Background: Transanal Endoscopyic Microsurgery (TEM) has been a new method of micro invasive surgery for management of special conditions. Big deal of this procedure is avoiding of open abdominal surgeries or better exposure in transanal approches. Objectives: The purpose of this study was to present a single institutional experience in Shiraz, Iran regarding the application of Transanal Endoscopic Microsurgery (TEM). To our knowledge this is the first report from the Middle East.Patients and Methods: Between 2009 and 2012, thirty patients underwent TEM in our center. We assessed complications and recurrence rate. Patients with fewer than six months of follow-up were excluded.Results: Patients included 17 men and 13 women with a mean age of 44.4 years (ranged 17-80). The mean tumor distance from the anal verge was 9.8 cm. One patient with adenomatous polyp experienced recurrence 14 months postoperatively. Regarding procedure-related complications, one case developed hemorrhage and another case fever and infection in the site of operation. Two patients experienced incontinence for about 3 weeks after TEM surgery. Conclusions: Considering the cultural and religious context of the Middle East, we recommend TEM procedure in specialized centers in this region of the world.

Laparoscopy has had a remarkable impact in the field of gynecology over a short period of time which is the final diagnostic procedure of any infertility investigation, included in the basic infertility work-up outlined by the American Fertility Society in 1992 and World Health Organization (WHO) guidelines. In addition to pelvic pain Laparoscopy permits evaluation of tubal and peritoneal factors in the infertile patients. A thorough evaluation of the severity of pelvic adhesion or the extent of endometriosis allows selection of the appropriate treatment. Uterine leiomyomas are the most frequent benign neoplasm of the female genital apparatus which is associated with a high morbidity rate, being reported to occur in 20% to 50% of women of reproductive age. The data from several studies show a link between myomas, fetal wastage, and premature delivery. The factors such as the size, number, and location of the tumors influence the choice of the operation. In spite of the increasing improvements in laparoscopic instruments and techniques, advanced laparoscopic technical skills are required to perform laparoscopic myomectomy with success.Thus the workshop of Laparoscopy and Tubal Microsurgery was held at the Endocrinology and Female Infertility Department of Reproductive Medicine Research Center, Royan Institute (ACECR), Tehran, Iran on Aug 25th and 26th, 2008 (Before the 9th International Royan congress). The objective of this workshop was specifically focused on developing the knowledge and dexterity of science and technology in laparoscopy and tubal microsurgery and providing the information required by expert surgeons.The following agenda was established to give to all participants of the workshop:Aug 25, 2008: Presentation of operative laparoscopic techniques, indications, contraindications and complications given by Dr Sawalhe S, Dr Tehraninejad E2- Aug 26, 2008,: Presentation of Tubal microsurgery techniques, adhesion prevention, the diagnosis methods of tubal diseases and microsurgery in different part of uterine tube, given by Dr Alborzi S, Dr Tehraninejad E.Target audiences: Obstetrics and Gynecology specialists.This activity was sponsored by Parto Rayan Darman Company (representative of Storz's Company in Iran).

Subclinical Varicocele (SV) remains one of the most controversial entities in male infertility management. Although major guidelines do not recommend treatment, growing evidence suggests that microsurgical repair may benefit selected patients. This review critically examines current guidelines, available clinical evidence, potential mechanisms of damage, and patient selection strategies. Emerging biomarkers and personalized approaches may help redefine management. While routine surgery for SV is not justified, individualized decision-making may bridge the gap between evidence and clinical need [1, 2].

BACKGROUND: The aim of this study was to perform a bibliometric analysis to assess the number of articles published by Iranian researchers in the field of hand and microsurgery over the last four decades. MATERIALS AND METHODS: An online search was conducted using 685 keywords in the abstract/ title sections of articles, including carpal tunnel syndrome, wrist fractures, nerve injury and repair, skin flap and graft in the hand, congenital disorders in the hand and forearm, tumor in the hand and wrist, and infection in the hand and wrist. From February 1976 to May 2021, EndNote software version 8. 1 was used to search articles in PubMed and Scopus databases. Articles in which at least one of the authors was affiliated with Iran were chosen. The name of the original institution, field of study, total number of publications, type of study, collaboration rate of Iranian hand surgeons for each year, and annual sharing of Iranian articles in journals with the highest cite scores in the field of hand and microsurgery were all examined in the present study. RESULTS: The total number of publications in the field of hand and microsurgery was 632 (an average of 11 papers per year). Most of the Iranian hand and microsurgery papers were from the capital city, Tehran (38. 09%). There was an increasing trend in the number of publications over the years, most which were about carpal tunnel syndrome (21. 5%), tendon (9. 8%), and nerve (9. 6%). In total, 59. 6% were descriptive articles, whereas the proportion of clinical trials was relatively small (22. 3%). CONCLUSIONS: Iranian hand microsurgeons have continued to increase their scientific output in hand microsurgery and related fields over the last 40 years. The quality of Iranian hand microsurgeons’,scientific output, both within and outside their discipline, has greatly improved,however, they still have a long way to go before becoming a hub of science. LEVEL OF EVIDENCE: IV, retrospective study without control group.

The aim of this manuscript is to describe and discuss the advantages and obstacles of using a guided implant system adapted for endodontic microsurgery in the execution of a case with indication of multiple endodontic microsurgery intervention in a single appointment. Cone-beam computed tomography (CBCT) scans were aligned and processed with the planning software, complementing the Straumann® guided instruments. The drill handles of the system employed directed milling cutters and guided drills based on the sleeve-in-sleeve concept used in the osteotomy and apical resection of teeth #13, #14, #23 and #24. The root-ends were retro-prepared and sealed with putty bioceramic sealer. The patient was completely asymptomatic at the 12 months follow up visit and CBCT revealed complete tissue healing of the involved teeth. The protocol demonstrated to be reliable and reproducible. Its applicability can be extended to other anatomical complex scenarios. The reproducibility of the technique would encourage the maintenance of teeth in patients with indication to multiple endodontic surgery and permitted the conclusion of this case with precision and comfort to both patient and operator.