Emily Jamaer

Primary malignant melanoma of the vagina

Primary malignant melanoma of the vagina is a rare gynaecological neoplasm with an aggressive course of disease. Although not many cases have been reported in the literature, its manifestations appear to be fairly consistent. The challenge comes in knowing how to approach this cancer clinically, since information about its staging and treatment is limited. In this report, we present a case of an 84-year-old postmenopausal woman in whom a suspicious vaginal lesion was discovered incidentally during a procedure. Wide local excision was carried out at a later date and histopathology confirmed a malignant melanoma of the vagina contained locally with no radiological finding of distant metastases. No additional treatment was given, and three monthly follow-ups were arranged for this patient. We review the literature and briefly discuss the epidemiology, treatment approaches, prognostic factors and expected outcomes of this rare disease.

Pioneering telesurgery in gynecology: the first European case of total hysterectomy

Abstract This report describes the first European clinical case of robot-assisted telesurgery in gynecology using the Toumai® Endoscopic Surgery System. A 34-year-old woman with recurrent cervical glandular intraepithelial neoplasia underwent a total hysterectomy with bilateral salpingectomy. The procedure was performed remotely between two institutions in Belgium, approximately 20 km apart. The remote surgeon operated from a dedicated console, while the patient and the surgical team were on site. The operation was completed successfully without intraoperative complications or conversion. Total operative time was 74 min, with a console time of 47 min. The mean latency was 20 ms with a jitter < 10 ms, with high image quality and no connection issues. Postoperative recovery was uneventful, and the patient was discharged on day 2. At the 18-day follow-up, no complications were observed. Subjective feedback highlighted a high level of satisfaction among the patient and surgical staff, with the remote surgeon reporting a slightly reduced sense of control, mitigated by the on-site stand-by surgeon. Poor audio quality was noted as a minor issue. This first experience confirms that telesurgery in gynecology is technically feasible and safe, even using a standard network connection. Although further improvements and larger studies are needed, this experience supports telesurgery as a promising tool to expand access to expert surgical care.