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Objective: The aim of this research was to assess the effectiveness of antislip surfaces for reducing intraoperative patient displacement while in the Trendelenburg position. Materials and Methods: A prospective randomized trial was conducted on intraoperative displacement in patients undergoing major laparoscopic or vaginal gynecologic surgery from June 2018 to December 2019. Patients were randomly assigned to 1 of 3 antislip surfaces: pink pad (The Pink Pad XL®; Xodus Medical Inc., New Kensington, PA), gel pad (Action® O.R. Overlay; Action Products Inc., Hagerstown, MD), or beanbag (Olympic Vac-Pac®; Natus Medical Inc., Pleasanton, CA). A total of 161 patients were enrolled, with 148 eligible for analysis. The primary outcome was intraoperative displacement related to the Trendelenburg position. This was assessed by measuring movement at the perineum, anterior superior iliac spine (ASIS), umbilicus, acromion, and head. Secondary measures also assessed included positioning time, postoperative pain, and erythema. A sample size of 50 patients per arm could achieve a >90% power. Results: There was significantly less movement on the pink pad at all anatomical landmarks, compared to the gel pad (p ≤ 0.001). The beanbag was equivalent to the pink pad, except at the ASIS (p = 0.008) and perineum (p = 0.022), where it had greater displacement. The most-consistent predictors of movement included: height; weight; and body mass distribution. Obese patients' displacement was 32%–55% greater than the nonobese patients' displacement. The pink pad was 19.2% (p = 0.042) and 30.8% (p < 0.001) faster to position than the gel pad and beanbag, respectively. Postoperative back pain was less on the pink pad, compared to the gel pad (p = 0.036). Postoperative erythema was significantly less common on the pink pad versus the beanbag (6.2% versus 30%, respectively; p = 0.005). There were no differences in complications among the antislip surfaces. Conclusions: Patients on the pink pad had significantly less displacement with Trendelenburg and faster positioning, compared to the gel pad. Obesity is a major predictor of movement. The pink pad was associated with less postoperative pain than the gel pad and less postoperative erythema than the beanbag. (J GYNECOL SURG 38:153) [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic has altered health care. The aim of this study was to evaluate changes in gynecology practice patterns in response to the pandemic. Materials and Methods: A survey was created and distributed to members of the American Association of Gynecologist Laparoscopists, using REDCap [Research Electronic Data Capture] from July 2020 to August 2020. The responses of 112 gynecologists representing all U.S. regions and several other countries were analyzed. Results: In response to the pandemic, almost all providers' institutions took action to increase social-distancing efforts (99.1%) and to encourage use of personal protective equipment (95.5%). Furthermore, 75.5% of institutions cancelled elective surgeries and 80% started utilizing telemedicine. Practice volume dropped by 27% among respondents, and 64% felt that patients were delaying needed care. The gynecologic diagnosis felt to be most impacted by COVID-19 secondary to delays in care was pelvic pain. The pandemic accelerated implementation of telemedicine, and, interestingly, 65% of providers reported that they would continue to use telemedicine 25% of the time going forward. Conclusions: COVID-19 has reshaped clinical and surgical practices in benign gynecology. It has led physicians to begin utilizing telemedicine for gynecologic care more readily, and many will continue to utilize this method of health care even when the pandemic ends. (J GYNECOL SURG 38:115) [ABSTRACT FROM AUTHOR]