Greg Marchand

Marchand Institute for Minimally Invasive Surgery · Minimally Invasive Surgery

Objective: Routine hysteroscopic evaluation before assisted reproductive technology treatment is a novel approach with the potential to reduce assisted reproductive technology failure even in the absence of evidence of uterine pathology. Following the publication of several relatively high-quality trials on this topic, we sought to determine if th...

Abstract Recent evidence has shown an increase in recurrence and a decrease in overall survival in patients treated with laparoscopic radical hysterectomy (LRH) and robotic assisted radical hysterectomy (RRH) open techniques (ORH). In addition, several high quality trials were recently published regarding the laparoscopic treatment of early stage c...

Acupuncture has been introduced as an adjuvant therapy to in vitro fertilization (IVF) cycles in many randomized controlled trials (RCTs). However, there has been a debate among trials regarding the effectiveness and safety of the procedure. To determine how effective and safe acupuncture is as an adjunct to IVF cycles for primary and secondary fem...

Introduction: Sterilization of females is considered one of the most prevalent contraceptive techniques among women in the United States. There are many surgical sterilization procedures including salpingectomy, tubal ligation, and hysteroscopic occlusion of the fallopian tubes. We provide an overview of these methods from the clinical data and la...

Objective: Although many studies have been performed, no consensus exists as to the ideal entry for laparoscopic gynecologic surgery. We sought out to compare the safety of direct trocar insertion with that of the Veress needle entry technique in gynecologic laparoscopic surgery. Design: Systematic review with meta-analysis. Setting: We search...

Background: Preoperative single-shot peripheral nerve blocks (sPNBs) represent promising candidates for controlling postoperative pain, reducing dependence on opioid medications, and reducing postoperative constipation and ileus. However, there is not yet complete consensus regarding their efficacy. The primary aim of this study was to assess the...

Importance: While some studies have found an association between marijuana use and adverse neonatal outcomes, results have not been consistent across all trials. Objective: To assess available data on neonatal outcomes in marijuana-exposed pregnancies. Data sources: PubMed, Medline, ClinicalTrials.gov, Cochrane, Scopus, and Web of Science were...

Background Cervical insufficiency (CI) may result in preterm delivery. We sought out to perform this review and analysis to compare the efficacy of laparoscopic and open transabdominal cerclage (TAC) in patients suffering with CI. Methods Our search included PubMed, Scopus, MEDLINE, ClinicalTrials.Gov, Cochrane and Web of Science. We analyzed the...

Objectives COVID-19 is a rapidly changing and developing emergency that requires constant re-evaluation of available data. We report a systematic review and meta analysis based on all published high quality data up to and including June 3rd 2021 on the maternal and neonatal outcomes in pregnant women infected with the Coronavirus Disease 2019 (COVI...

Introduction: We conducted a systematic review and meta-analysis of relevant clinical trials from 6 different full-text scientific journal archives in order to assess the efficacy of hyoscine for the management of pain during in-office hysteroscopy procedures. Methods: We searched Cochrane CENTRAL, Clinicaltrials.Gov, MEDLINE, PubMed, SCOPUS and...

Background Several authors have recently compared the outcomes and complications of surgical procedures that preserve or remove the uterus in the treatment of pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Following the publication of several high quality randomized control trials on this topic we performed a new systematic revi...

Objective: To assess the efficacy of gabapentin in women with chronic pelvic pain (CPP) without another diagnosis. Data Sources: We searched PubMed, SCOPUS, Web of Science, ClinicalTrials.Gov, Medline and The Cochrane Library from each database's inception until April 30th 2021. Study Eligibility Criteria: We included all the studies that had the f...

Objective: To determine the incidence of isthmocele, its effect on residual myometrial thickness (RMT), and other complications of Cesarean delivery (CD) in relation to single- and double-layer CD closure. We searched PubMed, SCOPUS, Web of Science, ClinicalTrials.gov, MEDLINE and Cochrane Library for relevant clinical trials assessing the use of...

We sought to analyze all high-quality studies available regarding the possible differences in contained and uncontained techniques for morcellation of fibroids and uteri. We systematically searched PubMed, Cochrane Central, Scopus, ClinicalTrials.Gov, MEDLINE and Web of Science from September 2010 to September 2020 for our search terms. We included...

Study Objective We aimed to conduct this systematic review and meta-analysis to investigate and compare the efficacy of laparoscopic and TAC in patients with CI. Design Systematic Review with Meta-analsysis. Setting We searched PubMed, Scopus, MEDLINE, ClinicalTrials.Gov, Cochrane and Web of Science using suitable keywords. Retrieved citations we...

This study aimed to systematically review the available literature on enhanced recovery after surgery (ERAS) following gynecologic procedures performed either as an open surgery or as a minimally invasive gynecological surgery (MIGS) in terms of outcomes. This review revealed the results of published literature and assessed the benefits and diverse...

Nonpuerperal uterine inversions are rare. Typically occurring in older women, they are most commonly due to transcervical mass expulsion. Diagnosis is often difficult because of vague symptomatology, presentation, and unknown course of the pathology. Surgical correction is often necessary in the presence of active bleeding or prolapse severity caus...

Objective: We set out to evaluate whether the instillation of bupivacaine versus a saline solution into the peritoneal cavity at time of laparoscopic gynecologic surgery will reduce postoperative pain and postoperative opioid consumption. Data sources: We searched six databases: Web of Science, SCOPUS, Cochrane CENTRAL, ClinicalTrials.Gov, MEDLI...

Objective Following the publication of several high quality randomized controlled trials regarding the comparison of similar laparoscopic gynecologic procedures being performed with or without robotic assistance, we aimed to perform a systematic review to identify any differences in patient safety and expected incidence of complications in these pr...

Objective: To review all high quality available evidence regarding the effect of intraoperative bupivacaine 24 hours (or 8.9 half-lives) after intraoperative administration at time of gynaecologic surgery and to ascertain whether a second mechanism of action, beyond the initial prevention of sodium channel depolarization and blockade of nerve impu...

Objective To assess the efficacy, safety, and tolerability of retosiban—a novel tocolytic unavailable in the US—in the management of preterm labor. Methods We searched ClinicalTrials.Gov, MEDLINE, PubMed, SCOPUS, Web of Science, and the Cochrane Library for relevant clinical trials using the terms “retosiban” and “preterm labor” through 09/2020. W...

Office hysteroscopy (OH) is a common procedure in gynecology. Pain is the most frequently reported problem in OH. In this study, we aimed to investigate the role of tramadol administration in relieving pain in women undergoing OH. We searched PubMed, the Cochrane Library, ClinicalTrials.gov, MEDLINE, Scopus, and Web of Science databases for relevan...

Objective: Despite limited data, acetaminophen, along with other agents, is commonly included in enhanced recovery after surgery (ERAS) protocols following laparoscopic hysterectomy. We aimed to systematically review the efficacy of acetaminophen on the management of postoperative pain after laparoscopic hysterectomy. Methods: We searched PubMed...

To assess the efficacy of all forms of ropivacaine administration for the management of pain and opioid use, specifically in patients undergoing laparoscopic hysterectomy. We searched PubMed, Cochrane CENTRAL, Web of Science, and SCOPUS for relevant clinical trials matching our eligibility criteria. Outcomes of interest included: Pain intensity (me...

BACKGROUND Advances in minimally invasive surgery are essential for the improvement of patient care, overall health care efficiency, and total cost reductions. Morcellation, the technique used in the present case, is often used to aid minimally invasive laparoscopic procedures, whereby larger tissue specimens are broken down and divided to be remov...

Objective: This meta-analysis aimed to compare the effect of laparoscopic supracervical hysterectomy (LSH) with endometrial ablation (EA) in terms of general and menstrual-related quality of life in women opting for surgical treatment for abnormal uterine bleeding. Material and methods: Sources searched included PubMed, Cochrane library, Scopus,...

Background Mood and anxiety disorders are common in women of childbearing age, especially during the peripartum period. As more women seek medical management for these conditions, there is an increasing need for studies to better examine the effects of exposure to selective serotonin reuptake inhibitors (SSRIs), and other antidepressants, on newbor...

Interstitial pregnancy is a rare, life-threatening condition that requires high clinical suspicion for diagnosis. Most cases are discovered after complications have occurred. Many authors have described laparoscopic management. Although previous systematic reviews have compared the attributes and complications associated with interstitial pregnancy...

An ovarian mucinous cystadenoma is a common benign tumour of the ovary that tends to reach very large sizes. Although traditional morcellation in the abdominal cavity is largely avoided in gynaecologic surgery, several authors have proposed other systems and techniques for the removal of large masses without resorting to laparotomy. We proposed an...

Objective: The objective of this study is to assess the perioperative outcomes when prophylactic bilateral salpingo-oophorectomy (BSO) is performed concomitantly with surgery to repair pelvic organ prolapse (POP) or stress urinary incontinence (SUI). Materials and methods: This is a retrospective case-control study of patients who underwent abdo...

Background: Interstitial pregnancy is a rare but life-threatening condition accounting for 1-4% of all types of tubal ectopic pregnancies. It can be managed by open and minimally invasive surgical techniques. Our goal was to compare laparoscopic and open surgery for managing interstitial pregnancy. Search strategy: We searched PubMed, Scopus, We...

In the field of minimally invasive surgery, there is constant drive to devise and execute the most minimally invasive surgeries possible. By the very nature of laparoscopy and robotic surgery, what one can accomplish with several ports of a given size will invariably be studied and attempted with fewer ports and with ports of smaller sizes. After r...

Study Objective To demonstrate a unique case study focusing on the location of a lost Vibrator. Design A narrated video demonstration of the surgical procedure (Canadian Task Force Classification III). Setting 29-year-old gravida 1 para 0-0-1-0 Ab1 white female presented to the emergency room at approximately 1 AM after reporting that she lost he...

Study Objective Demonstration of an extremely minimally invasive technique to remove a large (20cm diameter) benign ovarian tumor. The tumor is taking up essentially all of the pelvis and abdomen but our extremely minimally invasive technique is able to remove the mass with no visible scars and only two small ports. Design A narrated video demonst...

At the forefront of female sexual and reproductive health, OBGYNs play a pivotal role in assessing and managing sexual satisfaction and dysfunction. Satisfying sexuality often relates to a woman's ability or likelihood to relay to her partner the steps and actions required for her to reach orgasm. Female orgasms, in contrast to male orgasms, can be...

Objective Cervical insufficiency is a defect of the cervix that leads to failure to preserve a full-term intrauterine pregnancy. Laparoscopic cerclage and open transabdominal cerclage (TAC) are effective ways to manage patients with cervical insufficiency. We performed this systematic review and meta-analysis to investigate the complications of lap...

As a major institute in the field of minimally invasive gynecologic surgery, we constantly endeavor to develop and perform the least-invasive surgeries possible. In laparoscopy and robot-assisted laparoscopy, we should expect that complex surgeries that are currently undertaken with the use of many ports of a given diameter will eventually be accom...

Objective: Following strong evidence and major organizations recommending salpingectomy over tubal ligation, we sought to perform a systematic review and meta-analysis comparing the intraoperative attributes and complication rates associated with these two procedures. Data sources: We searched PubMed, the Cochrane Library, EMBASE and clinical tr...

Despite the advantages of a decreased risk of epithelial-cell ovarian cancer and the extremely minimally invasive nature of the procedure, combined salpingectomy and endometrial ablation is a potentially underused procedure in the United States to treat abnormal uterine bleeding and desired sterilization. The lack of utilization of this combined pr...

Objective: To report a unique surgical procedure that was utilized to locate a missing vibrator in the pelvis of a patient. Emergency room admissions and surgery secondary to the malfunctioning of devices intended for sexual stimulation are extremely common. Emergency room staff of hospitals in the United States usually are skilled in the detectio...

In the field of minimally invasive surgery, there is constant drive to devise and execute the most minimally invasive surgeries possible. By the very nature of laparoscopy and robotic surgery, what one can accomplish with several ports of a given size will invariably be studied and attempted with fewer ports and with ports of smaller sizes. Althoug...

Trachelectomy is a notoriously difficult laparoscopic procedure secondary to remaining scar tissue from the prior supracervical hysterectomy, as well as the necessity to clear vital organs including the bladder and the rectum out of the plane of dissection in order to remove the cervix. Many authors have suggested techniques involving ureteral sten...

Background Induction of labor using prostaglandins is a common and effective strategy for induction of labor. In order to improve safety associated with the administration of prostaglandins, health systems have developed protocols dictating when subsequent doses of prostaglandins must be held. Ideally, these criteria would prevent the administratio...

Background: Cornual (or interstitial pregnancy) is a rare but life-threatening condition with an incidence of about 1-4% of all types of tubal ectopic pregnancies. It can be managed by open and minimally invasive surgical techniques. Therefore, we aim to compare between laparoscopy and traditional open surgery for managing interstitial pregnancy. M...

The unproven link between Cocoa Butter and fetal heart defects remains an often discussed topic, causing concern among pregnant women. This brief review tracks down the origins of this myth and the limited data available on the topic.

A short review of the uncomfortable scenario of a negative laparoscopy when expecting endometriosis, adhesive disease or other pathology. The article reviews different commonly used but rarely documented strategies for ameliorating pelvic pain in the absence of clear pathology.

Induction of labor using prostaglandins is a common and effective strategy for induction of labor. In order to improve safety associated with the administration of prostaglandins, health systems have developed protocols dictating when subsequent doses of prostaglandins must be held. Ideally, these criteria would prevent the administration of prosta...

Greg J Marchand, Katelyn M Sainz The Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USACorrespondence: Greg J MarchandThe Marchand Institute for Minimally Invasive Surgery, 10238 E. Hampton, Suite 212, Mesa, AZ 85209, USATel +1 480 999 0905Fax +1 480 999 0801Email gm@marchandinstitute.orgAbstract: A review of the common but questionab...

Introduction: Clinically, vaginal packing provides the benefit of hemostasis and is designed to prevent the formation of postoperative hematomas. Despite the common use of vaginal packing in pelvic surgery, there is limited data to indicate which material has the ideal characteristics for vaginal packing. Materials and methods: Three packing mat...

Introduction: Clinically, vaginal packing provides the benefit of hemostasis and is designed to prevent the formation of postoperative hematomas. Despite the common use of vaginal packing in pelvic surgery, there is limited data to indicate which material has the ideal characteristics for vaginal packing. Materials and Methods: Three packing materi...

Emergency room admissions and surgery secondary to the malfunctioning of devices intended for sexual stimulation are extremely common. Emergency room staff in the United States are commonly skilled in the detection and removal of some of these frequent occurrences. Occasionally, surgical intervention can be warranted if the device enters a cavity t...

he antidepressant, Sertraline is a commonly prescribed selective serotonin reuptake inhibitor (SSRI). SSRI’s account for upwards of 80% of the prescribed antidepressants on the market and are used by approximately 3% of pregnant women in Europe as well as 8% of pregnant women in the United States7. Antidepressants, including Sertraline, cross the p...

Background: Intrauterine devices (IUDs) offer long-term, highly effective contraception with a failure rate less than 1 percent, however there are cases where patients develop an intrauterine pregnancy with an IUD in situ. Studies have shown that women with retained IUDs were at the greatest risk of adverse pregnancy outcomes, and that IUD removal...

Novel Technique for Labiaplasty (Vulvectomy) that reduces scarring by avoiding the use of sutures.

Appropriate counselling may help some patients see beyond preconceived notions of treatment options resulting in less minimally invasive routes to satisfactory outcomes.

Objective: To demonstrate the feasibility of a single port laparoscopic hysterectomy technique performed through a single smaller umbilical incision than has been described. Design: A narrated video demonstration of the surgical procedure. Material and Methods: Multiple authors have documented the feasibility of single incision laparoscopic h...

Study Objective To design a laparoscopic technique to perform a safe laparoscopic trachelectomy in the safest, most minimally invasive, cost effective way possible, without the use of ureteral stents. Design: We designed a surgical technique based on keeping pressure pushed against the vaginal cuff deep within the abdomen to move the ureters latera...

Self described as an informal textbook, "Single Port Advanced Laparoscopic Hysterectomy" reviews a single technique of removing the uterus through a tiny umbilical incision, and explains the processes in great detail. The book revolves around a step-by-step analysis of the surgical technique, complete with in-depth analysis of both the support in t...

Self described as an informal textbook, "Single Port Advanced Laparoscopic Hysterectomy" reviews a single technique of removing the uterus through a tiny umbilical incision, and explains the processes in great detail. The book revolves around a step-by-step analysis of the surgical technique, complete with in-depth analysis of both the support in t...

This chapter is largely a discussion of fundamentals of avoiding the ureter during hysterectomy.

Brief discussion of the importance of getting through to the anesthesiologist or nursing anesthetist involved with your case, and how to make them understand that you are advocating what is best for the patient.

In-depth discussion of the choice of appropriate candidates and preparation for single port laparoscopic hysterectomy.

This chapter is a discussion of the best uterine manipulators to utilize to perform a single port laparoscopic hysterectomy. Includes comparison of characteristics and features, as well as expert opinion of performance in surgery.

A discussion of the preoperative counselling essential to proper consent for a single port laparoscopic hysterectomy.

This chapter is a discussion of the different vessel sealing and dividing power devices that can be used during laparoscopic hysterectomy, and a discussion of the superiority of some devices.

This chapter discusses the laparoscopic entry into the abdominal cavity, which is considered by many to be the most challenging portion of laparoscopic surgery.

This chapter entails a short discussion of the instrumentation, other than power devices and trochars, which can best assist the surgeon in performing a single port laparoscopic hysterectomy.

This chapter discusses the first steps of a single port laparoscopic hysterectomy and discusses the proper technique to successfully accomplish the procedure.

This chapter discusses different techniques for removing detached uterii from the abdominal cavity, and careful attention is paid to specifically discuss morcellation, and it's acceptance in the gynecologic community.

This chapter discusses closure of laparoscopic port sites, and discusses in what circumstances it may be acceptable to refrain from closing the fascia.

This chapter discusses the utility and possible drawbacks to cystoscopy when performed for the purpose of seeing jets of urine from the ureteral orifices in order to prove ureteral patency.

This chapter explains the importance of examining the abdomen and pelvis when beginning laparoscopy, and that this time should be used to make the important decisions regarding the surgery. It is proposed that only upon actually visualizing the anatomy and pathology should one decide whether a single port, traditional laparoscopic or open approach...

This chapter discusses vaginal closure following laparoscopic hysterectomy, and discusses several techniques for closure including the appropriateness of each technique in certain circumstances.

We designed and performed a surgical technique for the safe removal of a cervix with optimal lysis of adhesions and use of only two laparoscopic ports. Presentation included description and video presentation.

We performed a randomized retrospective chart review of 42 pediatric patients seen at our offices. All of these patients received gonorrhea and chlamydia testing one at least one occasion in our offices. We then matched this group with an equal number of adult patients that were seen in our offices during the same time period, for similar symptomol...

Better than Blood: An Aggressive Pharmacologic and Surgical Protocol for Avoiding Transfusion in Treating Molar Pregnancy

Better than Blood: An Aggressive Pharmacologic and Surgical Protocol for Avoiding Transfusion in Treating Molar Pregnancy

A Simple and Novel Technique for Cleaning Up after the Ovarian Cystectomy of a Dermoid Cyst Marchand GJ, Sainz KM,* Rials L, Ware K. Marchand OBGYN PLLC, Mesa, Arizona * Corresponding author. Objective: The avoidance of a chemical abdominal peritonitis secondary to spilling the irritating contents of a mature cystic teratoma is an important goal of...

Conclusions: We believe our novel technique for avoiding chemical peritonitis following extensive dissection and ovarian cystectomy of a bilateral ovarian dermoid cyst may be a useful skill and a gynecologic surgeon’s armamentarium. Although, the scenario of a young patient with a bilateral teratoma is quite rare, with bilateral teratomas only acco...

Background: A 46-year-old gravida 2 para 2002 Hispanic female presented to a community hospital with severe primarily left-sided pelvic pain. On examination the pain was primarily left lower quadrant pain. The patient also stated on presentation that she had some pain in the left costal-vertical area and an ultrasound showed a 4cm left-sided adnexa...

An 87-year-old G4P2022 presented to the office for three week history of postmenopausal bleeding. The patient notes she will have vaginal spotting for few days followed by two to three days of no bleeding, with her longest consecutive stretch of bleeding being 6 days. She was seen in the Emergency departments prior to this where an ultrasound showe...

NovaSure endometrial ablation is one of the most common ablation procedures performed today in the United states. With one of the highest success rates of any of the endometrial ablation procedures NovaSure uses RF, or radiofrequency energy in order to ablate the endometrial surface. One unique feature of the NovaSure endometrial ablation device is...

Despite the extremely rare incidence of Heterotopic pregnancy outside of women undergoing assisted reproduction treatments, simultaneous intra and extra-uterine pregnancies are often suspected or unnecessarily included in the differential diagnosis in emergency departments in the United States. This has led to patient injuries, including unnecessar...