s America’s capital, Washington DC is a powerful and energetic city that will not only impress you with its grand monuments, memorials, and museums, but it will also leave you feeling a sense of deep understanding of

America’s history. History comes alive as one visits the many sites located across and throughout the city that are both pleasing to the eye and heart. One can walk through the emotional walls of the Vietnam Memorial, snap a picture of Lincoln in his large, white chair as he watches over his nation, visit and tour the White House, see the changing of the guard at the Arlington National Cemetery, and feel the rush of energy coming from the many congressional

offi cials running throughout Capitol Hill—just to name a few. If this does not sustain your wandering eyes, visit the Smithsonian, the National Museum of Natural History, The U.S. Holocaust Memorial Museum, or venture into the National Air and Space Museum. To get a feel of the people, journey to the Georgetown campus where one can shop, stroll the area and admire the architecture.

At night, one can dine in one of the many restaurants that boast international fl avor and indulge in cross-cultural dishes. While the meal comes to an end, the night only begins. The nightlife proves to be just as lively as the day as Washington offers a plethora of activities.

In addition to this incredible venue, this year’s Global Congress promises to be one of the most exciting annual meetings in AAGL’s history. We have expanded the various committees to include over 150 physician members who will participate in the development of the Congress. We had a

tremendous response to the Call for Abstracts and look forward to working with the committees to develop a clinical program that is educationally and professionally stimulating.

In addition, I am pleased to announce that Professor Christopher J.G. Sutton from Surrey, United Kingdom has accepted our invitation to serve as Honorary Chair. Prof. Sutton plans to present “People, Places and Publications Which Have Infl uenced My Surgical Career”. You will not want to miss the Honorary Luncheon, where we plan to recognize Professor Sutton and hear his lively and entertaining presentation.

The next issue of NewsScope will update you on the educational programming scheduled. And look for the First Announcement in your mail in mid-August.

No matter your schedule, Washington D.C. will provide you with as much entertainment as you can manage. Just step out your hotel door and start walking - you are sure to come across something amazing.

My thanks to my daughter Abagayle for her contributions to this article.

NewsScopeAAGL Advanc ing Min imal ly Invas ive Gyneco logy Wor ldwide

APRIL – JUNE 2007 VOL. 20, NO. 2

a n n u a l m e e t i n g

Washington, D.C. Hosts the 36th Annual Meeting of the AAGLAn Incredible Scientifi c Enclave Deserves an Incredible Venue

ACharles E. Miller, M.D.

Scientifi c Program ChairVice-President, AAGL

Experience Excellence

in Education

Th e AAGL Global Congress is the pre-eminent meeting for physicians interested in providing optimal patient care through minimally invasive gynecology. Designed to meet the needs of practicing surgeons, residents and fellows, operating room personnel and other allied healthcare professionals, the Congress covers traditional topics as well as presentations of “cutting edge” material. With opportunities to discuss and share discoveries, you will experience excellence in formal, informal and collegial education.

NewsScope [Library of Congress Cataloging in Publica-tion Data, Main entry under NewsScope, Vol. 20, No. 1; (ISSN 1094–4672)] is published quarterly by the-AAGL for ten dollars, paid from member’s dues. Periodicals Postage Paid at Cypress, California.Copyright 2007 AAGL.

PublisherAAGLAdvancing Minimally Invasive Gynecology Worldwide6757 Katella AvenueCypress, California 90630-5105 USATel 714.503.6200, 800.554.2245Fax 714.503.6201, 714.503.6202E-mail: newsscope@aagl.orgWebsite: www.aagl.org

The views and opinions expressed by the authors in this publication do not necessarily refl ect those of NewsScope, its editors, and/or the AAGL.

e d i t o r i a l s t a f f

t h e a a g l v i s i o n

The AAGL vision is to serve women

by advancing the safest and most

effi cacious diagnostic and therapeutic

techniques that provide less invasive

treatments for gynecologic conditions

through integration of clinical practice,

research, innovation, and dialogue.

NewsScope

Resad P. Pasic, M.D., Ph.D.

Linda MichelsFranklin D. Loffer, M.D.

Lynn Bell

Jennifer Sanchez

Grace M. Janik, M.D.

Charles E. Miller, M.D.

Resad P. Pasic, M.D.

Luiz F. Albuquerque, M.D.Krisztina I. Bajzak, M.D.Martin Farrugia, M.D.Gary N. Frishman, M.D.Keith B. Isaacson, M.D.Alan M. Lam, M.D., FRACOGDavid J. Levine, M.D.Javier F. Magrina, M.D.

Richard J. Gimpleson, M.D

Franklin D. Loffer, M.D.

Linda Michels

Editor-in-Chief

Managing Editors

Marketing Coordinator

Art Director

President

Vice-President

Secretary-Treasurer

Trustees

Immediate Past President

Executive Vice President,Medical Director

Executive Director

b o a r d o f t r u s t e e s

f y i

NewsScope

f r o m t h e e d i t o r

here are a total of fi ve Board of Trustee positions open. Three candidates must come from the general membership and four candidates must come from specifi c regions of the world. This year, two candidates will be nominated from the Pacifi c Rim/India/Asia region and two candidates will come from the Central/South America/Mexico

region. In addition, two other candidates will be selected to run for the position of secretary-treasurer. This is a four-year commitment that leads to the presidency of the AAGL.

If you wish to be considered as a candidate for one of these positions, you should ask fi ve AAGL members to submit your name along with a short letter or email of support. These should be sent to nominations@aagl.org. You are also encouraged to directly contact any member of the Nominating Committee to make your thoughts known. Their addresses can be found on the AAGL membership list (go to www.AAGL.org and click on “Find a physician”)

The Nominating Committee will meet in early July 2007. It is time for you to voice your opinion about your future elected offi cers.

Committee Members are:Richard J. Gimpelson – Chair, Immediate Past PresidentG. David Adamson – Past PresidentAndrew Brill – Past PresidentCharles E. Miller – Vice PresidentRonald L. Levine – Advisory ChairFranklin D. Loffer – Executive Vice President/Medical DirectorLinda Michels – Executive Director

TAAGL Nominations are Open

2 APR - JUN 2007

lthough this well recognized proverb used in medical teaching might be less applicable to laparoscopic surgery because of the complexity of the procedures and the slow learning curve, it remains an important adage.

An equivalent of laparoscopic hysterectomy in general surgery would be a lap chole, which is performed by 95% of general surgeons. On the other hand, laparoscopic hysterectomy is performed by less than 15% of gynecologists. The situation around the world is even more dismal when it comes to minimally invasive approaches to gynecologic pathology.

I recently participated as faculty at the AAGL Annual Course for Residents and Fellows held in Chicago. This course has been a success for 16 consecutive years. The participants get fi rst class training in energy modalities, operative hysteroscopy, hysteroscopic resection, laparoscopic morcellation, laparoscopic suturing and robotic surgery by distinguished faculty who graciously donate their time to teach these important techniques. I was very pleasantly surprised at the high participation of very enthusiastic residents, fellows and several practicing gynecologists. At the same time, I was dismayed by the fact that there are not many residency programs around the country that offer comprehensive training in operative laparoscopy and hysteroscopy.

The 9th Annual Advanced Workshop on Gynecologic Laparoscopic Anatomy and Surgery on Unembalmed Female Cadavers was held on May 18 and 19, 2007 in Louisville, Kentucky. The participants from fi ve different countries received hands-on experience and training in pelvic anatomy, laparoscopic dissection, as well as the techniques used in laparoscopic suturing and laparoscopic hysterectomy. Generous support by the industry has made all of these courses possible.

In the year 2001, AAGL began fellowship training in pelvic surgery and gynecologic laparoscopy. Currently, there are 15 training sites and their number is growing each year. I personally encourage graduating residents to consider applying to any one of the fellowships. The application process is currently open and all pertinent information can be found at the AAGL’s website.

The AAGL has been on the forefront of the educational initiative and is certainly making a tremendous effort to promote laparoscopy and physician training but much more is needed to close the gap with the general surgeons – we need to reach the goal where 95% of gynecologists feel comfortable performing a laparoscopic hysterectomy and teach others to do so!

ASee one, do one, teach one…

Franklin D. Loffer, M.D.Executive Vice President/Medical Director, AAGL

Resad P. Pasic, M.D., Ph.D.Editor-in-Chief, NewsScopeSecretary-Treasurer, AAGL

c l i n i c a l o p i n i o n

ince the fi rst laparoscopic tubal sterilization was performed 45 years ago the technique has undergone several modifi cations but still fundamentally involves peritoneal entry. The overwhelming majority of these

procedures are performed under general anesthesia in an operating room. With the development of hysteroscopically guided placement of micro-inserts for tubal occlusion the opportunity to offer non-incisional truly minimally invasive permanent contraception under local anesthesia in the offi ce setting became a reality. Should this technique replace the laparoscopic approach?

The decision must be made on the basis of four “C’s”: Complications, Contraceptive Effectiveness, Cost, and Choice.

Complications of laparoscopic tubal ligation are relatively uncommon, but when they occur they are frequently severe and occasionally life-threatening. Many complications are related to the initial insuffl ation and scope insertion, such as intestinal perforation, abdominal wall vascular injury, and major vascular injury. However, it is the risk of general anesthesia that far surpasses all other factors except diabetes in causing complications from laparoscopic sterilization. The risks increase dramatically when the patient is obese or has prior abdominal surgery. In the largest study to date of complications of laparoscopic sterilization the incidence of obesity was only 13.6% - far below the current level in the United States.4 In contrast, the complications associated with hysteroscopic sterilization are those common to diagnostic hysteroscopy, namely cervical injury from dilation, uterine perforation and bleeding. The rate of injury from diagnostic hysteroscopy has been estimated at approximately 0.13% in experienced hands and the addition of tubal cannulation has not been shown to cause signifi cant risk. Uterine perforation has been described following hysteroscopic sterilization but these have been uniformly asymptomatic and discovered at the time of confi rmatory hysterosalpingogram. Finally, hysteroscopic sterilization is optimally performed in the offi ce setting under local anesthesia, carrying one-third the odds-ratio of risk compared to general anesthesia.

Contraceptive effectiveness of the laparoscopic approach is well documented with a failure rate at ten years of approximately 2%.4 The CREST data excluded the Filshie clip, however, which is more effective than the other methods, and which carries a 10 year failure rate of 0.9%. With over 110,000 hysteroscopic systems placed, there have been slightly over 100 pregnancies reported at time of publication giving a failure rate of 0.1% which is one-tenth that of even the most optimistic outcome of even the Filshie method. Essure® has been commercially available for only fi ve years, but even comparing fi ve-year failure rates with the Collaborative Review, there is only one pregnancy with hysteroscopy for every fi ve pregnancies by other methods.

Cost has become the great leveler when it comes to selection of patient treatment. Here again, hysteroscopy offers major savings over laparoscopy. By minimizing personnel costs, supplies and instrument processing, eliminating OR time costs and anesthesiologist fees the public hospital at our institution saves approximately $1200 per hysteroscopic procedure compared to laparoscopy. When the option to perform the procedure in the offi ce under local anesthesia is added, costs are further reduced. From the physician standpoint, it is far better to perform the procedure in the offi ce setting.

There is no need for dictating hospital records. Scheduling the procedure is completely at the surgeon’s convenience and can be incorporated into the rest of the offi ce schedule without waiting for room turnover in the hospital from another doctor’s procedure. With regard to reimbursement, there is no comparison. Sterilizations performed in the hospital with either method are paid at a hospital procedure code. In the offi ce, a global fee applies that encompasses supplies as well as professional services and provides higher reimbursement than the hospital-based procedure. When combined with the time, effi ciency and convenience factors, the choice is clear.

Choice is the ultimate determinant in this process. Women who previously rejected the idea of permanent surgical contraception because of reluctance to undergo anesthesia or even go into a hospital are now actively seeking hysteroscopic sterilization in their doctor’s offi ce. The idea of abdominal scarring, however small, is a turn-off to many people. Patients return to their normal activity within one day of hysteroscopic sterilization, compared to several days to a week after laparoscopy. Out-of-pocket expenses are less. In our patient-driven world of medicine, women will seek physicians who are able to perform hysteroscopic procedures in general, and sterilization in particular. It is clear that this option is not appropriate for all women, as technical and anatomic factors may preclude its universal use, but for all intents and purposes, laparoscopic tubal occlusion can no longer be regarded as the procedure of choice, and hysteroscopic sterilization should be considered the standard of care.

References

1. Palmer MR. Essais de stérilisation tubaire coelioscopique par électrocoagulation isthmique. Bull Fed Soc Gynecol Obstet Lang Fr. 1962;14:298-305.

2. G.C. Roviaro, F. Varoli, L. Saguatti, C. Vergani, M. Maciocco and A. Scarduelli, Major vascular injuries in laparoscopic surgery, Surg Endosc 16 (2002), pp. 1192–1196.

3. Moore CL, Vasquez NF et al, Major Vascular Injury after Laparoscopic Tubal Ligation, J Emerg Med. 2005 Jul;29(1):67-71. 4. Jamieson DJ, Hillis SD, Duerr A, Marchbanks PA, Costello C, Peterson

HB. Complications of interval laparoscopic tubal sterilization: fi ndings from the United States Collaborative Review of Sterilization. Obstet Gynecol. 2000 Dec;96(6):997-1002.

5. Laparoscopic Trocar Injuries: A report from a U.S. Food and Drug Administration (FDA) Center for Devices and Radiological Health (CDRH) Systematic Technology Assessment of Medical Products (STAMP) Committee www.fda.gov/cdrh/medicaldevicesafety/ stamp/trocar.html .

6. Jansen FW, Vredevoogd CB, van Ulzen K, Hermans J, Trimbos JB,Trimbos-Kemper TC. Complications of hysteroscopy: a prospective,multicenter study. Obstet Gynecol. 2000;96:266 –270.

7. Nichols M, Carter JF, Fylstra DL, Childers M; Essure System U.S. Post- Approval Study Group. A comparative study of hysteroscopic sterilization performed in-offi ce versus a hospital operating room.

J Minim Invasive Gynecol. 2006 Sep-Oct;13(5):447-50.8. Thoma V, Chua I, Garbin O, Hummel M, Wattiez A. Tubal perforation

by ESSURE microinsert. J Minim Invasive Gynecol. 2006 Mar-Apr; 13(2):161-3

9. Trussell J, Guilbert E, Hedley A. Sterilization failure, sterilization reversal, and pregnancy after sterilization reversal in Quebec. Obstet Gynecol. 2003 Apr;101(4):677-84.

10. Data on fi le, Conceptus, Inc., Mountain View, CA Levy B, Levie MD, Childers ME. A summary of reported pregnancies

after hysteroscopic sterilization. J Minim Invasive Gynecol. 2007 May- June; 14(3):271-274.

11. Levie MD, Chudnoff SG. Offi ce hysteroscopic sterilization compared with laparoscopic sterilization: a critical cost analysis. J Minim nvasive Gynecol. 2005 Jul-Aug; 12(4):318-22.

Will Hysteroscopic Sterilization Replace Laparoscopy?

Robert K. Zurawin, MDAssociate Professor

Department of Obstetrics and GynecologyBaylor College of Medicine

Houston, Texas

The opinions, viewpoints, conclusions, recommenda-tions and statements in the Clinical Opinion column are solely those of the author(s) and are not-attributable to the sponsor, publisher, editor or editorial board of NewsScope, the AAGL, or any of its affi liates.

S

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3APR - JUN 2007

NewsScope

4 APR - JUN 2007

w o r k s h o p n ew s

hicago again was the location of the AAGL Comprehensive Workshop on Gynecologic Endoscopy for Residents and Fellows (April 20-

21, 2007). This was the 16th annual workshop. It was successful and well attended. One-hundred, thirty-four residents, fellows, and practicing physicians attended and the feedback regarding the workshop was extremely positive.

This workshop is a didactic program with a structured curriculum that has been developed over the course of several years. The initial impetus to establish this course with a curriculum that stresses surgical skills and fundamental surgical knowledge for laparoscopy and hysteroscopy, rather any specifi c endoscopic procedures, stems from the efforts of Mac Munro and Andy Brill. The course emphasizes risk reduction and strategic thinking and is designed specifi cally for residents and fellows, although several practicing physicians attended this year as well. Didactic lectures, videos, and hands-on exercises are used educate the participants about endoscopic anatomy, tissue manipulation and dissection, the safe use of electrosurgery and ultrasonic energy, laparoscopic suturing, techniques for tissue removal and morcellation, avoiding and managing complications, and diagnostic and operative hysteroscopic procedures. This year the hands-on time for laparoscopic suturing was

again expanded, based on the residents’ feedback from prior years regarding their need for enhanced education in laparoscopic suturing skills. This change was obviously

appreciated by the attendants. Grace Janik deserves particular kudos for the superb program in suturing skills that she has developed for this program (and for again providing diligent service in spite of a broken hand). Additionally, for the fi rst time an introduction to the use of robotics as a surgical tool was introduced to the residents, spearheaded by Chuck Miller. This addition appeared to be very well received by the attendees.

This course has a long tradition in the AAGL and is particularly important because of its focus on the education of residents. It is especially enhanced by its strong faculty participation, all of whom volunteer their time to teach in the Residents’ and Fellows’ Workshop. This year’s faculty was Krisztina I. Bajzak, Amy Garcia, Andrew I. Brill, Jeremy Carver, Frank Tu, Grace M. Janik, Franklin D. Loffer, Magdy Milad, Charles E. Miller, Resad (Paya) Pasac, Lisa M. Roberts, Ted Anderson, and Jim Shwayder. This was my third year as the Scientifi c Program Chair. I truly appreciated the outstanding job the faculty did this year.

Next year’s workshop will most likely occur in April, 2008, although the location is yet to be determined. Suggestions, ideas, and feedback from AAGL members

are welcomed, as is interest in participation in the workshop. Please be sure to recommend this course to your residents and fellows.

C

Gynecologic Endoscopy Workshop— Another Success

Fred M. Howard, M.D.Professor and Associate Chair Director, Gynecologic Specialties

Department of Obstetrics & Gynecology

University of Rochester School of Medicine & Dentistry

Rochester, New YorkAAGL Advisor

n ew p r o d u c t s

Conceptus Incorporated manufactures and markets the Essure® Permanent Birth Control system, an innovative medical device and procedure designed to provide a non-incisional alternative to tubal ligation, which is the leading form of birth control worldwide. The Essure system is approved for sale in many countries, including the United States, Europe, Australia, Canada, Mexico, Central and South America, and New Zealand. Conceptus is working to make Essure available world-wide upon receipt of appropriate regulatory and/or governmental clearances.

Conceptus Incorporated331 East Evelyn AvenueMountain View, CA 94041Telephone: 650-962-4000

Essure® Permanent Birth Control system

Dr. Miller teaching robotics

Jeremy Carver (L) suturing

Workshop Faculty

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6 APR - JUN 2007

NewsScope

s the newly appointed Chair of the Gynecologic Oncology Committee for the AAGL, I am honored to assume this responsibility and owe a great deal of gratitude to my predecessor in this position,

Dr. Javier Magrina. I see this opportunity as a challenge to continue expanding the role and integration of gynecologic oncology in AAGL. As gynecologic oncologist, we routinely collaborate with our colleagues in the different disciplines of obstetrics and gynecology with the common goal of improving women’s health.

There are a number of projects that we envision will be accomplished through the Gynecologic Oncology Committee during the coming year. We are very excited to integrate and share our expertise through a series of courses offered either at the annual meeting of the AAGL or at different facilities throughout the country. These courses will not only emphasize teaching through didactic training but also through hands-on experience taught by the leading surgeons in laparoscopic surgery within the fi eld of gynecologic oncology. The AAGL is currently extending an invitation to the 2nd Annual Workshop on Advanced Laparoscopic Techniques for Gynecologic Oncologists that will be held in Louisville, Kentucky October 19-20, 2007. We also will work very hard to encourage our fellows-in-training and colleagues to submit their research for presentation at each of the annual meetings.

In the area of clinical research, the Gynecologic Oncology Committee has made a commitment to develop

clinical trials that will be reviewed by our committee for value of content, design, and relevance of study end-points to our fi eld. Our fi rst project is of paramount importance to the fi eld of oncology and it will be an honor to establish the development of such project through the AAGL. This trial will be a prospective randomized trial evaluating the feasibility and safety as well as perioperative outcomes comparing laparoscopic radical hysterectomy vs. open radical hysterectomy. This will be the fi rst trial of its kind in the world.

In our commitment to structured laparoscopic surgical training, we are in the process of fi nalizing the development of the fi rst laparoscopic surgery fellowship solely devoted to training in minimally invasive surgery strictly in the area of gynecologic oncology. This fellowship will be offered to several training programs that will have the opportunity to apply and, based on strict criteria set forth by our committee, a selection will be made prior to designating the program that will be granted such fellowship.

We will continue to integrate leaders in the fi eld of gynecologic oncology not only from the most prestigious training centers in the United States but also from around the world. This is an exciting opportunity for the Gynecologic Oncology Committee and I look forward to working with the AAGL to further strengthen and broaden the scope of our society.

c o m m i t t e e n ew s

News from the Oncology Committee

A

The University of LouisvilleLouisville, KentuckyJavier Magrina, Scientifi c Program ChairResad P. Pasic, Course Director

October 19-20, 2007Experience Excellence in EducationCombining lectures from the foremost experts in laparoscopic surgery with 8 hours of mentored dissection limited to three participants for each cadaver, this advanced course will provide you an unparalleled opportunity to advance your skills. All taught and supervised by a distinguished faculty. Questions are encouraged. This year, to accommodate demand, cadaver dissection sessions are open to observation. Go to www.aagl.org to enroll.

2nd Annual Workshop Advanced Laparoscopic Techniques for Gynecologic Oncologists Using Unembalmed Female Cadavers

Pedro T. Ramirez, M.D.Director of Minimally

Invasive SurgeryDepartment of

Gynecologic OncologyThe University of Texas

M.D. Anderson Cancer CenterHouston, TexasAAGL Advisor

“It’s like

smooth sailing”

©2006 Ethicon Endo-Surgery, Inc.All rights reserved. DSL#06-0129.GYN2

Discover Harmonic ACE™—designed for improved performance

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• Reliable—seal small and large vessels (up to 5 mm) while maintaining hemostasis*

• Multifunctional—cuts, coagulates, grasps, and dissects for procedural effi ciency

*When compared with LCSC5.

NewsScope

8 APR - JUN 2007

m e m b e r s h i p n ew s

he web casts and podcasts of the AAGL 35th Annual Meeting are online. This is a great opportunity to experience the excellent education from the Annual Meeting. We encourage you to link in

today. Go to www.aagl.org and click on the above.

T

Education Highlights from the 35th Global Congress

a f f i l i a t e d s o c i e t i e s

Ukrainian Society of Gynecological Endoscopists and Pelvic Surgeons

The Ukrainian Society is new and its young members represent the continued advance of organized endoscopy and minimally invasive

gynecology through out the world. Their recent meeting (only the society’s second) was organized by Drs. Dmitry Ledin and Andrew Tkachenko. It was well attended with over 150 participants. It reminds me of other fl edgling societies from the recent past who are now major contributors to the AAGL’s Journal of Minimally Invasive Gynecology.

– Franklin Loffer, M.D.Executive Vice President/Medical Director

AAGL “Advancing Minimally Invasive Gynecology Worldwide”

NS: When and how was your society established?The Ukrainian Society of Gynecological Endoscopy and Pelvic Surgery was formed in 2006 by a group of young and professional gynecological surgeons from all regions of Ukraine. They gathered under the aegis of Ukrainian National Academy of Postgraduate Education. From the very beginning, this initiative was supported by major Ukrainian gynecological institutions, as well as by other Societies from all over the world. During the 2nd Annual Congress “Kiev School of Advanced Gynaecological Endoscopy” in June 2007, the Society was offi cially established.

Ukrainian Society was formed only recently, and the availability of endosurgical equipment in Ukraine is still very limited, but our team is enthusiastic, and this energy gives us a hope for further progress in becoming a worthy member of the world endoscopic community and sisterhood of AAGL Affi liated Societies.

NS: What is its mission statement/primary goal? To promote the science and art of gynecological endoscopy, continuous training in laparoscopy and hysteroscopy, research and education in the fi eld of minimally invasive surgery and facilitate the dissemination of information and gynecological surgery as state of art. The Ukrainian Society of Gynecological Endoscopy and Pelvic Surgery primary mission is to provide adequate level of gynecological care to all women by joint efforts of Society members, as well as medical-legal protection of Society members and introduction of modern, minimally invasive surgical technologies into Ukrainian medical practice. The Society slogan is “Ars chirurgiae in feminae bonum”.

The future plans of our Society is to create a training program for Ukrainian doctors with invited world surgeons, which will include participation in O.R. and work on pelvic trainers. This would create a practical add-on for the annual National Conference, which is usually attended by more than 150 participants.

NS: Approximately how many members are there?At the present moment Society consists of approximately 120 full members and 30 associated members from different regions of Ukraine. Society honorary members are Harry Reich, Franklin Loffer, Resad Pasic, Mario Malzoni and Antonio Setubal.

TProf. Yuriy Vdovichenko

PresidentUkranian Society of

Gynecological Endoscopistsand Pelvic Surgeons

PresidentProf. Yuriy Vdovichenko

Vice PresidentIhor Gladchuk

SecretaryDmitry Ledin

TreasurerAndrew Tkachenko

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NewsScope

10 APR - JUN 2007

Ramzi Elias Aboujaoude, M.D.Hani Abu-Halimeh, M.D.Theresa Y. Acquaah, M.D.Ejibunmi Adetola, M.D.Nancy Aguirre, M.D.Geraldine Alba, M.D.Jamison C. Alexander, D.O.Luigi Alio, M.D.Arielle Allen, M.D.Badria M. Alnouh, M.D.Edy Amisial, M.D.Cynthia L. Anderson, M.D.Don M. Armstrong, M.D.Amol Arora, M.D.Rebecca Arthur, M.D.Yelena A. Atlanova, M.D.Leslie Ayensu-Coker, M.D.Megan N. Beatty, M.D.Lorena Benavides, M.D.Rosa H. Bermudez Emmanuelli, M.D.Lisa Bhagan, M.D.Richard L. Biggs, D.O., MPHIrene Bittencourt, M.D.Julie A. Bleyenberg, D.O.Emily Bowsher, M.D.Emily B. Boyd, M.D.Krystene Boyle, M.D.Randall J. Bremner, M.D.Maria A. Brito Perez, M.D.Elizabeth R. Burchard, M.D.Kathy CarlsonKathleen Carroll, M.D.Allison Carter, M.D.Jori Carter, M.D.Kimberly Carter, M.D.Andrew P. Cassidenti, M.D.Megan Cassidy, M.D.Stephanie L. Caywood, M.D.Giulia Cerenzia, M.D.Donald H. Chamberlain, M.D., FACAmy Chapman, M.D.Lorne H. Charles, M.D.Hanna Chehade, M.D.Vera K.F. Cheung, M.D.Sophia Chin, M.D. Jennifer Cho, M.D.Carol Y. Choi, M.D.Giuseppe Ciravolo, M.D.Jennifer E. Coles, M.D.Jeannette Colon-Marin, M.D.Amber R. Cooper, M.D.Chris Alita Cravey Hart, M.D.Debra Crawford, M.D.Patrick J. Culligan, M.D.Mary Dahling, M.D.Angela M. Dawson, M.D.Roya K. Dehkordi, M.D.Nita A. Desai, M.D.Angelo Di Sparti, M.D.

Fares Diarbakerli, M.D.Hilda M. Diaz, M.D.Courtenay Diehl, M.D.Melissa Dietz, M.D.Mert Dinc, M.D.Danielle M. Dion, M.D.Christina E. Dolhaniuk, M.D.John J. Dougherty, M.D.George L. Drake, D.O.Marc H. Eigg, M.D.Cheryl P. Ekkebus, M.D.Cynthia Ann English, D.O.Julian Escobar, M.D.Amr Etman, M.D.Thoraya Fadulelahi, M.D.Elizabeth Ferries-Rowe, M.D.Giuseppe Florio, M.D.Tamra N. Fortenberry, M.D.Laura Fox Lee, M.D.Stephen D. Frausto, M.D.Virginia FrennaSara Friedman, M.D.Hany Gaafer-AhmedSuzanne Galloway, M.D.Katie H. Garrelts, M.D.Maryanne Garvie, M.D.Phyllis J. Gee, M.D.Tracy L. Glass, D.O.D. Bruce Glover, D.O.Marketa Gogela-Spehar, M.D.Jay Goldberg, M.D., MSCP Ethan N. Goldstein, M.D.Oscar Gonzalez-Vera, M.D.Kirsten Grabowska, M.D.Ernesto Graham, M.D.Marija Grahovac, M.D.Mario Greco, M.D.Vanessa H. Gregg, M.D.Giorgio Guazzelli, M.D.Hemi Gupta, M.D.Tara L. Haas, M.D.Lucinda Ann Hany, M.D.Anita Harding, M.D.Atsuko Zoe Haruyama, M.D.Laura Haskins, M.D.Ann Hatfi eld, M.D.Eric Carroll Helms, M.D.Daniel R. Hersh, M.D.Tony V. Hoang, M.D.Paula Hobson, M.D.George Hodnett, M.D.Camille M. Hoffman, M.D.Shelley-Ann Hope, M.D.Terry Huff, M.D.Lt Kim Hui, M.D.Jennifer C. Hunt, M.D.Christian Ineg benijie, M.D.Julia Initial, M.D.Marco Iraci Sareri, M.D.

Rebecca Jacobs, M.D.Tasha Johnson, M.D.Nicole B. Johnston, M.D.Leticia A. Jones, M.D.Michael G. Jones, D.O.Sook Young Jung, M.D.Tiffany D. Justice, M.D.Samatha Kadiyala, M.D.Sue Burcu Kafali, M.D.Dimitri Kamenshikov, M.D.Hisham Keblawi, M.D.Allison J. Keen, M.D.Amy Kelley-Osdoba, M.D.Kimberly Kho, M.D.Nidhi Khosla, M.D.Amanda L. Kim, M.D.Cheung Kim, M.D. Ju H. Kim, M.D.Sung H. Kim, M.D.Sunghoon Kim, M.D.Susan Kim, M.D.Yoon Jeong Kim, M.D.Young Tae Kim, M.D.Armen Kirakosyan, M.D.Dominik Kissing, M.D.Sara Klevens, M.D.Kirsten B. Kluivers, M.D.Gwendolyn Knuckles, M.D.Mary J. KotobZachary Kuhlmann, D.O.Jennifer Elaine Kuhn, M.D.Michele La Greca, M.D.Ben Lannon, M.D.Edgar L. LeClaire, M.D.Kevin Lee, M.D.Tat Choi Eric Lee, M.D.Ying Lei, M.D.Nucelio Lemos, M.D.Alexey Levashkevich, M.D.Chong-Hsiang Liang, M.D.Kim Linn, R.N.C.F.A.David P. Linton, D.O.Lana E. Lipkin, M.D.Randolph Dean Lizardo, M.D.John A. Lovier, Jr., M.D.William J. Lowery, M.D.Richard R. Lubell, M.D.Surekha Machupalli, M.D.Paul M. Magtibay, M.D.Shruthi Mahalingaiah, M.D.Tarang Majmudar, M.D.Afshin Malaki, M.D.Marilou C. Mangubat, M.D.Miriam B. Marcum, M.D.Anjali G. Martinez, M.D.Ana Lucia Martinez Cermeño, M.D.Julio Mateus, M.D.Joseph M. Maurice, M.D.Sean McConnell, M.D.

Gerald B. McLaughlin, D.O.Glennis Menozzi, M.D.Eduardo Mercurio, M.D. Carrie Lynn Merrill, D.O.Michael R. Milam, M.D., M.P.H.Merida Ann Miller, M.D.Gennady Miroshnichenko, M.D.H. Sidney Mitchell, M.D.Khyaati Modii, M.D.Mohammed M. Mohiuddin, M.D.Jose Carlos M. Monteiro, M.D.Andrew Moore, M.D.Javaka K. Moore, M.D.Michael B. Moore, M.D.Vasiliki A. Moragianni, M.D.Fred Morgan Ortiz, M.D.Daniela MorriconeMagnus Murphy, M.D.Robert Bryan Murphy, M.D.Martina F. Mutone, M.D.Samar SN Nahas, M.D.Yanouchka D. Narcisse, M.D.Jovanni Neblett, M.D.Roberto A. Nevarez-Bernal, M.D.Aimee Nguyen, M.D.Lan Thi Nguyen, M.D.Erica Nickeson, M.D.Ebenezer A. Niimoi, M.D.Carlos D. Nogueira, M.D.Mesut Oktem, M.D.David M. Owens, M.D.Giovanni Parisi, M.D.Vida K. Parsi, M.D.Payal P. Patel, M.D.Priya Patel, M.D.Fatemeh Pazouki, M.D.David Peleg, M.D.David Pennington, M.D.Nancy Pham-Thomas, M.D.Michael J. Piegari, M.D.John G. Pierce, Jr.Torri Ja’Net Pierce, M.D.Lina Pilshchik, M.D.Roberta Pinzano, M.D.Michael C. Pitter, M.D.Karen L. Plymel, M.D.Angela M. Poole, IV, M.D.Juan Carlos Prada Rojas, M.D. Sudeepthi Prasad, M.D.Julie E.S. Price, M.D.Tyler James Prouty, M.D.Manisha Purohit, M.D.Alexander M. Quaas, M.D., Ph.D.Kristen Quinn, M.D.Ritu Rana, M.D, MRCOG, D.N.BLexy C. Regush, M.D.Gregory Brian Reynolds, M.D.Helizabet A. Ribeiro, M.D.Paulo A. Ribeiro, M.D., Ph.D.

Brian J. Riley, D.O.Carla Roberts, M.D.Giuseppe Rochira, M.D.Claudia Rodriguez, M.D.Jennifer Roelands, M.D.Sarah Rosen, M.D.Michael Rotas, M.D.Mariya Rozenfeld, D.O.Dennisse Ruiz Adib, M.D.William J. Rush, M.D.Susan SadeghiKavitha Master Sankar Raj, MBBSAngela Rouse Scharschmidt, M.D.Darshita S. Shah, M.D.Tana Shah, M.D.Nicole Sharkey, M.D.Mohamed ShawkatJessica A. Shepherd, M.D.Tammy Shim, M.D.Tara Singh, M.D.Aubrey Smith, M.D.Chad M. Smith, M.D.Doosa Sobouti, M.D.Jennifer Spiegel, M.D.John C. Stallworth, M.D.Christopher J. Stanley, M.D.Gina Sternschuss, M.D.Daniel Jason Stewart, M.D.Christine M. Sticco, M.D.Sara Stoneburg, M.D.Anupama Sunkaualli, M.D.Katie Sutton, M.D.Yoko Suzuki, M.D.Brad Swelstad, M.D. Sameera Syed, M.D.Vonetta Sylvestre, M.D.Miki Takase-Sanchez, M.D.Julierut Tantibhedhyangkul, M.D.Megan Tarr, M.D.Chemen Tate, M.D.Nazia Tauseef, M.D.Hena Tewari, M.D.Farzan Thahir, M.D.Sujatha N. Thota, M.D.Anhtho Tran, M.D.Clayton Tuffnell, M.D.Michelle Uaje, M.D.Aubree Van Mierlo, M.D.Sara Vance, M.D.Beverly A. Vavricka, M.D.Neelima A. Vegesna, M.D.Sergio Vignali, M.D.Karen Visser, M.D.Duska Vukojevic, M.D.Shawna R. Wall, M.D.Shirley Wang, M.D.Dympna Weil, M.D.Julie A. Welischar, M.D.Michael S. Werkema, M.D.

Welcome New MembersMarch 2, 2007 to May 31, 2007

n ew m e m b e r s

It’s no dayat the hospital.

Refer to the HTA System User’s Manual provided with product for complete instructions for use. INDICATIONS: The HTA System is a hysteroscopic thermal ablation device intended to ablate the endometriallining of the uterus in premenopausal women with menorrhagia (excessive uterine bleeding) due to benign causes for whom childbearing is complete. CONTRAINDICATIONS: The HTA System is contraindicatedfor use in a patient: who is pregnant or wants to be pregnant in the future, as pregnancy after ablation can be dangerous to both mother and fetus; who has known or suspected endometrial carcinoma orpremalignant change of the endometrium, such as adenomatous hyperplasia; who has active pelvic inflammatory disease or pyosalpinx; hydrosalpinx; who has any anatomical or pathologic condition in whichweakness of the myometrium could exist, such as, prior classic cesarean section or transmural myomectomy; who has an intrauterine device in place; or who has active genital or urinary tract infection, e.g., cervicitis,endometritis, vaginitis, cystitis, etc., at the time of treatment. POTENTIAL ADVERSE EFFECTS that may occur include: thermal injury to adjacent tissue including cervix, vagina, vulva, and/or perineum; heatedsaline escaping from the device system into the vascular spaces; hemorrhage; perforation of uterus; complications with pregnancy (Note: pregnancy following ablation is dangerous to both the mother and thefetus); risks associated with hysteroscopy. WARNINGS: NOTE: Failure to follow any instructions or to heed any Warnings or Precautions could result in serious patient injury. CAUTION: Federal Law (USA) restrictsthis device to sale by or on the order of a physician. The physician using the device must be trained in diagnostic hysteroscopy.

MVA210 06/07

1 Carter, J. Endometrial Ablation:More Choices, More Options.

For more information on the HTA System,please call 1.888.272.1001.

HTA® System In-Office ProcedureExpand Your Options for Endometrial Ablation

As physicians, you know that patient tolerability and consistent clinical outcomes are what matters. The ability to perform the HTA System procedure in an In-Office environment may provide benefits for both you and your patient ... the comfort yourpatients desire, and the clinical results you demand.

• Consistent Clinical Outcomes - The HTA System has been reported to have excellentclinical amenorrhea rates vs. competitors at three years (per protocol patients)1

• Tolerability - IV sedation may not be required

• Versatility - The HTA System may have the ability to treat irregular cavities, allowingmore patients to receive treatment

© 2007 Boston Scientific Corporation or its affiliates. All rights reserved.www.bostonscientific.com/gynecology

PERIODICALS

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6757 Katel la AvenueCypress, Cal i fornia 90630-5105Tel 714.503.6200 Fax 714.503.6201E-mai l newsscope@aagl.orgWeb site www.aagl .org

NewsScope

e d u c a t i o n c a l e n d a r

AAGL “Advancing Minimally Invasive Gynecology Worldwide”

2nd Annual Comprehensive Workshop on Hysteroscopy, Suturing & Advanced Laparoscopic Techniques (For Fellows Only)Grace M. Janik, Scientifi c Program ChairSeptember 28-30, 2007St. Mary’s Hospital • Milwaukee, Wisconsin

2nd Workshop on Advanced Laparoscopic Techniques for Gynecologic Oncologists Javier F. Magrina, Scientifi c Program ChairResad P. Pasic, Scientifi c Program ChairOctober 19-20, 2007University of Louisville • Louisville, Kentucky

36th Global Congress of Minimally Invasive Gynecology/ AAGL Annual MeetingCharles E. Miller, Scientifi c Program ChairPre-congress Workshops – November 13, 2007Congress - November 14-17, 2007 Marriott Wardman Park • Washington, D.C.

XVII Annual Congress of the ISGEWorld Congress of Gynecological EndoscopyIn affi liation with AAGL Advancing Minimally Invasive Gynecology WorldwideProf. Stefano Bettocchi, PresidentJune 4-7, 2008Bari, Italy

2nd AAGL International Congress on Minimally Invasive Gynecology In conjunction with V Brazilian Congress of SOBENGEPaulo Roberto Cara, Scientifi c Program Chair September 3-6, 2008Hotel SerranoGramado-Rio Grande do Sul, Brazil

37th Global Congress of Minimally Invasive Gynecology/ AAGL Annual MeetingResad P. Pasic, Scientifi c Program ChairOctober 29-Nov. 1, 2008 Paris Hotel • Las Vegas, Nevada

3rd AAGL International Congress on Minimally Invasive GynecologyIn conjunction with the Australian Gynecological Endoscopy Society and ASMMay 2009Brisbane, Australia

38th Global Congress of Minimally Invasive Gynecology/AAGL Annual MeetingNovember 16-19, 2009Gaylord Palms, Orlando, Florida