Rare autosomal trisomies (RATs) other than common aneuploidies can be detected using noninvasive prenatal testing (NIPT). However, conventional karyotyping is insufficient for evaluating diploid fetuses with uniparental disomy (UPD) due to trisomy rescue. Using the diagnostic process for Prader–Willi syndrome (PWS), we aim to describe the need for additional prenatal diagnostic testing for confirming UPD in fetuses diagnosed with RATs via NIPT and its clinical implications. NIPT was performed using the massively parallel sequencing (MPS) method, and all pregnant women with RATs underwent amniocentesis. After confirming the normal karyotype, short tandem repeat (STR) analysis, methylation-specific PCR (MS-PCR), and methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) were performed to detect UPD. Overall, six cases were diagnosed with RATs. There was a suspicion of trisomies of chromosomes 7, 8, and 15 in two cases each. However, these cases were confirmed to have a normal karyotype using amniocentesis. In one of six cases, PWS caused by maternal UPD 15 was diagnosed using MS-PCR and MS-MLPA. We propose that in cases where RAT is detected by NIPT, UPD should be considered following trisomy rescue. Even if amniocentesis confirms a normal karyotype, UPD testing (such as MS-PCR and MS-MLPA) should be recommended for accurate assessment, as an accurate diagnosis can lead to appropriate genetic counseling and improved overall pregnancy management.

Background: There is still concern regarding postoperative adhesion formation and adverse effects on pregnancy outcomes caused by barbed suture (BS) after myomectomy. The aim of this study was to compare the postoperative adhesion and pregnancy outcomes between conventional suture (CS) and BS after minimally invasive myomectomy (MIM) by robotic myomectomy (RM) or laparoscopic myomectomy (LM). Methods: The medical records of 94 women who had undergone MIM with CS and 97 who had undergone MIM with BS and achieved pregnancy were reviewed. Postoperative adhesion was evaluated following cesarean section. Results: The number of removed myomas was greater (5.3 ± 4.6 vs. 3.5 ± 3.1, p = 0.001) and the size of the largest myoma was larger (7.0 ± 2.2 vs. 5.8 ± 2.7 cm, p = 0.001) in the BS group relative to the CS group. A total of 98.9% of patients in the CS group and 45.4% in the BS group had undergone LM (p < 0.001), while the others underwent RM. There was no significant difference in the presence of postoperative adhesion at cesarean section between the BS and CS groups (45.5 vs. 43.7%, p = 0.095). Additionally, there were no intergroup differences in pregnancy complications such as preterm labor, placenta previa, accrete or abruption. Note also that in our logistic regression analysis, the suture type (BS or CS) was excluded from the independent risk factors regarding postoperative adhesion formation. Conclusions: Our data indicated that the incidence of postoperative adhesion after MIM with BS was similar when compared with CS. Also it seems that the suture type does not have a significant effect on pregnancy outcomes.

Background: Robotic single-site plus two port myomectomy (RSTM) was designed to reduce the number of incision sites while retaining the advantage of conventional robotic multi-port myomectomy (CRM). This study aimed to explicate RSTM and compare surgical outcomes between it and CRM. Methods: The medical records of 146 patients who had undergone RSTM and 173 who had undergone CRM were reviewed. The surgical outcomes between them were compared by propensity score matching (PSM) analysis. Results: The PSM analysis showed no statistically significant inter-group differences in patient characteristics. With regard to surgical outcomes, the RSTM group enjoyed shorter operative time (148.30 ± 44.8 vs. 162.3 ± 47.4 min, p = 0.011), less hemoglobin decrement (1.8 ± 0.9 vs. 2.3 ± 1.0 g/dL, p < 0.001), and shorter duration of hospital stay (5.4 ± 0.7 vs. 5.8 ± 0.7 days, p < 0.001). Conclusions: RSTM was associated with shorter operative time relative to CRM. Further prospective studies are needed in order to more fully investigate the advantages of RSTM.

Aim: The aim of this study was to determine the age-specific characteristics of ovarian teratoma and associated malignancies. Methods: This retrospective single-centre cohort study included 2181 women with ovarian teratoma who underwent surgery at our institution between January 2008 and April 2019. Malignancies associated with ovarian teratoma were divided into immature teratoma, combined ovarian malignancy, and malignant transformation of mature cystic teratoma. The median patient age was 30 years (range, 7–82) and the median follow-up duration was 10 months (range, 0–152). Results: Most ovarian teratomas were detected incidentally, except in patients with abdominal pain under 20 years of age; torsion was significantly more common in this age group (p < 0.001). Tumours were larger in the younger age group (p < 0.01). The incidence of immature teratoma was 0.5% (n = 11), that of combined ovarian malignancy was 0.4% (n = 9), and that of malignant transformation was 0.4% (n = 9). The median patient age was 24.0 years for immature teratoma and 27.0 years for combined ovarian malignancy. The most common cell type was mucinous borderline tumour (55.6%, n = 5). The median patient age of malignant transformation was 33.0 years, and the most common cell type was carcinoid tumour (77.8%, n = 7). At our institution, the clinical manifestations of ovarian teratoma varied according to age group, with younger patients being more likely to be symptomatic and to have larger tumours and bilateral tumours. Although there was no statistically significant relationship between age and associated malignancy (p = 0.442), most of the malignancies associated with ovarian teratoma were found in childbearing age, not in older age. Conclusions: Given the possible associated malignancy with ovarian teratoma, surgeons should perform detailed preoperative evaluations, avoid intraoperative spillage, and perform intraoperative frozen biopsy when appropriate.

Objectives: This study aimed to compare the impact of robotic (RO) versus laparoscopic single-site ovarian cystectomy (LO) on ovarian reserve, as measured by changes in anti-Müllerian hormone (AMH) levels. Methods: A total of 43 women undergoing LO and 40 women undergoing RO for mature cystic teratoma were included. The baseline characteristics and surgical outcomes were scrutinized. AMH levels were evaluated preoperatively and at 3 months after surgery. Results: BMI (body mass index) was higher in the LO group (23.1 ± 3.6 cm vs. 21.7 ± 2.1 kg/m², p = 0.03) than in the RO group. Otherwise, there were no statistically significant differences in patient characteristics. The LO group showed a shorter operative time (70.0 ± 24.0 vs. 86.5 ± 26.7 min, p = 0.002) than the RO group., However, multiple linear regression analysis revealed that BMI was independently associated with increased operative time (p = 0.001), while the surgical method was not a significant predictor (p = 0.725). There were no significant differences in the rate of decline in AMH level between the LO and RO groups (13.3 ± 21.2 vs. 4.64 ± 34.1%, p = 0.167). There were intergroup differences in the hemostasis method: in the LO group, bipolar coagulation was performed for 27 (62.8%) patients, and sutures were performed for 16 (37.2%) patients; in the RO group, bipolar coagulation was performed for 5 (12.5%) patients, and sutures were performed for 33 (82.5%) patients, while in the case of 2 (5.0%) patients, hemostasis was not performed (p < 0.001). However, note that in our logistic regression analysis, the hemostasis method was excluded as an independent factor affecting AMH. Conclusions: There appear to be no significant advantages of RO over LO in terms of ovarian reserve preservation.

Background: The aim of this study was to introduce a coaxial-robotic single-site myomectomy (C-RSSM) technique to compensate for the shortcomings of robotic single-site myomectomy (RSSM) using semi-rigid instruments and to compare the surgical outcomes of C-RSSM and RSSM. Methods: The medical records of 13 consecutive women who had undergone C-RSSM and 131 consecutive women who had undergone RSSM were retrospectively reviewed. Patient characteristics and surgical outcomes after propensity score matching were evaluated and compared between the two groups. Results: According to the propensity score matching results, the C-RSSM group had a lower estimated blood loss (75.0 vs. 210.5 mL, p = 0.001) and a shorter operating time (101.0 vs. 146.1 min, p = 0.008) relative to the RSSM group. In RSSM, there was one case of conversion to conventional laparoscopy and four cases of conversion to the multi-site robotic approach. There was no case of conversion from C-RSSM to conventional laparoscopy or the multi-site robotic approach. Conclusions: C-RSSM was found to be associated with shorter operative time and lower estimated blood loss. However, further prospective studies are needed to confirm these advantages.