherlands

11:10 am DISCUSSION

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LAPAROSCOPY AND MYOMAS

V-7
11:15 am (8 min)
Laparoscopic Lateral Ovarian Transposition.
G. Chen, A.M. Gustilo-Ashby, J. Juliano, T. Falcone. Cleveland Clinic, Cleveland, Ohio; Female Pelvic Medicine and Reconstructive Surgery

V-8
11:23 am (8 min)
How Can We Avoid a Conversion to Laparotomy? The Answer is Intracorporeal Suturing.
M. Andou. Kurashiki Medical Center, Kurashiki-Shi, Okayama-ken, Japan

V-9
11:31 am (8 min)
Various Intracorporeal Suturing Techniques and Application- Submucosal Myomectomy.
M. Andou. Kurashiki Medical Center, Kurashiki-Shi, Okayama-ken, Japan

V-10
11:39 am (8 min)
A Novel Vaginal Occlusion of the Uterine Arteries Technique for the Conservative Management of Symptomatic Fibroids.
M. A. Pelosi II, M.A. Pelosi, III. Pelosi Medical Center, Bayonne, New Jersey

V-11
11:47 am (8 min)
Laparoscopic Management of Adnexal Mass in Pregnancy.
F. R. Nezhat, B. Fazilat, C.H. Nezhat, C.R. Nezhat. Mount Sinai School of Medicine, New York, New York; Stanford University School of Medicine, Palo Alto, California

11:55 am DISCUSSION

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Return to the Final Program

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