{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:08:44Z","timestamp":1784300924464,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the learning curve of uterine artery blockage via the anterior cul\u2010de\u2010sac and demonstrate the favorable outcomes of its application into complex minimally invasive myomectomy (MIM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective case series conducted at a teaching hospital and tertiary referral center, including 86 consecutive patients who underwent MIM by a single surgeon between September 2022 and August 2025. Uterine artery blockage via the anterior cul\u2010de\u2010sac was attempted in 61 cases, while 25 cases of MIM were performed without attempt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 61 attempted cases, bilateral blockage was successful in 49 cases, unilateral in seven, and none in four. Consistent bilateral success was achieved after 34 cases. Most patients had more than five fibroids (39\/61), with a median largest fibroid size of 8.1\u2009cm (interquartile range [IQR]: 6.2\u201312.0\u2009cm), and specimen weight of 430\u2009g (IQR: 205.5\u2013772.5\u2009g). The median estimated uterine size was 16.0\u2009weeks (IQR: 15\u201320\u2009weeks). The median operative time was 246\u2009min (IQR: 209\u2013281\u2009min), and the median estimated blood loss (EBL) was 250\u2009mL (IQR: 100\u2013350\u2009mL). Preoperative hemoglobin averaged 11.8\u2009\u00b1\u20091.8\u2009mg\/dL, with a mean drop of 2.1\u2009\u00b1\u20091.4\u2009mg\/dL. Surgical approaches included laparoscopy (17), laparoscopic\u2010assisted myomectomy (LAM) (26), and mini\u2010laparotomy (18). One intraoperative vascular complication and one intraoperative transfusion occurred. The median hospital stay was 1\u2009day (IQR: 1.0\u20132.0). There was eight postoperative transfusions, and two Clavien\u2010Dindo class I complications with no readmissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Approximately 34 cases are required for a surgeon to achieve proficiency, and incorporation of this technique facilitates the safe and feasible performance of complex MIM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70913","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T04:41:10Z","timestamp":1771648870000},"page":"844-851","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Uterine artery blockage via the anterior cul\u2010de\u2010sac in minimally invasive myomectomy: Experience of 61 cases"],"prefix":"10.1002","volume":"174","author":[{"given":"Salma","family":"Moustafa","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology BronxCare Health System  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Di Francesco","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology BronxCare Health System  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liaisan","family":"Uzianbaeva","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology BronxCare Health System  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdy","family":"Mikhail","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology BronxCare Health System  Bronx New York USA"},{"name":"Department of Obstetrics &amp; Gynecology and Reproductive Science The Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4479-5357","authenticated-orcid":false,"given":"Pengfei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology BronxCare Health System  Bronx New York USA"},{"name":"Department of Obstetrics &amp; Gynecology and Reproductive Science The Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.99"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.07.017"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14124313"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.09.052"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2024.00078"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2021.00065"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30484-9"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogoh.2022.102485"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2012.03.022"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2016.01.026"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005355.pub5"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2022.06.021"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2020.02.110"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2019.08.026"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2015.02.003"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2014.00189"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.12.011"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurox.2022.100162"}],"container-title":["International Journal of Gynecology &amp; 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