Background: Minimally invasive surgical techniques, including laparoscopic and robotic surgery, have profoundly impacted surgical practice by improving precision, reducing recovery times, and minimizing complications. However, these modalities differ in their cognitive demands and skill acquisition requirements, which can influence the learning curve and operative performance. To assess and evaluate this variability across these modalities, a functional near-infrared spectroscopy (fNIRS) system is used as an objective method for monitoring cognitive activity in surgical trainees. fNIRS can provide insights and further our understanding of the mental demands of different surgical techniques and their association with varying task complexity. Objective: This study seeks to assess the influence of surgical modality (laparoscopy vs. robotic surgery) and task complexity (pick and place (PP) vs. knot tying (KT)) on cognitive workload through fNIRS. We compare real-world and simulation-based training environments to determine changes in brain activation patterns and task performance. Methods: A total of twenty-six surgical trainees (general and gynecologic surgery residents and specialists) participated in this study. Participants completed standardized laparoscopic and robotic surgical tasks at varying levels of complexity while their cognitive workload was measured using fNIRS. This study included both simulation-based training and real-world surgical environments. Hemodynamic responses in the prefrontal cortex (PFC), task completion times, and performance metrics were analyzed. Results: Laparoscopic surgery elicited higher activity changes in the prefrontal cortex, indicating increased cognitive demand compared with robotic surgery, particularly for complex tasks like knot tying. Task complexity significantly influenced mental load, with more intricate procedures eliciting greater neural activation. Real-world training resulted in higher cognitive engagement than simulation, emphasizing the gap between simulated and actual surgical performance. Conclusions: Cognitive workload was lower and significantly different during robotic surgery than during laparoscopy, potentially due to its ergonomic advantages and enhanced motor control. Simulation-based training effectively prepares surgeons, but the cognitive workload results indicate that it may not fully replicate real-world surgical environments. These findings reveal the importance of cognitive workload assessment in surgical education and suggest that incorporating neuroimaging techniques such as fNIRS into training programs could enhance skill acquisition and performance.

Recent developments in cervical cancer treatment have highlighted concerns about minimally invasive surgery. Our team explored an innovative approach that

Amaç: Bu çalışmanın arka planı, labia majoraplasti tekniğimiz ve komplikasyonları ile ilgili deneyimlerimizi ve cerrahi sonuçlarımızı paylaşmaktır. Gereç ve Yöntem: Çalışmaya labium majus sarkması, yağ dokusunda azalma, ciltte aşırı kırışıklık ve katlanma şikayeti ile başvuran 63 hasta dahil edildi. İşlem sonrası labia majoranın görünümü fotoğraflarla ve kadın genital benlik imajı ölçeğini (FGSIS) içeren hasta memnuniyet anketleriyle değerlendirildi. Bulgular: İşlemden sonra hayatı tehdit eden herhangi bir komplikasyon veya ciddi sekeller görülmedi. Dolayısıyla, daha yüksek FGSIS puanı daha olumlu bir genital benlik imajına işaret ettiğinden ve kadının cinsel işlevi, cinsel davranışı ve cinsel davranışı ile önemli ölçüde ilişkili olduğundan, ameliyat sonrası genital güzellik açısından daha iyi sonuçlar elde edildi. cinsel ve genital sağlık bakım davranışları. 6 aylık takipte ortalama toplam FGSIS skoru ameliyat öncesi 20,4 ± 1,2 ve ameliyat sonrası 22,4 ± 1,4 olup istatistiksel olarak anlamlı bir farka işaret etmektedir (p = 0,026) Sonuç: İç dudak estetiği, fonksiyonlara, hijyene ve estetik görünüme olumlu katkı sağlayan bir cerrahi işlemdir. Mevcut cerrahi teknikte yaşamı tehdit eden kalıcı sekel bırakan majör komplikasyonların görülmemesi ve minör komplikasyonların kısa sürede kontrol altına alınabilmesi bu çalışmada uygulanan tekniğin rahatlıkla uygulanabilir olduğunu göstermektedir. Aynı zamanda FGSIS sonuçlarında da olumlu yönde anlamlı bir iyileşme gözlendi ve hastalarda özgüven artışıyla ilişkilendirildi.

Aims: The aim of this study is to share our experiences and results with our intravaginal gas ozone technique in the treatment of bacterial vaginosis (BV) by retrospective data analysis. Methods: Salutem plus brand medical ozone device, 60 gamma 200 cc gas ozone was administered intravaginally through 50 cc syringes with the help of a nasogastric catheter to 102 patients diagnosed with BV using Amsel criteria. Patients whose hemogram parameters were checked before and after the procedure were called for 1st, 3rd, 6th, 9th and 12th month clinical controls in terms of recurrence, and the examination findings and digital data of these patients were analyzed retrospectively in terms of treatment, complications and recurrence. Results: No life-threatening complications were encountered. Minor adverse effects were observed and resolved spontaneously in a short time without the need for any treatment. Recurrence rates were observed to be lower than in classical regimen treatments. Additionally, no more than 2 recurrences were observed during 1-year follow-up. Conclusion: Our study is the first example of the literature in terms of evaluation of treatment, recurrence and complications of intravaginal gas ozone therapy in the treatment of bacterial vaginosis. These finding suggest that intravaginal gas ozone therapy, which is considered a safe form of treatment, will become more widespread in the future and the number and frequency of its application will increase even more. Further investigation with a larger number of patients should be conducted to confirm our data.

Vaginal myomectomy (VM) is a minimally-invasive surgery to remove uterine fibroids; however, limited exposure, difficulties in suturing, and challenges in achieving hemostasis restrict its wider adoption. To address these limitations, the Sahin transvaginal extracorporeal (STVEC) technique was developed, allowing for complete uterine exteriorization for extracorporeal reconstruction. We aimed to evaluate the safety, feasibility, and perioperative outcomes of the STVEC technique in women undergoing surgery for symptomatic uterine myomas. This retrospective cohort included 200 consecutive patients who underwent VM using the STVEC technique between February 2021 and October 2024. Demographic characteristics, myoma features according to the International Federation of Gynecology and Obstetrics (FIGO) classification, operative variables, postoperative outcomes, and complications were analyzed. The complications were graded using the Clavien–Dindo system. Conversion to laparotomy was performed when safe continuation of the STVEC approach was not feasible. Mean (SD) age of the study cohort was 39.1 (6.5) years and mean (SD) body mass index was 27.5 (5.8) kg/m². Mean (SD) myoma count was 1.8 (1.4; range: 1–5) and mean (SD) diameter was 6.7 (2.4; range, 5–10) cm. Intramural myomas (FIGO type 2–5) were the most common (55%). Conversion to laparotomy occurred in 8 patients (4%) due to adenomyotic uteri, adhesions, prior vaginal surgery, or altered cervical anatomy. Median (interquartile range [IQR]) hemoglobin decrease was 1.7 g/dl, median (IQR) estimated blood loss was 180 ml, and mean (SD) operative time was 71.9 (19.5) minutes. Blood transfusion was required in 18 patients (9%). Early complications occurred in 7 participants (3.5%), and all were minor. The STVEC technique appears safe and feasible, offering good bleeding control, low complication rates, and rapid recovery. Further multicenter studies are needed to confirm our findings.