ABSTRACT
Background: Ovarian cysts, common in women of reproductive age, often require surgical intervention, with minimally invasive laparoscopic surgery becoming the preferred method due to its reduced complications and faster recovery. Despite its benefits, challenges such as instrument collisions and operational difficulties limit the use of single- or two-port approaches. The purpose of this study was to evaluate the feasibility of laparoscopic adnexa surgery using an articulating laparoscopic instrument, which offers flexible and ergonomic movements similar to robotic systems. Methods: This multicenter prospective observational study was conducted in South Korea and Taiwan. The electronic medical records of patients who underwent laparoscopic adnexectomy using the articulating laparoscopic instrument (ArtiSential®, LIVSMED Inc., Seongnam-si, South Korea) between October 2022 and September 2023 were analyzed. Data on patient demographics, operative and pathologic data were collected prospectively. Results: A total of 66 patients underwent laparoscopic adnexal surgery using the articulating instrument. The median age of the patients was 43 (range, 23-76) years, and the median body mass index (BMI) was 22.5 (range, 17.1-43.4) kg/m2. Thirty-five (53.0%) patients underwent oophorectomy or salpingectomy, while 31 (47.0%) underwent cystectomy of the ovary or fallopian tube. The final pathology after surgery was benign in 61 patients (92.4%), borderline in 3 patients (4.5%), and malignant in 2 patients (3.0%). During surgery, pelvic adhesions were found in 13 patients (19.7%) and adhesiolysis was performed. The median total operation time was 53.5 (range, 26-174) minutes, and median estimated blood loss (EBL) was 50 (range, 10-200) mL. Median length of hospital stay was 1 (range, 0-3) days. Only two patients experienced a postoperative complication, which was trocar site wound dehiscence in both cases. Conclusions: The results of this study demonstrated the feasibility of using the articulating laparoscopic instrument during laparoscopic adnexectomy.
ABSTRACT
It is a well held concept that the magnitude of red-tide occurrence is dependent on the amount of nutrient supply if the conditions are same for temperature, salinity, light, interspecific competition, etc. However, nutrient sources fueling dinoflagellate red-tides are difficult to identify since red tides usually occur under very low inorganic-nutrient conditions. In this study, we used short-lived Ra isotopes (223Ra and 224Ra) to trace the nutrient sources fueling initiation and spread of Cochlodinium polykrikoides blooms along the coast of Korea during the summers of 2014, 2016, and 2017. Horizontal and vertical distributions of nutrient concentrations correlated well with 224Ra activities in nutrient-source waters. The offshore red-tide areas showed high 224Ra activities and low-inorganic and high-organic nutrient concentrations, which are favorable for blooming C. polykrikoides in competition with diatoms. Based on Ra isotopes, the nutrients fueling red-tide initiation (southern coast of Korea) are found to be transported horizontally from inner-shore waters. However, the nutrients in the spread region (eastern coast of Korea), approximately 200 km from the initiation region, are supplied continuously from the subsurface layer by vertical mixing or upwelling. Our study highlights that short-lived Ra isotopes are excellent tracers of nutrients fueling harmful algal blooms in coastal waters.
