Is there proof of transferability of laparoscopic psychomotor skills from the simulator laboratory to the operating room? Results from a systematic review.

This systematic review aims to understand better the translation of laparoscopic psychomotor skills, acquired in dry lab training, into a direct patient benefit in actual clinical practice in the operating room. The review was performed according to PRISMA guidance, searching database-specific filters for controlled trials: 'laparoscopy', 'simulator', 'surgical training', 'dry lab', 'psychomotor skills'. We included only RCTs in which the study population was the surgical trainee or novice surgeon with no prior simulation training, and the intervention was simulation training in laparoscopic surgery, regardless of subspecialty. Ten studies were included in this systematic review. The mean performance score was higher compared to the control groups. Fewer errors were noted in the intervention groups. No clinical patient outcomes (mortality, morbidity, quality of life) were addressed in these studies. All the trials were at high risk of bias. Training outside the operating room may lead to better surgical performance and less operative time. Nevertheless, additional studies with better designs are needed to provide more robust evidence.

Hymen conservative techniques for vaginal surgery - a practical approach.

Vaginal approach remains one of the safest and easiest surgical procedures to treat many gynaecological pathologies such as cervico-vaginal fibroids or vaginal septum. These classical procedures are, however, hindered by the disruption of the integrity of the hymen, an issue that remains controversial if not unfavourable in certain conservative geographical areas such as the Middle East. Herein, we describe 3 alternative surgical laparoscopic techniques to deal with the issue of hymen conservation. In the first 2 cases we suggest a laparoscopic approach through an anterior or a posterior colpotomy to treat large cervico-vaginal fibroids. In the third case, we propose a laparoscopic technique for the resection of a vaginal septum in a young girl with obstructed hemivagina and ipsilateral renal agenesis syndrome.

Strong Coupling of a Single Ion to an Optical Cavity.

Strong coupling between an atom and an electromagnetic resonator is an important condition in cavity quantum electrodynamics. While strong coupling in various physical systems has been achieved so far, it remained elusive for single atomic ions. Here, we achieve a coupling strength of 2π×(12.3±0.1) MHz between a single ^{40}Ca^{+} ion and an optical cavity, exceeding both atomic and cavity decay rates which are 2π×11.5 and 2π×(4.1±0.1) MHz, respectively. We use cavity assisted Raman spectroscopy to precisely characterize the ion-cavity coupling strength and observe a spectrum featuring the normal mode splitting in the cavity transmission due to the ion-cavity interaction. Our work paves the way towards new applications of cavity quantum electrodynamics utilizing single trapped ions in the strong coupling regime for quantum optics and quantum technologies.

Enhanced ion-cavity coupling through cavity cooling in the strong coupling regime.

Incorporating optical cavities in ion traps is becoming increasingly important in the development of photonic quantum networks. However, the presence of the cavity can hamper efficient laser cooling of ions because of geometric constraints that the cavity imposes and an unfavourable Purcell effect that can modify the cooling dynamics substantially. On the other hand the coupling of the ion to the cavity can also be exploited to provide a mechanism to efficiently cool the ion. In this paper we demonstrate experimentally how cavity cooling can be implemented to improve the localisation of the ion and thus its coupling to the cavity. By using cavity cooling we obtain an enhanced ion-cavity coupling of [Formula: see text] MHz, compared with [Formula: see text] MHz when using only Doppler cooling.

Uterine manipulator in total laparoscopic hysterectomy: safety and usefulness.

The aim of this review is to evaluate the effectiveness and safety of uterine manipulators in facilitating total laparoscopic hysterectomy (TLH). A literature search in MEDLINE, EMBASE, Cochrane Library, UpToDate, SpringerLink, ClinicalKey and Elsevier ScienceDirect databases was performed, and articles describing TLH with or without the use of uterine manipulators were retrieved. Complications related to the use of uterine manipulators are numerous, and although uterine manipulator seems to facilitate TLH, the procedure without a uterine manipulator seems to have a comparable safety and effectiveness, although evidence based on a direct comparison of the two approaches is limited without available controlled trials. Uterine manipulator may provide support in cases of large uteri, severe endometriosis, recto vaginal adhesions and regional anesthesia, while its use may increase complications in cases of vaginal stenosis and nulliparity. Therefore, to perform TLH, the surgeon should individualize for each case if uterine manipulator is needed and which manipulator best suits the surgical procedure requirements and case characteristics. Further studies comparing the two approaches are mandatory.

Murine typhus in pregnancy: a case report from Cyprus.

R. typhi is one of the rickettsial species endemic in the Mediterranean countries and is associated with the zoonotic infection of murine typhus, which may have a complicated course especially in adult patients. Murine typhus in pregnancy has rarely been reported in the medical literature. We describe a case of murine typhus in a pregnant woman who was effectively treated with erythromycin.