or the fi rst time in its history, the AAGL will offer six hands-on workshops to include the use of unembalmed cadavers. In addition, we will offer two days of postgraduate courses covering

the spectrum of minimally invasive gynecology. The reason for the addition of so many hands-on courses is to accommodate the high demand of our membership to provide this type of training as it is essential to their practice. The expenses for cadaver courses are signifi cantly higher, and we appreciate in advance the commitment by our industry sponsors to provide unrestricted educational grants to help to offset expenses.

Participants for the hands-on cadaver courses will be bused to the MERIN facility, a state-of-the-art laboratory located in Las Vegas. To allow for an excellent learning experience, registration for all hands-on courses will be limited. I strongly urge you to take advantage of this offer and sign up for one of the following courses:

• We are continuing with two, popular hands-on courses on laparoscopic suturing on Tuesday, October 28, 2008, one at 7:45 a.m. and the other at 1:15 p.m.

• We will again offer a hands-on training on operative hysteroscopy, endometrial ablation, and simulator diagnostic hysteroscopic training on Wednesday, October 29, at 1:15 p.m.

• There will be a full-day cadaver course on pelvic anatomy and dissection techniques for GYN generalists on Tuesday, October 28, at 7:45 a.m.

• We will also offer a cadaver course for GYN oncologists to practice techniques of radical hysterectomy, para-aortal lymphadenectomy, and bowel resection, on Wednesday, October 29, at 7:45 a.m.

• The third cadaver course will be on uro-gynecology and placement of retro-pubic slings on Wednesday, October 29, at 1:15 p.m.

Distinguished faculty will be teaching these courses; it is an utmost privilege to work with these experts and learn from them one-on-one. So, sign-up early and do not miss the best action in Las Vegas!!!

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

AP R I L-J U N E 20 0 8 VO L . 22 N O . 2

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

Sign-Up for Hands-On in Las Vegas!

FResad P. Pasic, M.D., Ph.D.

Scientifi c Program ChairVice President, AAGL

n o m i n a t i n g c o m m i t t e e

he AAGL Nominating Committee will soon select nine members of the AAGL as candidates for four trustee positions for the years 2009 and 2010. Three of the candidates will be from the general membership

and four must come from specifi c regions. This year, two candidates will be from Europe, Middle East, and Africa and two from Canada and the United States. (Next year, the regional candidates will be from Asia/India/Pacifi c Rim and from South America). In addition, two other members will be selected to run as candidates for the position of secretary-treasurer. This position leads to vice presidency and then the presidency of 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 to

nominations@aagl.org. You are also encouraged to directly communicate with the committee at this email address as well.

The nominating committee will meet in early July 2008. It is time for you to voice your opinion about your future elected offi cers.

Committee Members are:Grace M. Janik – Chair, Immediate Past PresidentRichard J. Gimpelson – Past PresidentG. David Adamson – Past PresidentResad P. Pasic – Vice PresidentWilliam H. Parker – Representative of the Advisory CommitteeFranklin D. Loffer – Executive Vice President/Medical DirectorLinda Michels – Executive Director

AAGL Nominations are Open

TGrace M. Janik, M.D.

Nominating Committee ChairImmediate Past President

AAGL

Oct 28 ~ Nov 1, 2008Paris Las Vegas • Las Vegas, Nevada

NewsScope

2 APRIL - JUNE 2008

n my referral-based practice, I see large number of patients with endometriosis, the vast majority of whom have already undergone several surgeries for this condition. Yet despite multiple surgeries, these patients continue to be plagued by debilitating pain, dyspareunia, or the inability to

conceive. Advancement in medical science has been remarkable, but the etiology and pathophysiology of endometriosis are still poorly understood. The complexity of this disease adamantly refuses to yield simple answers. Moreover, no suitable animal model exists on which to study anatomic correlates and natural history of the disease.

Not surprising, then, are the current controversies regarding the management of endometriosis, especially severe debilitating endometriosis. I believe the consensus among AAGL members is that severe endometriosis is a disease that should be treated surgically, preferably using endoscopic (laparoscopic or robotic) surgical techniques. Such surgery, especially for severe conditions, is well recognized as one of the most diffi cult in our fi eld. The majority of my cases present markedly distorted pelvic anatomy due to dense infi ltrating fi brotic scars, nodules, and large endometriomas. Frequent involvement of endometriosis to bowel, bladder, and ureters pose additional challenge. I do my own bowel, bladder, and ureteral

NewsScope [Library of Congress Cataloging in Publica-tion Data, Main entry under NewsScope, Vol. 22, No. 2; (ISSN 1094–4672)] is published quarterly by the AAGL for ten dollars, paid from member’s dues. Periodicals Postage Paid at Cypress, California.Copyright 2008 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

C.Y. Liu, M.D

Linda MichelsFranklin D. Loffer, M.D.

Lynn BellJan Lombardi

Jennifer Sanchez

Charles E. Miller, M.D.

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

C.Y. Liu, M.D.

Grace M. Janik, M.D.

Errico Zupi, M.D.

Arnold P. Advincula, M.D.Krisztina I. Bajzak, M.D.Martin Farrugia, M.D.Emilio Fernandez, M.D.Gary N. Frishman, M.D.Chyi-Long Lee, M.D., Ph.D.Javier F. Magrina, M.D.Ceana H. Nezhat, M.D.

Franklin D. Loffer, M.D.

Linda Michels

Editor-in-Chief

Managing Editors

Editorial Staff

Art Director

President

Vice-President

Secretary-Treasurer

Immediate Past President

International Vice-President

Trustees

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

n 2001, the AAGL and the Society for Reproductive Surgeons (SRS) joined to form the Fellowship in Gynecologic Endoscopy. While it is affi liated with both the AAGL and SRS, it is a separate corporation with its own Board of Directors.

The origin goes back to the 1980s when Dr. Veasy Buttram recognized that most graduating residents in obstetrics and gynecology were not fully trained in modern endoscopic surgery and it was primarily physicians in private practice who were providing postgraduate training. He started a one-year program and was soon joined by other leaders in endoscopic surgery.

When the Fellowship was formed in 2001 there were 7 participating sites. Since then several sites have closed but enough new ones have opened that there are now 19 sites with 24 fellows in training (5 sites are two-year programs). Fellowship sites tend to vary in their areas of expertise and the most recent site is training only gynecologic oncologists.

Unfortunately there were only 19 slots available for the 53 applicants who applied for 2008-2009. Not everyone requesting postgraduate training is able to receive it. Additional sites are needed and further information on the Fellowship program can be found on www.aagl.org.

By July of 2007 there were 59 graduates from the Fellowship program. Many of these graduates have taken positions in major teaching and university hospitals where they have been charged with establishing minimally invasive gynecologic programs. And this is the real purpose and the success of the Fellowship program. There is now a developing cadre of teachers with endoscopic skills who will lead our specialty in providing minimally invasive gynecology for the benefi t of our patients.

I

Fellowship in Gynecologic Endoscopy: Training Our Future Leaders

Debilitating Endometriosis Baffl es, but is Treatable

IC.Y. Liu, M.D.Editor-In-Chief

Secretary-Treasurer, AAGL

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

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

(continued on page 9)

NewsScope

3APRIL - JUNE 2008

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NewsScope

4 APRIL - JUNE 2008

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

t has been nearly 90 years now since Dr. John Sampson theorized that refl ux menstruation causes endometriosis. By this theory, menstruum carrying viable endometrial cells

refl uxes through the fallopian tubes. These cells fall into the pelvis, attach themselves to the peritoneum, proliferate and invade, and become the autotransplant disease we call endometriosis. There are fatal problems with this theory. Over the last 100 years, given the number of individual menstrual cycles in women and the number of surgeries done for endometriosis, our textbooks should be fi lled with thousands of easily-obtained photomicrographs scientifi cally proving the initial attachment and secondary invasion and proliferation of these invading cells. Yet all we have are cartoon depictions of these steps.

It has been accepted as dogma that endometriosis remains identical to endometrium, which is characteristic of autotransplants, yet the dozens of profoundly fundamental differences between endometrium and endometriosis have suddenly multiplied into hundreds of differences with the results of a recent study from the University of South Dakota of more than 700 genetic expression differences. Also, if refl ux menstruation is the cause of endometriosis, then it should spread progressively and incurably throughout the pelvis over time, and there should be no cure without hysterectomy or tubal ligation. Scientifi c evidence shows these notions to be wrong, too. Sampson did not have the information about endometriosis that we have today, so it is extremely unlikely that he conveniently arrived at the perfect answer for the origin of endometriosis with his fi rst simplistic effort. He was doing the best he could at the time and bears no current blame for the confusion about the disease. We are not doing so well today.

Supporters of Sampson’s theory have avoided rational response to the contradictions between this theory and scientifi c fact. Researchers fi nding contradictory evidence have become apologists for this theory, concluding that their results somehow are supportive when they are not. Facts have been twisted and contorted to somehow seem as though the vast majority of observations about endometriosis are congruent with refl ux menstruation, rather than follow logic that nearly always leads to a different conclusion.

A recent editorial from the urogynecology literature calls upon authors to disclose their raw data prior

to statistical manipulation (Nagelkerke NJD, Bernsen RMD, Rizk DEE. Authors should publish their raw data. Int Urogynecol J (2007) 18:1387-1390). This is an excellent article that should be read by every author of medical literature, and it speaks directly to the subject at hand. Authors of signifi cant numbers of papers on endometriosis, including those on the lateral distribution thereof, massage their data with various statistical tactics to make the data agree with their preordained conclusions, and thereby create “statistically, manipulated evidence-based medicine”. If the raw data were available, readers and reviewers could see how weak the arguments were, and may come to their own alternate conclusions. Falsehoods pertaining to a disease such as endometriosis are diffi cult enough to correct when they are based on rumors alone, but such mistruths masquerading as science do even more damage to both science and patients.

Intellectual honesty is the foundation of evidence-based medicine. It means that we need to be willing to put aside our preconceived ideas about a concept when there is good data to the contrary and be willing to accept the implications of the new data. We see this all the time in disciplines such as astronomy or physics, where researchers and the professors themselves are quick to re-interpret beliefs based on new fi ndings. We are not seeing this in gynecology. If we are to be intellectually honest about the origins of endometriosis, we need to let the theory fi t the facts, rather than manipulating conclusions about the facts to fi t the theory. When the commonly accepted theory is not supported by newly discovered facts, then consideration should be given to alternate theories rather than further strained mutations of the current theory.

We as scientists and physicians should be able to have open and rational discussions about how data stacks up both for and against each theory. When it becomes obvious that even a long-held belief such as Sampson’s theory is no longer supported by the majority of the current data, then it must be discarded in order to remain true to ourselves (intellectual honesty) and our colleagues and patients (evidence-based medicine). The real winners would be women with endometriosis who would receive better treatment based on accurate, objective evidence.

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.

I

David B. Redwine, M.D.St. Charles Medical Center

Bend, Oregon

Why the Continued Support for Sampson’s Theory?

Sound Surgical Technologies

The ways in which our Key Partners support the mission of the AAGL include:

• Committing year round support through our Corporate Sponsorship program.

• Funding our fellowship sites. • Giving unrestricted educational grants

to enhance our programs. • Supporting our hands-on seminars

with workstations. • Providing prizes for scholarly activities. • Funding unrestricted grants for the

Patient Awareness Initiative. • Advertising in The Journal of Minimally

Invasive Gynecology, the offi cial journal of the AAGL and ordering reprints of articles

to disseminate to physicians.

The support from our Key Partners meets the rigid criteria of the Accreditation Council

for Continuing Medical Education.

DIAMOND(Up to $500,000)

KEY PARTNERS

SAPPHIRE($100,000-$200,000)

EMERALD($50,000-$100,000)

RUBY($25,000-$50,000)

Opening the Doors to Education

A partner is defi ned as “someone who shares an activity.” The

AAGL acknowledges the corporations who partner with the

AAGL to open the doors to educating the next generation of

minimally invasive gynecologists. With their support the AAGL

can provide more programs that will educate physicians and

provide better patient care.

AAGLPresented by the

AAGLAdvancing Minimally Invasive Gynecology Worldwide

NewsScope

6 APRIL - JUNE 2008

Laparoscopic Retroperitoneal Para-Aortic Lymphadenectomy in Patients with Cervical Cancer

aparoscopic retroperitoneal (also called extraperitoneal) lymph node dissection (LRLND) has been utilized in patients with locally advanced cervical cancer with the

concept of tailoring adjuvant therapy to the individual patient. Limiting or extending radiation fi elds based on pathologically confi rmed para-aortic nodal metastasis can potentially benefi t those patients with extensive disease and limit the morbidity from extended fi eld radiation.

The use of laparoscopic retroperitoneal para-aortic lymph node dissection has been discussed and in publication for more than 20 years1 . However acceptance of this technique has most likely been limited by the combination of few surgeons willing to incorporate this in their practice, the overall decrease of cervical cancer in the US2, and the improvement in diagnostic imaging techniques. These advances in positron emission tomography and/or computed tomography (PET-CT) and magnetic resonance imaging (MRI) have potentially diffused some of the enthusiasm for a new, technically challenging procedure. However, the limited ability of these diagnostic imaging modalities to correctly identify all potential para-aortic lesions3-7 underscores the importance of incorporating another minimally invasive technique such as LRLND.

The technique of laparoscopic retroperitoneal para-aortic lymph node removal has been previously described with the emphasis that techniques used for minimally invasive radical gynecologic surgery are transferable to this new procedure8,9. In fact, recent publications have demonstrated this technique to be cost effective in comparison to current imaging techniques10.

Leblanc et al demonstrated that, in a series of 184 patients with locally advanced cervical cancer, the majority (173/184 or 94%) successfully underwent laparoscopic retroperitoneal para-aortic lymph node dissection7. Of those eleven cases that were not completed, eight had advanced disease and three were not completed due to morbid obesity. Median operative times and average length of stay were 155 minutes (range 90–280) and 1.4 days (range 1–4) respectively7. Perioperative morbidity was low (6 or 3.3%) with the majority of complications associated with vascular injury – and these were controlled intraoperatively without need for transfusion. Lymphocyst formation was reported in approximately 9.4% of the patients during the postoperative period, and although they demonstrated improvement over their series, it continues to be the main postoperative issue

with this procedure. With a median follow up of almost 27 months their group also demonstrated a potential survival advantage for surgical resection of positive para-aortic lymph nodes7.

As the fi eld of minimally invasive oncology in gynecologic cancers continues to evolve, further techniques will and should be refi ned to include retroperitoneal pelvic lymph node dissection in cervical cancer11. Further studies and applicability in other gynecologic malignancies, including ovarian or uterine cancers, will be needed. Those patients with previous abdominal surgery or body habitus that may limit transperitoneal lymph node dissection may also benefi t from the broad application of this surgical technique.

References1. Dargent D, Ansquer Y, Mathevet P. Technical development and results of left extraperitoneal laparoscopic paraaortic lymphadenectomy for cervical cancer. Gynecol Oncol 2000;77:87-92.

2. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin 2008;58:71-96.

3. Choi HJ, Roh JW, Seo SS, et al. Comparison of the accuracy of magnetic resonance imaging and positron emission tomography/computed tomography in the presurgical detection of lymph node metastases in patients with uterine cervical carcinoma: a prospective study. Cancer 2006;106:914-22.

4. Chou HH, Chang TC, Yen TC, et al. Low value of [18F]-fl uoro-2-deoxy-D-glucose positron emission tomography in primary staging of early-stage cervical cancer before radical hysterectomy. J Clin Oncol 2006;24:123-8.

5. Wright JD, Dehdashti F, Herzog TJ, et al. Preoperative lymph node staging of early-stage cervical carcinoma by [18F]-fl uoro-2-deoxy-D-glucose-positron emission tomography. Cancer 2005;104:2484-91.

6. Loft A, Berthelsen AK, Roed H, et al. The diagnostic value of PET/CT scanning in patients with cervical cancer: a prospective study. Gynecol Oncol 2007;106:29-34.

7. Leblanc E, Narducci F, Frumovitz M, et al. Therapeutic value of pretherapeutic extraperitoneal laparoscopic staging of locally advanced cervical carcinoma. Gynecol Oncol 2007;105:304-11.

8. Lowe MP, Bahador A, Muderspach LI, et al. Feasibility of laparoscopic extraperitoneal surgical staging for locally advanced cervical carcinoma in a gynecologic oncology fellowship training program. J Minim Invasive Gynecol 2006;13:391-7.

9. Ramirez PT, Milam MR. Laparoscopic extraperitoneal paraaortic lymphadenectomy in patients with locally advanced cervical cancer. Gynecol Oncol 2007;104:9-12.

10. Tillmanns T, Lowe MP. Safety, feasibility, and costs of outpatient laparoscopic extraperitoneal aortic nodal dissection for locally advanced cervical carcinoma. Gynecol Oncol 2007;106:370-4.

11. Querleu D, Ferron G, Rafi i A, et al. Pelvic lymph node dissection via a lateral extraperitoneal approach: description of a technique. Gynecol Oncol 2008;109:81-5.

L

o n c o l o g y p e r s p e c t i v e

Michael R. Milam, M.D.Dept. of Gynecologic Oncology

The University of Texas M.D. Anderson Cancer Center

Houston, Texas

Pedro T. Ramirez, M.D.Dept. of Gynecologic Oncology

The University of TexasM.D. Anderson Cancer Center

Houston, Texas

The opinions, viewpoints, conclusions, recommenda-tions and statements in the Oncology Perspective 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.

1Source: Payne T, Dauterive F. A Comparison of Total Laparoscopic Hysterectomy to Robotically Assisted Hysterectomy: Surgical Outcomes in a Community Practice. The Journal of Minimally Invasive Gynecology. May/June 2008;

15:3:286-291.2Source: Statement from Dr. Arnold Advincula (University of Michigan, Ann Arbor, MI), PN 8711843 Source: Gehrig PA et al. Gynecologic Oncology. 2008 (108): S2-S31. Abstract.

The presentations described are for general information only and are not intended to substitute for formal medical training or certification. Independent surgeons, who are not Intuitive Surgical employees, provide procedure descriptions.

Intuitive Surgical trains only on the use of its products and is not responsible for surgical credentialing or for training in surgical procedure or technique. As a result, Intuitive is not responsible for procedural content. While clinical studies

support the use of the da Vinci Surgical System as an effective tool for minimally invasive surgery, individual results may vary. ©2008 Intuitive Surgical, Inc. All rights reserved. Intuitive, Intuitive Surgical, da Vinci, da Vinci S, Dynamic Atrial Retraction, InSite, and EndoWrist are trademarks or registered trademarks of Intuitive Surgical, Inc. PN 871997 Rev A 5/08

Contact Intuitive Surgical to learn more about da Vinci Surgery:Inside U.S.: +1 888 409 4774 or Outside U.S.: +800 0 821 20 20

To see live da Vinci gynecologic procedures, visit:http://www.or-live.com/vbc/davinci/

Compared to conventional laparoscopy, the unsurpassed visualization, dexterity and control of the da Vinci® Surgical System allows surgeons:

To treat more pathology minimally invasively, including patients with:Pelvic adhesive disease1,2

Large uteri1,2

High BMI3

To reduce conversions1 and minimize total abdominal hysterectomy (TAH)1,2

To control the camera and all three operative arms for the ultimate in surgical autonomy and efficiency

To translate open surgical technique to minimally invasive surgery

Treat Complex PathologyMinimally Invasively withthe da Vinci® Surgical System

NewsScope

8 APRIL - JUNE 2008

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

Turkish Society of Gynecologic Endoscopyince its founding 5 years ago, the Turkish Society of Gynecologic Endoscopy has grown to be one of the largest societies of gynecologists interested in minimally invasive procedures.

Their membership has grown to include 700 physicians and they have held two annual meetings. Judging by the large number of attendees at their recent meeting in April, their congress is now considered to be a major regional event.

We are pleased that 36 of their members are also active in the AAGL.

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

When and how was your society established? The Turkish Society of Gynecologic Endoscopy was established in 2003 with the aim to assemble surgeons working in gynecologic endoscopy. The founding president of the society was Hikmet Hassa and the secretary was Hakan Yarali.

What is its mission statement/primary goal? The aim of our society is to assemble our colleagues working in endoscopic surgery, generalize applications on endoscopic surgery and to work on establishing

educational institutions. At the same time one of our aims is to communicate with the other societies from different countries and cooperate with them.

Approximately how many members are there? In spite of being a very young society; we have achieved 700 members.

What are some of the benefi ts of membership? We are informing our members about the activities of our society and they are taking advantage of registering for our congress with discounted fees. Also, we publish an endoscopic bulletin that is mailed to the members without any extra fee.

We are also supporting local workshops held in our country and our members are encouraged to pursue the latest improvements in endoscopy.

Is there any additional information you would like to provide about your society? Our society is organizing a national congress every two years and contributing to local workshops. The latest congress held in April 2007, had 650 participants. The third national congress is going to be held on April 7 – 11, 2009, and for further information go to our website at: www.jed.org.tr

SOnur Bilgin, M.D.

President

PresidentOnur Bilgin, M.D., Professor

Vice PresidentGurkan Uncu, M.D., Professor

SecretaryFatih Sendag, M.D., Associate Professor

TreasurerBilgin Gurates, M.D., Associate Professor

NewsScope

9APRIL - JUNE 2008

surgery when endometriosis is involved. Severe cases can require upwards of 5 to 6 hours for adequate resection of endometriosis and restoration of pelvic anatomy. Unfortunately, reimbursement from insurance companies is disheartening.

A recent Wall Street Journal article, “The Health Insurance Mafi a,” (April 14, 2008, page A15) “hit the nail right on the head.” True, the practice of medicine has been grossly robbed by the “mafi a.” Yet extending far beyond any monetary consideration is the intrinsic

reward of seeing the excitement in my patient as she fi nally achieves her long-hoped-for pregnancy or as she enjoys a quality of life never dreamed possible. And this can never, ever be robbed -- even by the “mafi a.”

More about this baffl ing disease appears in the “Clinical Opinion” of this issue’s NewsScope. An internationally renowned endoscopic surgeon who has dedicated more than 25 years of his professional life to the study and treatment of endometriosis shares his insights. Be sure to read David Redwine’s article.

f r o m t h e e d i t o r (continued from page 2)

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NewsScope

10 APRIL - JUNE 2008

ProgramFriday • Fundamental Laparoscopic Pelvic Anatomy • Laparoscopic Retroperitoneal Anatomy of the Lateral Pelvic Walls• Parametrial Ureter: Anatomy and Laparoscopic Dissection • Laparoscopic Radical Hysterectomy • Questions and Answers• Transperitoneal Laparoscopic Pelvic Node Dissection• Laparoscopic Transperitoneal Aortic Lymphadenectomy • Laparoscopic Extraperitoneal Para-aortic Lymphadenectomy• Questions and Answers

Hands-on Cadaver Dissection• Retroperitoneal Spaces, Vessels, Nerves Dissection, Pelvic Lymphadenectomy, Radical Hysterectomy Type III, Aortic Lymphadenectomy, Extraperitoneal & Intraperitoneal.

Saturday • Complications of Laparoscopy and How to Avoid Them• Laparoscopic Splenectomy• Laparoscopic Ureteral Resection and Anastomosis • Laparoscopic Colostomy; Laparoscopic Repair of Major Vascular Injury • Laparoscopic Rectosigmoidectomy• Questions and Answers

Hands-on Cadaver Dissection• Colostomy, Splenectomy, Rectosigmoidectomy with low colorectal anastomosis • Complete evaluation forms - adjourn

Enrollment InformationAAGL Advancing Minimally Invasive Gynecology Worldwide6757 Katella Ave., Cypress, CA 90630 USA PH: 800-554-2245 or 714-503-6200FAX: 714-503-6201E-mail: generalmail@aagl.org Web Site: www.aagl.org

Course OverviewThe course is designed to teach gynecologic oncologists and general gynecologists advanced laparoscopic techniques through lecture and hands-on dissection.

• Didactic sessions address a review of retroperitoneal anatomy and several surgical techniques with practical emphasis.• Presentations are geared to offer detailed practical information.• Eight hours of hands-on dissection, limited to three participants per cadaver.

Because of the advanced information presented and the limited number of participants, you will get the most out of this advanced workshop if you are versed in basic laparoscopic techniques and are familiar with open techniques.Enrollment LimitsTo ensure a quality learning experience the enrollment will not exceed the following: Dissection limited to 27. Observation of Dissection limited to 10.

Course Objectives At the completion of the workshop, the practicing oncologist will be able to: 1. Identify the anatomy and techniques to access lateral pelvic spaces.2. Describe techniques for parametrial ureteral dissection.3. Select patients with cervical cancer for trachelectomy.4. Discuss benefits and results of laparoscopy for patients with endometrial cancer.5. Discuss applications of laparoscopy for patients with ovarian cancer.

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

September 26-27, 2008Experience 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. To accommodate demand, the cadaver dissection sessions are open to observation.

3rd Annual Workshop

Advanced Laparoscopic Techniques for Gynecologic Oncologists Using Unembalmed Female Cadavers

AccreditationThe AAGL is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physi-cians. The AAGL designates this educational activity for a maximum of 15 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. Participants must sign in daily to receive CME credits.

Fees Member Non-Member

Lecture & Dissection $2000 $2260Lecture & Lab Observations $695 $955

NewsScope

11APRIL - JUNE 2008

Ishola S. Adeyemo, M.D. Annebelle D. Aherrera, M.D. Randy Alejo, M.D. Asma Ali, M.D. Haifa Alturki, M.D. Abby F. Anderson Ruswana Anwar, M.D. Johanna S. Archer, M.D. Saverio Arena, M.D. Mira Aubuchon, M.D., FACOB Caudrean Latiste Avery, M.D. Maryam Awan, M.D. Cheryl Ekkebus Axelrod, M.D. Mohammad MB Badawi, M.D. John M. Baird, M.D. Sonal Bakaya, M.D. Vicencia S. Balajo, M.D. Clarissa Bambao, M.D. Spencer P. Barney Maria Teresa D. Benitez, M.D. Lauren Bertivegna, M.D. Bala Bhagavath, M.D. Timothy J. Billharz, M.D. Amelia Simone Blissett, M.D. Bryan J. Blonder, M.D. Michael L. Boroditsky, M.D. Tharwat Stewart Boulis, M.D. Jenni Bradley, M.D. Matthew C. Brennan, M.D. Jubilee Brown, M.D. Tova Burge, M.D. Jamie Marie Byler, M.D. Kevin A. Byrd, M.D. Antoinette Byrd-Carr, M.D. Faunda N. Campbell, M.D. Eugen Cristian Campian, M.D. Nikolas G. Capetanakis, D.O. Ingrid A. Carlson, M.D. Andrea Casalini, M.D. Chadwick T. Caudill, M.D. Tammy Chan, M.D. Tong-Fu Chou, M.D. Linus T. Chuang, M.D. Charles Cunningham, M.D. Natalya Danilyants, M.D. Michael Demishev, M.D. Aarti A. Dharmani, M.D.

Brian D. Dobbins, M.D. Gonzalo Duque Arredondo, M.D. Maria L. Echavarria Cano, M.D. Suzanne M. Eggers, M.D. Elizabeth Keith Elkinson, M.D. Nefertari D. Esemuede, M.D. Stephanie J. Estes, M.D. Diane Evans, D.O. Benjamin Feiner, M.D. Caroline F. Filor, M.D. Laura Finger, M.D. Timothy J. Fisher, M.D. Rebecca L. Flyckt, M.D. David W.I. Fong, M.D. Katie A. Fossen, M.D. Nichole M. Giannios, D.O. Robert K. Gildersleeve, M.D. Hartaj Gill, M.D. Veronica C. Gillispie, M.D. Akiva Gimpelevich, D.O. Karine Girard, M.D. Julia Girzhel, M.D. Aimee Jean Glidden, D.O. Eleonora Gokoyeva, M.D. Natalya Goltyapina, D.O. Gustavo Gonzalez, M.D. Ciaran A. Goojha, M.D. Jennifer L. Graff, M.D. Catherine Cray Graziani, D.O. Janis L. Green, M.D. Terry W. Grogg, M.D. Jacqueline M. Guerrero, M.D. Tyler D. Handcock, M.D. Cindy C. Hartley, M.D. Jennifer Heinemann, M.D. Elanie R. Herer, BSc, M.D. John W. Hering, M.D. Jason Hoppe, M.D. Kathryn Houston, M.D. Lisa M. Hovenga, M.D. Andriy Hryhorenko, M.D. Andrea Hutchison, M.D. Sarah Lorraine Jeffers, M.D. Gina Jereza-Harris, M.D. Arthur Jones, D.O. Peggy H. Jones, M.D. Analiza T. Justo, M.D.

Theodore Kabisios, M.D. Deepali Kashyap, M.D. Sari J. Kasper, D.O. Diana Kaufman, M.D. Erin M. Kearney, M.D. Carey Keiter, D.O. Raniah S. Khairy, M.D. Amr Khalil, M.D. Ali Khazaei-Nezhad, M.D. Nikolaos Kiouranakis, M.D. John H. Kirk, M.D. Jun Koike, M.D. Surya Sky Krishnan, MBBS, FRANZCOG Kathy M. La Favor, D.O. Lynne L. Lafl amme, R.N. Michelle Lafornara, M.D. Lakshmi Rani Laguduva, M.D. Laurie B. Landeen, M.D. Greta Larsen, M.D. Chadwick S. Leo, D.O. Jae-Yun Lim, M.D. Marigrace Lim, M.D. Christian Litton, M.D. Alessandro Loddo, M.D. Karine J. Lortie, M.D. Erin Patricia Lovett, M.D. Meghan A. Lynch, M.D. Gillian Mackay, M.D. Marni Madnick, M.D. Gabriela Mandolesi, M.D. Jennifer Mankowski, M.D. Kimberlee A. McKay, M.D. Katherine K. McKnight, M.D. Karen McLean, M.D., Ph.D. Natalya Medrano, M.D. Hector R. Mendez-Figueroa, M.D. Thomas J. Mendise, M.D. Jennifer A. Meyer, M.D. Kelli Miller, M.D. Maria M. Molina, M.D. Christopher M. Morosky, M.D. Ellen Morris, M.D. Kristie Moss, M.D. Christine Mullin, M.D. Snezhana Mullokanodov Sudha Nair, M.D.

Gregory Nelson, M.D. Amanda G. Nicols, M.D. Ann-Edwidge Noel, M.D. Suzanne Nogami, BS, M.D. Stefan Novac, M.D. Elvira O’Brien, M.D. Jonathan E. O’Brien, M.D. Victoria Ochoa, M.D. Nnamdi C. Okoroafor, M.D. Sallie S. Oliphant, M.D. Kenan Omurtag, M.D. David O’Rourke, M.D. Leslie Ostler, M.D. Charles B. Palmer, D.O. Matthew M. Palmer, D.O. Anita Patibandla, M.D. Monu MR Pattanayak, M.D. Thomas N. Payne, M.D. Vanessa Valerie Pena, M.D. Nicole A. Persall, M.D. Prashanti Pilla, M.D. Anna Pilzek, M.D. Pavani R. Pingle, M.D. Raisa Platte, M.D. Monica Popov, M.D. Nicole C. Powell, M.D. Tarah Pua, M.D. Suzanne K. Pugh, M.D. Kari Lynn Purcott, M.D. Jill Q. Purdie, M.D. Roa Qato, M.D. Laura B. Ramsay, M.D. Kathryn Erin Randel, M.D. Caren C. Reaves Kristy L. Ritchie, M.D. Pablo Rivera, M.D. Veronica Rivera, M.D. Rachel Robinson, M.D. David F. Rodriquez, M.D. Amanda J. Romanovsky, M.D. Michelle Rosario, M.D. Shon Patrick Rowan, M.D. Levent Sahin, M.D. Tamer Said, M.D. Jessica Salas, M.D. Alice M. Salvador, M.D. Alison Rae Sampson, D.O.

Joannna L. Santiesteban, M.D. Djalma Santos, M.D. Stacey A. Scheib, M.D. Brett Schultz, D.O. Leslie A. Scott, M.D. Jeffrey C. Sellers, M.D. Rana F. Shayya, M.D. Karima M. Shmila, M.D. Tomer Singer, M.D. Jarett Skinner, M.D. Kathleen J. Slugocki, D.O. Joon Song, M.D. Marka Steensma, M.D. Dawn Steiner, M.D. Jill F. Sternquist, M.D. Rebecca Lynn Stone, M.D. Ryan A. Stone, M.D. Christopher Michael Sullivan, M.D. Yoko Suzuki, M.D. Michella Switzer, D.O. Sreedhar Tallapureddy Niamh M. Tallon, M.D. Catherine Thomas, M.D. Brent J. Tierney, M.D. Audrey C. Toda, M.D. Saioa Torrealday, M.D. Angelo Turi, M.D. Dhiraj L. Uchil, M.D. Joseph S. Valenti, M.D. Nancy A. Van Eyk, M.D. Emine Vanlioglu, M.D. Faruk Vanlioglu, M.D. Wendelly J. Vasquez, M.D. Tannys Vause, M.D. David A. Wagar, M.D. Sally J. Wentross, M.D. Henry Earl West, M.D. Karen White, M.D. Susan Elizabeth Wing, M.D. Christina M. Wong, M.D. Jessica H. Wong, M.D. Hilaire C. Wood, M.D. Catherine L. Worden, M.D. Kai Qi Wu, M.D. Paul John Yong, M.D.

Welcome New MembersMarch 7, 2008 – June 11, 2008

m e m b e r n ew s

In Remembrance: C. Paul Perry, M.D. 1945–2008Friends and colleagues were saddened to learn of Dr. Paul Perry’s death on May 3, 2008. Paul, a long time supporter of minimally invasive gynecology, had been treated for a malignant mediastinal tumor. He leaves his wife, Suzanne Noel Perry, two sons, a daughter, three grandchildren and many grateful patients.

For the past 30 years, Paul practiced in Birmingham, Alabama. He was a leader in gynecology having co-founded the

International Pelvic Pain Society (an AAGL Affi liated Society) in 1996 where he served as President and Chairman of the Board. He became a member of the AAGL in 1987 and, as an author and lecturer, participated in raising our members’ awareness to the problems associated with pelvic pain. Paul will be missed for his outstanding work in the fi eld of pelvic pain and for his many contributions to improve the health care of women worldwide.

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NewsScope

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

AAGL “Advancing Minimally Invasive Gynecology Worldwide”

3rd Annual Workshop on Suturing, Operative Hysteroscopy & Advanced Laparoscopic TechniquesCharles H. Koh, Scientifi c Program ChairAugust 15-17, 2008St. Mary’s Hospital • Milwaukee, Wisconsin

2nd AAGL International Congress on Minimally Invasive Gynecologyin conjunction with V Brazilian Congress of SOBENGEPaulo Roberto Cará, Scientifi c Program Chair September 11-14, 2008Maksoud Plaza • São Paulo, Brazil

VIIIth PAX Meetingin affi liation with AAGLAdvancing Minimally Invasive Gynecology WorldwideMichel Canis, Congress PresidentSeptember 18-20 2008Clermont-Ferrand, France

3rd Annual Workshop on Advanced Laparoscopic Techniques for Gynecologic Oncologists using Unembalmed Female CadaversJavier F. Magrina, Scientifi c Program ChairResad P. Pasic, Course DirectorSeptember 26-27, 2008University of LouisvilleLouisville, Kentucky

Global Congress of Minimally Invasive GynecologyAAGL 37th Annual MeetingResad P. Pasic, Scientifi c Program ChairOctober 28-November 1, 2008Paris Las Vegas • Las Vegas, Nevada

18th Annual Comprehensive Workshop on Minimally Invasive Gynecology for Residents and FellowsGrace M. Janik, Scientifi c Program ChairApril 2009Chicago, Illinois

11th Annual Advanced Workshop of Gynecologic Laparoscopic Anatomy & Minimally Invasive Surgery including TVT and TOTResad P. Pasic, Scientifi c Program ChairMay 2009University of LouisvilleLouisville, Kentucky

3rd AAGL International Congresson Minimally Invasive Gynecology in conjunction with the Australian Gynecologic Endoscopy SocietyChris Maher, Scientifi c Program ChairMay 20-23, 2009Sofi tel/Hilton BrisbaneBrisbane, Australia

Global Congress of Minimally Invasive GynecologyAAGL 38th Annual MeetingC.Y. Liu, Scientifi c Program ChairNovember 16-19, 2009Gaylord Resort • Orlando, Florida