Gynecologic Surgical Procedures

The study is a prospective, double-blinded, placebo-controlled multi-center trial to measure if postoperative pain and the amount of narcotics used are reduced by a clinically significant amount in women undergoing minimally invasive hysterectomy receiving a continuous infusion of intraperitoneal (IP) local anesthetic (LA) or a continuous infusion of LA combined with an NSAID compared with a control group who receives only 0.9% normal saline.

Optical biopsy is a new technology that generates a real-time, cell-based, high-resolution view and analysis of tissues. Observation is instantaneous and non-invasive. This allows reliable and fast diagnosis which facilitates decision making as well as patient management. The investigator have already conducted a feasibility study on the use of this new technology to evaluate ovarian and tubal pre-cancerous lesions in laparoscopy. In this new study, he wants to continue investigations, expand its use to other gynecological pathologies, and demonstrate the benefit of such a non-invasive technology in gynecology on the one hand in the diagnosis of lesions but also to appreciate the margins as accurately as possible surgical excision of tumors and / or endometriosis lesions. The investigator have set up a prospective monocentric descriptive study. The hypothesis is that optical biopsy by Cellvizio® allows to observe in real time microscopically tissues and to characterize them in the field of gynecological surgery

With the global rates of gynecologic cancers on the rise, optimizing perioperative care is imperative. Accurate risk prediction is essential for enhancing patient care, directing preoperative interventions, and facilitating informed decision-making in oncology. This research compares two widely-used risk assessment tools: the Charlson Comorbidity Index (CCI) and the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), in predicting perioperative outcomes. The CCI predominantly addresses comorbidities, providing simplicity and broad applicability, while POSSUM incorporates both physiological and operative factors for a more comprehensive risk assessment. Despite their application across various surgical specialties, the specific utility of these tools in onco-gynecologic surgery remains insufficiently explored. The study aims to evaluate the effectiveness of CCI and POSSUM in predicting perioperative complications, with a focus on the incidence of these complications, length of hospital stay, and 30-day mortality. The implementation of these risk tools may enhance multidisciplinary risk management, thus improving patient outcomes in gynecologic oncology surgery.

The goal of this clinical trial is to learn if the level of intra-abdominal pressure during benign gynecologic laparoscopic surgery impacts postoperative pain. The main question it aims to answer is: • Does use of low (8 mmHg) versus standard (15 mmHg) intra-abdominal pressure impact postoperative pain? Researchers will compare the use of low (8 mmHg) versus standard (15 mmHg) intra-abdominal pressure. Participants will: * Undergo their regular scheduled gynecologic laparoscopic surgery * Complete pain measures one hour, 3 hours, and 24 hours after surgery