Greg Marchand

Marchand Institute for Minimally Invasive Surgery · Minimally Invasive Surgery

Objective We aimed to investigate trends in residency program application and acceptance rates according to sex and race and ethnicity. Methods We collected data from the Journal of the American Medical Association Graduation Medical Education Reports. We extracted the data for 25 residency programs in the United States from 2005 to 2021 and condu...

Objective As the second most common surgery performed on women in the United States, hysterectomy techniques are constantly examined for validity and superiority. The vaginal natural orifice transluminal endoscopic surgery (vNOTES) has increased in popularity since the first vNOTES hysterectomy was performed in 2012. We sought out to evaluate the s...

Objective First-generation and second-generation endometrial ablation (EA) techniques, along with medical treatment and invasive surgery, are considered successful lines of management for abnormal uterine bleeding (AUB). We set out to determine the efficacy of first and second-generation ablation techniques compared with medical treatment, invasive...

OBJECTIVE Because vaginal natural orifice transluminal endoscopic surgery and laparoscopic hysterectomy techniques both aim to decrease tissue injury and postoperative morbidity and mortality and to improve a patient's quality of life, we sought to evaluate the safety and effectiveness of a hysterectomy by vaginal natural orifice transluminal endos...

OBJECTIVE To compare surgical efficacy outcomes and complications after laparoscopic hysterectomy and vaginal hysterectomy performed for benign gynecologic conditions. DATA SOURCES We performed an online search in major databases, including PubMed, Scopus, Web of Science, ClinicalTrials.gov, and the Cochrane Library from 2000 until February 28, 20...

This is a response to Mr. Somovilla del Saz’s letter to the editor regarding Marchand et al.‘s article, “Risk of all-cause and cardiac-related mortality after vaccination against COVID-19: A meta-analysis of self-controlled case series studies.” The response is on behalf of all authors clarifying misconceptions about the work.

Objective: Following compelling evidence that open techniques may be related to better survival and disease free survival rates, many gynecologic oncologists in the US have turned away from performing laparoscopic radical hysterectomy (LRH) and robotic radical hysterectomy (RRH) for the treatment of early-stage cervical cancer. While this may be w...

Self-controlled case series (SCCS) is a novel study design uniquely equipped to ethically quantify the safety of vaccination. We sought out to perform a meta-analysis on all SCCS assessing mortality associated with COVID-19 vaccination in the immediate post-vaccination period. We included SCCS investigating the safety of COVID-19 vaccination and re...

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is associated with increased pregnancy complications. Despite effective vaccination strategies for the general population, the evidence on the safety and efficacy of Coronavirus disease 2019 (COVID-19) vaccinations in pregnancy is limited due to a lack of well-powered studies. The present...

Background and aim: The aim of this study was to evaluate the efficacy a 20% intravenous fat emulsion therapy in women suffering from recurrent pregnancy loss or recurrent implantation failure (RPL/RIF) who are undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Materials and methods: We searched Cochrane Library,...

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...

Unlabelled: Cesarean scar ectopic pregnancy (CSP) is a rare form of ectopic pregnancy, and treatment of CSP with uterine artery embolization (UAE) is a novel approach. With increasing numbers of cesarean sections being performed annually, the incidence of this condition is likely to increase. The authors became aware of an unusually high number of...

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...

Study Objective Although laparoscopic radical hysterectomy (LRH) and robotic radical hysterectomy (RRH) are both minimally invasive procedures commonly performed for the treatment of early-stage cervical cancer, there is little high quality data on the head-to-head comparison of these two procedures. We sought to perform the largest study to date t...

Study 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. This is the largest analysis to date on this subject. Design Me...

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, MEDLINE a...

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...

Patient: Female, 47-year-old Final Diagnosis: Adenocarcinoma of the ovary Symptoms: Pain Medication: — Clinical Procedure: Completely laparoscopic staging of ovarian cancer • laparoscopic morcellation of ovarian tumor Specialty: Obstetrics and Gynecology Objective Rare co-existance of disease or pathology Background Advances in minimally invasive...

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...

(Abstracted from Am J Obstet Gynecol 2020; doi: 10.1016/j.ajog.2020.09.011) The association between removal of the fallopian tubes and decreased risk of ovarian cancer is well documented. Although complete removal of the fallopian tubes (salpingectomy) for the prevention of ovarian cancer seems promising, no unequivocal evidence supports this pract...

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...

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...

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...

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...

A review of the common but questionably ethical practice of refusing to refill a patient’s birth control prescription until they are seen in office for, and presumably pay for, a yearly examination. This forced decision between making time for the appointment or risking an unintended pregnancy is comically referred to as “Pap Smear Ransom.” This sh...

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...