{"id":198,"date":"2025-10-09T16:26:59","date_gmt":"2025-10-09T06:26:59","guid":{"rendered":"https:\/\/escope.ages.com.au\/october-2025\/?p=198"},"modified":"2025-10-23T14:51:34","modified_gmt":"2025-10-23T04:51:34","slug":"recap-of-the-combined-ages-esge-webinar-pelvic-perspectives-anatomy-hysteroscopy-and-robotic-surgery","status":"publish","type":"post","link":"https:\/\/escope.ages.com.au\/october-2025\/recap-of-the-combined-ages-esge-webinar-pelvic-perspectives-anatomy-hysteroscopy-and-robotic-surgery\/","title":{"rendered":"Recap of the Combined AGES\/ESGE Webinar: Pelvic Perspectives: Anatomy, Hysteroscopy and Robotic Surgery"},"content":{"rendered":"\n<h1>\n\t\t\tRecap of the Combined AGES\/ESGE Webinar: Pelvic Perspectives: Anatomy, Hysteroscopy and Robotic Surgery\t<\/h1>\n\t\t\t\t<p>One of the benefits of the AGES Society Membership is access to online webinars for educational purposes, featuring international speakers and conveners. The recent June 26th\u00a0 webinar involving AGES and the European Society of Gynaecologic Endoscopy (ESGE) was the first of two joint webinars for 2025. It was facilitated by AGES President Dr Michael Wynn-Williams, with organisational input from Dr Amani Harris and Dr Samantha Mooney.<\/p>\n<p>This webinar aimed to tackle three important topics for the gynaecological surgeon: a review of important pelvic anatomy, to support learning of advanced hysteroscopic techniques, and to improve understanding of robotic surgical techniques. The impressive international and local representation of clinicians included:<\/p>\n<ul>\n<li>Professor Benoit Rabischong &#8211; The Immediate Past President of European Society for Gynaecological Endoscopy (ESGE) and the Head of Training at the International Center for Endoscopic Surgery (CICE), as well as past President of International Society of Neuropelveology (ISON) (2020-2022)<\/li>\n<li>Dr Ursula Catena &#8211; Chair of the ESGE Special interest group in Hysteroscopic surgery and Lead at the Digital Hysterscopic Centre at the IRCCS in Rome.<\/li>\n<li>Dr Yogesh Nikam &#8211; Experienced Endoscopic and Robotic Surgeon based at Norwest, Westmead, Blacktown and SAN Hospitals in Sydney, having proctored many surgeons in robotics in Australia and New Zealand<\/li>\n<li>Prof Vasilios Tanos &#8211; the Incoming ESGE President-Elect in 2027 and Professor at University of Nicosia Medical School<\/li>\n<\/ul>\n<p>The webinar began with a review of the role of pelvic neuroanatomy and nerve sparing surgery approaches in complex benign gynecological surgical procedures with Prof Rabischong. He reiterated the need to preserve autonomic and peripheral nerve function during complex dissection, without being more traumatic than the disease itself, reinforcing an atraumatic approach, without pulling and grasping the nerve to avoid axon damage.<\/p>\n<p>Prerequisites for dealing with the pelvic nerves were highlighted in this first talk, in particular, the anatomical knowledge of the para-rectal and perivesical fossa and three other key anatomical spaces &#8211; the Yabuki (or the\u00a0 &#8220;Fourth&#8217; space), Latzko and Okabyashi spaces. This was combined with high quality dissection videos from the author, to reveal the anatomy of these spaces, as well as the various nerve plexuses. It is worth spending some time reviewing these videos on your own, to absorb and revise these high-end dissections. A future Artificial Intelligence (AI) nerve recognition model for the prediction of nerve locations in the pelvis, may prove to be a valuable future education tool and a surgical support technology for laparoscopic and robotic surgery.<\/p>\n<p>The second speaker, Dr Ursula Catena, provided a phenomenal videographic journey of challenging hysteroscopic resection procedures. She introduced the concept of the Digital Hysteroscopy Clinic, as a new concept in precision medicine &#8211; which includes the combination of hysteroscopic surgical approaches with integrated 3D ultrasound imagery (into the endoscopic tower), thus providing more extensive diagnostic and therapeutic benefits during hysteroscopic surgery.<\/p>\n<p>She presented various adhesiolysis and myomectomy videos, and various challenging resections that most gynecologists would not often have the chance to see. It is definitely worth spending the time to review her videos, which are of excellent quality; reinforcing the gold standard of vaginoscopic entry into the cervix, managing a difficult cervical entry and tips and tricks for Type 2 hysteroscopic myomectomy with a resectoscope, as well as a Cullens needle.<\/p>\n<p>She presented several fascinating cases of complex uterine anomaly corrections, including complex vaginal septum resected via vaginoscopy, followed by both intra-uterine and intra-cervical septal resection, and management of a Robert&#8217;s uterus malformation. The original videos were combined with post surgical &#8216;second look&#8217; hysteroscopy images, allowing the viewer to see the superior anatomical outcome achieved, as well as, to hear the clinical stories of the patients and their successful subsequent pregnancies.<\/p>\n<p>Our local representative, Dr Yogesh Nikam, brought with him a wealth of clinical, surgical and technological knowledge about the advantages of robotic surgery in the pelvis. He highlighted the precision that robotics offers as a tool in dissection, suturing, accessing difficult areas of the pelvis, managing very large fibroids and another key advantage of minimising surgeon fatigue. He reinforced the importance of anatomical knowledge and normalising anatomy, at the core of pelvic surgery skills, and the importance of mapping out the pelvis in terms of disease location, prior to undertaking surgery. This allows the surgeon to maximise the capability and visual advantages of the robotic platform, allowing for targeted ovarian, diaphragmatic and nerve sparing excisions in complex endometriosis cases, and multi-surgeon involvement in cases involving ureteric and bowel disease with lower conversion rates to open surgery.<\/p>\n<p>Overall, this was a very high quality webinar with an esteemed international panel and allows our members the chance to learn from the insights and expertise of international faculty. We look forward to the future combined AGES\/ESGE webinars, and invite you all to attend the next AGES M&amp;M webinar in October.<\/p>\n\t\t\t\t<img decoding=\"async\" src=\"https:\/\/escope.ages.com.au\/october-2025\/wp-content\/uploads\/sites\/11\/2025\/10\/escope-author__dr-basia-lowes-001.avif\" alt=\"escope-author__dr-basia-lowes-001\" title=\"escope-author__dr-basia-lowes-001\" itemprop=\"image\"\/>\n\t\t\t\t<p><em>Dr Basia Lowes<\/em><br \/><em>MBBS, LLB, BA, MS (AdvGynSurg), MWomHealthMed<\/em><br \/><em>Consultant Gynaecologist<\/em><br \/><em>Royal Hospital for Women, Randwick.<\/em><\/p>\n<p><em>\u00a0<\/em><\/p>\n\n","protected":false},"excerpt":{"rendered":"<p>The recent AGES\/ESGE webinar explored pelvic neuroanatomy, advanced hysteroscopic techniques, and robotic surgical innovations through expert international presentations and surgical 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