A practical program that will allow you to grow in your profession with the confidence of having all the essential support systems and flexibility to achieve the skills of a top professional”

Gynecological care has changed exponentially in recent times due to advances in diagnostic and treatment systems in all areas of practice.

One of the most relevant fields is oncogynecology. Nowadays, the social and emotional burden of gynecologic cancer is transforming it into highly interesting field, from a scientific and professional point of view. In order to keep abreast of advances in surgery and gynecologic oncology, it is essential that specialists commit to ongoing specialization that prevents obsolescence and allows them to continue to provide quality care.

Reproduction is another of the most important interventions, due to the increasing number of patients in this area. Reproductive problems have become one of the most frequent issues among patients in today's society, leading to Assisted Reproduction becoming one of the most rapidly growing medical specialties in recent decades. The demand for qualified professionals is especially high in developed countries, where it is common to wait until later in life to have children. This has created a progressive increase in the average age for pregnancy and, along with it, a list of complications.

Rapid advances and the need to constantly update their knowledge in all these aspects requires professionals to make an intense effort to remain at the forefront of this field. A commitment that may be too demanding for working professionals. This Advanced master’s degree is a specialist program, with a great scientific, technical, and practical scope that provides professionals with all the knowledge required to become leading physicians in this field. Everything you need to know, in one place and with all the facilities for learning.

An Advanced master’s degree developed to provide an extensive and up-to-date response to the needs of professionals in this area of intervention"

This Advanced master’s degree in Gynecologic Pathology and Assisted Reproduction contains the most complete and up-to-date scientific program on the market. The most important features of the program include:

• Clinical cases presented by experts in the different specialties
• The graphic, schematic, and practical contents with which they are created, provide scientific and practical information on the disciplines that are essential for professional practice
• Diagnostic and therapeutic developments in Gynecology and Assisted Reproduction
• Practical workshops on procedures, diagnosis and treatment techniques
• Real images in high resolution and practical exercises where the self-evaluation process can be carried out to improve learning
• Interactive learning system based on algorithms to exercise decision making on clinical situations
• Special emphasis on evidence-based medicine and research methodologies
• Theoretical lessons, questions to the expert, debate forums on controversial topics, and individual reflection assignments
• Content that is accessible from any  fixed or portable device with Internet connection

This Advanced master’s degree is the best investment you can make in your future. A program created to be compatible with your professional and personal life that will help you achieve your goal in the easiest way, optimizing your time and effort"

TECH's teaching staff is made up of leading professionals in the sector. Practising professionals who contribute their experience to this program, as well as renowned specialists from leading scientific societies.

The multimedia content developed with the latest educational technology will provide the professional with situated and contextual learning, i.e., a simulated environment that will provide an immersive program to learn in real situations.

This program is designed around Problem-Based Learning, whereby the physician must try to solve the different professional practice situations that arise throughout the program. For this purpose, the physician will be assisted by an innovative interactive video system created by renowned and experienced experts in the field with extensive teaching experience.

The content, which is developed entirely by professionals in the sector, will allow you to assimilate the contents through an innovative concept of online learning, with which you will be able to observe the techniques being performed on real patients"

Take the opportunity to learn about the advances in Gynecologic Pathology and Assisted Reproduction and improve your patients' care"

The structure of this Advanced master’s degree has been created in order to compile each and every one of the subjects that professionals in this area ought to master in a comprehensive, but very specific syllabus. With an extensive course, structured into the different areas of intervention, the student will learn the different theoretical and practical approaches and techniques required for medical practice in Gynecology, Gynecological Oncology and Assisted Reproduction. Learning that will translate into practical mastery of the techniques. Accompanied at all times by the exceptional teachers who have developed the contents.

This Advanced master’s degree is an incomparable opportunity to obtain, in a single program, all the knowledge required in Gynecologic Pathology and Assisted Reproduction"

Module 1. Female Surgical Anatomy 

1.1. Anatomy of the Abdominal Wall 
1.2. Musculo-Fascial Anatomy of the Female Pelvis 
1.3. Visceral System of the Upper Abdomen 

1.3.1. Diaphragm 
1.3.2. Liver 
1.3.3. Omentum and Spleen 
1.3.4. Small Intestine, Large Intestine, and Stomach 
1.3.5. Rest of Organs in Upper Abdomen 

1.4. Pelvic Visceral System 

1.4.1. Uterus and Ovaries 
1.4.2. Rectum and Sigma 
1.4.3. Bladder and Ureters 

1.5. Abdomino-Pelvic Vascular System 
1.6. Abdominal and Pelvic Nervous System 
1.7. Lymphatic System in Abdomen and Pelvis 
1.8. Dissection and Limits of Avascular Spaces 
1.9. Vascular Anomalies

1.9.1. Abnormalities in Pelvic Area 
1.9.2. Corona Mortis 
1.9.3. Abdominal and Aortic Anomalies 
1.9.4. Use of Preoperative Imaging Techniques 

1.10. Anatomy of Vulva and Vagina 
1.11. Functional Anatomy of the Pelvic Floor 

Module 2. Hysteroscopic Surgery 

2.1. Introduction to Hysteroscopic Surgery 
2.2. Organization of an Outpatient Hysteroscopy Consultation 
2.3. Hysteroscopy Equipment and Instruments in Consultation  

2.3.1. Peculiarities of the Hysteroscopy Tower 
2.3.2. Types of Diagnostic Hysteroscopes 
2.3.3. Types of Instruments 

2.4. Hysteroscopy in Consultation 

2.4.1. Indications of Hysteroscopy in Consultation
2.4.2. Hysteroscopy Technique in Consultation 
2.4.3. How to Increase the Success Rate

2.5. Surgical Hysteroscopy 

2.5.1. Surgical Hysteroscopy Indications 
2.5.2. Peculiarities of the Procedure in the Operating Room 

2.6. Systematic Endometrial Examination and Biopsy 
2.7. Hysteroscopic Polypectomy
2.8. Foreign Body Removal (IUD, Essures) 
2.9. Hysteroscopic Myomectomy

2.9.1. Limitations for Doing It in Consultation 
2.9.2. Types of Hysteroscopic Morcellators 
2.9.3. Suitable Technique 

2.10. Resection of Septum and Intracavitary Malformations 
2.11. Intratubal Devices 
2.12. Endometrial Ablation 

2.12.1. Use of Resectoscope 
2.12.2. Novasure and Other Devices 

2.13. Complications and Post-Procedural Management in Hysteroscopy 

2.13.1. Uterine or Cervical Perforation 
2.13.2. Infections 
2.13.3. Vasovagal Syndrome 
2.13.4. Bleeding 
2.13.5. Postoperative Pain 
2.13.6. Hyperosmolar Syndrome 
2.13.7. Others 

2.14. New Developments in Hysteroscopy 

2.14.1. Use of Monopolar vs. Bipolar Energy 
2.14.2. Use of Laser in Hysteroscopy 
2.14.3. Other Developments 

Module 3. Exploratory Laparoscopy and Benign Adnexal Pathology 

3.1. General Considerations in the Operating Room
3.2. Use of Veress vs. Hasson Trocar 
3.3. Placement of Accessory Trocars

3.3.1. Choosing the Right Trocar 
3.3.2. How to Avoid Complications
3.3.3. Use of Direct Vision Trocars 

3.4. Performing the Pneumoperitoneum 
3.5. Systematic Exploration of the Cavity: Biopsies and Cytology 
3.6. Simple Adnexectomy and Salpingectomy 
3.7. Ovarian Cystectomy of Simple Cysts 
3.8. Management of Complex Non-Endometriotic Cysts 

3.8.1. Ovarian Teratomas 
3.8.2. Large Cysts 
3.8.3. Adnexal Torsion 
3.8.4. Ectopic Pregnancy 
3.8.5. Pelvic Abscess and Inflammatory Disease 

3.9. Remaining Ovary Syndrome 

Module 4. Benign Uterine Pathology and Dysgenesis 

4.1. Laparoscopic Myomectomy 

4.1.1. Medical Treatment of Myomas 
4.1.2. Surgical Treatment. Indications 
4.1.3. Prevention of Bleeding 

4.1.3.1. Injection of Vasoconstrictors 
4.1.3.2. Temporary Clipping of Uterine Arteries 

4.1.4. Basic Surgical Techniques 

4.1.4.1. Choosing the Incision 
4.1.4.2. Myomatous Dissection and Removal 
4.1.4.3. Bed Suture 
4.1.4.4. Morcellation of the Part 

4.1.4.4.1. Risk of Uterine Sarcoma 
4.1.4.4.2. Sealed Morcellation Systems 

4.1.5. Fertility after Myomectomy 

4.1.5.1. Obstetric Outcomes and Recommendations 
4.1.5.2. Non-Stick Systems 

4.2. Laparoscopic Hysterectomy 

4.2.1. Use of Uterine Mobilizers 

4.2.1.1. Types of Mobilizers 
4.2.1.2. Fitting the Mobilizers 
4.2.1.3. Advantages of Mobilizers 
4.2.1.4. Automatic Uterine Mobilization Systems 

4.2.2. Basic Simple Hysterectomy Technique 
4.2.3. Technique in Complex Situations 
4.2.4. Vaginal Vault Suture and Dehiscence 

4.3. Genital Malformation Syndromes 

4.3.1. Classification of Malformation Syndromes 
4.3.2. Laparoscopic Resolution of Malformation Syndromes 
4.3.3. Laparoscopic Neovagina 

Module 5. Pelvic Floor Pathology and Use of Vaginal Meshes 

5.1. Pathophysiology of Genital Prolapse 
5.2. Etiopathogenesis of Chronic Pelvic Pain 
5.3. Global Assessment of the Patient and Route of Approach 
5.4. Prosthetic Materials and Mesh Types 

5.4.1. Types of Material 
5.4.2. Meshes for Genital Prolapses 
5.4.3. Urinary Incontinence Meshes 

5.5. Laparoscopic Sacrocolpopexy 

5.5.1. Choosing the Right Mesh 
5.5.2. Surgical Technique 

5.5.2.1. When to Preserve the Uterus?

5.5.3. Technique Complications 
5.5.4. A Learning Curve 

5.6. Treatment of Urinary Incontinence 

5.6.1. Pre-Operative Study 
5.6.2. Endoscopic Treatment of Incontinence 
5.6.3. Vaginal Treatment of Incontinence 
5.6.4. Placement of Mini-Slings 
5.6.5. Placement of TVT - TOT 
5.6.6. Other Procedures 

5.7. Endoscopic Repair of Paravaginal Defects 
5.8. Role of Cystoscopy in Gynecologic Surgery 

Module 6. Laparoscopy in Endometriosis 

6.1. Laparoscopy in the Treatment of Endometriosis 
6.2. General Diagnosis of Endometriosis 

6.2.1. Clinical Examination 
6.2.2. Imaging Techniques 
6.2.3. Role of Tumor Markers 

6.3. Classification of Endometriosis 

6.3.1. Classification Systems by Authors 
6.3.2. Clinical Uses of Classifications 

6.4. Medical Treatment of Endometriosis 

6.4.1.    Non-Hormonal Treatment 
6.4.2.    Hormonal Treatment 

6.4.2.1. Contraceptives 
6.4.2.2. Progestogens 
6.4.2.3. Danazol 
6.4.2.4. Gestrinone 
6.4.2.5. Others 

6.5. Treatment of Ovarian and Peritoneal Endometriosis 

6.5.1. Types of Peritoneal Disease 
6.5.2. Adhesion Formation and Release 
6.5.3. Ovarian Endometriosis 

6.6. Management of Deep Endometriosis

6.6.1. General Concepts
6.6.2. Endometriosis Rectum Vaginal Septum
6.6.3. Lateral and Sciatic Compartment 
6.6.4. Intestinal Endometriosis 
6.6.5. Endometriosis in the Urinary Tract 

6.7. Extrapelvic Endometriosis 
6.8. Reproductive Effects of Laparoscopy and Endometriosis 
6.9. New Developments in Endometriosis and Laparoscopy 

Module 7. Minimally Invasive Surgery 

7.1. General Introduction 
7.2. History of Laparoscopy 
7.3. Introduction to Hysteroscopic Surgery 
7.4. Ergonomics in Laparoscopy 
7.5. Asepsis and Antisepsis 

7.5.1. Hand Washing 
7.5.2. Preparation of Instruments Sterilization
7.5.3. Preparing the Surgical Field 

7.5.3.1. Skin Cleansing 
7.5.3.1. Proper Placement of Cloths 

7.6. Laparoscopic Operating Room 

7.6.1. Conventional Operating Rooms 
7.6.2. Integrated Operating Rooms 
7.6.3. Future Perspectives 

7.7. Preoperative Preparation in Laparoscopy 

7.7.1. Physical Preparation of the Patients 
7.7.2. Preoperative Medication and Bowel Preparation 
7.7.3. Positioning of the Patient on the Operating Table 

7.8. Fast-Track/ ERAS Program
7.9. Anesthetic Considerations in Endoscopic Surgery 

7.9.1. General Aspects 
7.9.2. Effect on the Circulatory System 
7.9.3. Effect on the Respiratory System 
7.9.4. Placement of Spinal Catheters and Other Blockages
7.9.5. Post-Surgical Recovery 

Module 8. Instrumentation, Materials and Electrosurgery 

8.1. Laparoscopy Tower and General Equipment
8.2. Specific Vision Systems

8.2.1. Full HD High-Definition Systems
8.2.2. 3D Vision Systems
8.2.3. 4K Vision Systems

8.3. Endoscopes

8.3.1. Rigid Endoscopes
8.3.2. Flexible and Angle Adjustable Endoscopes
8.3.3. Small Caliber Endoscopes

8.4. Insufflation Systems

8.4.1. General Performance
8.4.2. Smoke Extraction Systems

8.5. Image Recording Modules
8.6. Access Instrumentation 

8.6.1. Veress Needle 
8.6.2. First Access Trocars
8.6.3. Accessory Trocars

8.7. Gripping Instruments

8.7.1. Types of Instruments 
8.7.2. Most Appropriate Uses for Each One 

8.8. Cutting Instruments 
8.9. Electrosurgery 

8.9.1. Electrosurgery in Medicine 
8.9.2. Monopolar Energy 
8.9.3. Bipolar Energy 
8.9.4. Electrical Isolation of Instruments 
8.9.5. Precautions to Avoid Accidents 

8.10. Endoscopic Tissue Sealants 
8.11. Bags and Specimen Extraction 
8.12. Endodontics and Instrumentation for General Surgery 
8.13. Morcellators and Containment Systems 
8.14. Other Instruments: Suction, Retractors, Organ Suspension Systems, Port Closure Systems, Tie Rods, etc

Module 9. General Training in Minimally Invasive Surgery 

9.1. Introduction 
9.2. Training Programs. Learning Pyramid

9.2.1. Organ Bank and Artificial Phantoms 

9.3. Ergonomics in CL
9.4. Devices for CL Training Simulators

9.4.1. Justification 
9.4.2. Classification 
9.4.3. Requirements 

9.5. Live Experimental Models in Gynecologic Endoscopy

9.5.1. Animal Welfare 
9.5.2. Justification for Its Use 
9.5.3. Techniques Validated in Live Experimental Models 

Module 10. Laparoscopic Suturing Training

10.1. Introduction and Use of Laparoscopic Suturing  
10.2. Types of Needles 
10.3. Types of Sutures Used 

10.3.1. Conventional Sutures 
10.3.2. Vascular Suture 
10.3.3. Chin Suture 
10.3.4. Automatic Suture Systems 

10.4. Specific Instrumentation 

10.4.1. Types of Needle Holders 
10.4.2. Low Knots 
10.4.3. LapraTy Applicator 
10.4.4. Others 

10.5. Technical Aspects 

10.5.1. Introduction of Needle into Cavity 
10.5.2. Placing the Needle in the Needle Holder 
10.5.3. Types of Sutures 
10.5.4. Intracorporeal Knotting 
10.5.5. Extracorporeal Knotting 
10.5.6. Single Port Knotting 
10.5.7. Sutures and Special Types of Knots (Vascular, Intestinal) 
10.5.8. Suture Removal 

Module 11. Complications in Minimally Invasive Surgery

11.1. Access and Abdominal Wall Complications 

11.1.1. Arterial Wall Lesion 
11.1.2. Vascular Lesions in the Access 
11.1.3. Intestinal Lesions in the Access 
11.1.4. Inlet Port Hernia 
11.1.5. Infections 
11.1.6. Others 

11.2. Intraoperative Vascular Complications 

11.2.1. Prevalence and Etiology 
11.2.2.  Resolution 
11.2.3.  Postoperative Aftercare

11.3. Intraoperative Intestinal Complications 

11.3.1.  Prevalence and Etiology 
11.3.2.  Resolution 
11.3.3.  Postoperative Aftercare. 

11.4. Urological Complications 

11.4.1.  Prevalence and Etiology 
11.4.2.  Resolution 
11.4.3.  Postoperative Follow-Up 

11.5. Nerve Complications
11.6. Inadvertent Complications 
11.7. Complications Specific to Radical Hysterectomy 
11.8. Complications Arising from the Meshes 
11.9. Other Complications: Lymphoceles, Infections, PTE, etc

Module 12. Ultra-Minimally Invasive Surgery 

12.1. Introduction to Ultra Minimally Invasive Surgery 
12.2.  Single Port Surgery 

12.2.1. Evidence in Gynecology for Its Use 
12.2.2.  Specific Instruments
12.2.3.  Procedural Surgical Technique 
12.2.4.  Single-Glove

12.3. Mini-Laparoscopic Surgery

12.3.1.  Evidence in Gynecology for Its Use 
12.3.2.  Specific Instruments
12.3.3.  Procedural Surgical Technique 

12.4.  Surgery without Access Ports

12.4.1.  Evidence in Gynecology for Its Use
12.4.2.  Specific Instruments
12.4.3.  Procedural Surgical Technique 

12.5.  Other Ultra-Mini-Invasion Breakthroughs 
12.6.  Comparison between the Different Techniques 

Module 13. Robotic Surgery in Gynecology 

13.1.  Introduction and Advantages of Robotic Surgery
13.2.  Different Types of Robotic Systems

13.2.1.  Da Vinci System 
13.2.2.  Zeus System 
13.2.3. Amadeus-Titan System 
13.2.4.  Others 

13.3.  Instrumentation in Robotic Surgery 
13.4.  Docking and Setting of Surgical Robots 
13.5.  Comparison between the Robotic Track and Other Tracks 
13.6.  Economic Factors and Efficiency of Robotics 
13.7.  Complications of Robotic Surgery 
13.8. Single-Port in Robotics 
13.9.  New Developments in Robotics 

Block II Gynecologic Oncology

Module 14. Biological Basis of Cancer

14.1. Cell Growth Regulation
14.2. Carcinogenesis and Carcinogens
14.3. Genetics of Cancer
14.4. Mechanisms of Apoptosis and Programmed Cell Death
14.5. Molecular Mechanisms of Cancer Production and Metastasis
14.6. Origin of Genetic Alterations
14.7. Epigenetic Changes and Oncogenes
14.8. Angiogenesis

Module 15. Basis of Chemotherapy Treatment, Adverse Effects and New Therapies

15.1. Introduction
15.2. Justification for the Use of Chemotherapy
15.3. Development of Cancer and the Influence of Chemotherapy

15.3.1. Tumor Growth
15.3.2. Cellular Cycle
15.3.3. Specific Drugs for each of the Cellular Phases

15.4. Factors that Influence Treatment

15.4.1. Tumor Characteristics
15.4.2. Patient Tolerance
15.4.3. Treatment Objectives
15.4.4. Pharmacological Factors and Administration Routes

15.5.  Principles of Resistance to Drugs
15.6. Combined Therapies
15.7. Treatment or Dose Adjustments
15.8. Drug Toxicity
15.9. General Management of Secondary Effects and Complications of Chemotherapy
15.10. Antineoplastic Agents in Gynecology

15.10.1. Alkylating Agents
15.10.2. Antibiotics
15.10.3. Antimetabolites
15.10.4. Plant Alkaloids
15.10.5. Topoisomerase 1 Inhibitors
15.10.6. Anti-Angiogenic Drugs
15.10.7. PARP Inhibitors
15.10.8. Tyrosine Kinase Inhibitors
15.10.9. Other Drugs

15.11 Future Indications

Module 16. Endometrial Cancer I

16.1. Epidemiology and Etiopathogenesis
16.2. Precancerous Lesions
16.3. Hereditary Carcinoma
16.4.  Pathological Anatomy and Different Types of Tumors
16.5.  Diagnostic Process
16.6.  Imaging Tests, Tumor Markers and Possible Screening
16.7. Molecular Diagnostic Tests
16.8. FIGO Classification and Others

Module 17. Endometrial Cancer II

17.1. Introduction
17.2. General Aspects of Surgical Treatment
17.3. Low Risk Tumors (Stage I, Grade 1)
17.4. High Risk Tumors (Grade 2-3, Serous or Clear Cells)
17.5. Laparotomy vs. Laparoscopy
17.6. Introduction of Robotic Surgery
17.7. Surgical Technique for High-Risk Tumors
17.8.  Adjuvant Treatment

17.8.1.  Observation without Additional Treatment

 17.8.1.1. Low Risk, Early Stage, Low Grade

17.8.2. Adjuvant Radiotherapy

 17.8.2.1. Early Stage, Intermediate and High Risk
 17.8.2.2. Advanced Stages

17.8.3. Adjuvant Chemotherapy
17.8.4. Peculiarities of Serous Tumors and Clear Cells

17.9. Hormonal Treatment
17.10. Recurrent Endometrial Cancer

17.10.1. Surgical Management
17.10.2. Radiotherapy
17.10.3. Chemotherapy

17.11. Follow-up Treatment of Endometrial Cancer
17.12.  Prognosis

Module 18. Cervical Cancer I

18.1. Epidemiology and Etiopathogenesis of the Disease
18.2.  Precancerous Lesions and the Evolutionary Process
18.3.  Risk Factors for Contracting the Disease
18.4.  Notions about Cervical Pathology and HPV
18.5.  Normal Colposcopy and Vulvoscopy
18.6.  Abnormal Colposcopy and Vulvoscopy
18.7.  Cervical Cancer Screening
18.8.  Hereditary Carcinoma
18.9.  Forms of Presentation in Anatomic Pathology
18.10.  Diagnostic Process: Imaging Tests and Tumor Markers
18.11.  Role of New Technologies such as PET-CT
18.12.  FIGO and TNM Classification in Cervical Carcinoma

Module 19. Cervical Cancer II

19.1. Treatment of Cervical Intraepithelial Neoplasia (CIN)

19.1.1. CIN Surgery
19.1.2. CIN Immunotherapy

19.2. Invasive Treatment of Cervical Cancer

19.2.1. Radical Hysterectomy with Nerve Preservation
19.2.2. Less Radical Hysterectomy
19.2.3. Radical Endoscopic Hysterectomy
19.2.4. Selective Sentinel Node Biopsy
19.2.5. Para-aortic Advanced Stage Lymphadenectomy Staging

19.3. Radiotherapy and Chemotherapy

19.3.1. Concurrent Chemoradiotherapy
19.3.2. Enhanced Radiation Therapy Treatment Modalities
19.3.3. Chemotherapy Modalities in Concurrent Treatment
19.3.4. Preoperative Chemoradiotherapy
19.3.5. Adjuvant Therapy after a Radical Hysterectomy
19.3.6. Neoadjuvant Chemotherapy
19.3.7. Adjuvant Therapy after Neoadjuvant and Previous Surgery

19.4. Treatment of Metastasis, Recurrent or Persistent Disease

19.4.1. Surgical Management
19.4.2. Chemotherapy

19.5. Management of Cervical Adenocarcinoma

19.5.1. Adenocarcinoma in Situ (AIS)
19.5.2. Comparison Between Squamous Cell Carcinomas and Adenocarcinomas
19.5.3. Surgery vs. Radiotherapy in Invasive Adenocarcinoma
19.5.4. Chemotherapy

19.6. Monitoring

Module 20. Ovarian Cancer I

20.1. Epidemiology of Ovarian and Fallopian Tube Cancer
20.2. Etiopathogenesis and Tubal Origin, New Trends
20.3. Precancerous Lesions in the Fallopian Tubes
20.4. Ovarian Cancer Screening
20.5. Hereditary Carcinoma and How to Evaluate It
20.6. Histological Forms and Pathological Anatomy
20.7. Diagnostic Process

20.7.1. Clinical Symptoms
20.7.2. Ultrasound
20.7.3. Computerized Tomography
20.7.4. Magnetic Resonance
20.7.5. Positron Emission Tomography

20.8. Serum Tumor Markers

20.8.1.  CA125
20.8.2. HE4
20.8.3. CA19.9
20.8.4. CEA
20.8.5. Other Markers

20.9.  FIGO Classification of the Disease

Module 21. Ovarian Cancer II

21.1. General Surgical Treatment
21.2. Complete Cytoreduction and Primary Debulking
21.3. Neoadjuvant Treatment and When to Choose It
21.4. Interval and Second Look Treatments
21.5. Adjuvant Therapy: Carboplatin-Taxol and Other Options
21.6. Radiotherapy: What Role Does it Play?
21.7. Hormonal Therapy Possibilities in Ovarian Cancer
21.8 Prognosis and Disease-Free Interval
21.9.  Monitoring and Treatment of Relapses
21.10.  Controversies in the Management of Ovarian Cancer
21.11. Peritoneal Carcinomas Hyperthermic Therapy
21.12. Intraperitoneal Chemotherapy, Indications and Results

Module 22. Vulvar Cancer I

22.1.  Epidemiology and Relationship with HPV
22.2. Etiopathogenesis and Precancerous Lesions
22.3. VIN I, II, III VAIN and Other Lesions
22.4.  Vulvar Cancer Screening
22.5. Hereditary Carcinoma
22.6. Pathological Anatomy, Histological Types
22.7. Imaging Tests and Extension Study
22.8. Tumor Markers: SCC

Module 23. Vulvar Cancer II

23.1. Introduction
23.2. Vulvar Paget’s Disease

23.2.1.  General Aspects
23.2.2. Paget’s Disease Type 1

23.2.2.1. Prevalence
23.2.2.2. Clinical Characteristics
23.2.2.3. Diagnosis
23.2.2.4. Treatment

23.2.3. Paget’s Disease Type 2 and 3

23.3.  Invasive Paget’s Disease

23.3.1. General Aspects
23.3.2. Prognosis

23.4. Invasive Vulva Carcinoma

23.4.1. Squamous Cell Carcinoma
23.4.2.  Clinical Characteristics
23.4.3.  Diagnosis
23.4.4. Dissemination Pathways
23.4.5. Staging
23.4.6. Treatment

 23.4.6.1. Primary Lesion Management
 23.4.6.2. Local Control after Primary Surgical Treatment
 23.4.6.3. Management of Ganglionic Chains
 23.4.6.4. Postoperative Care

  23.4.6.4.1. Early Postoperative Complications
  23.4.6.4.2. Late Postoperative Complications

 23.4.6.5. Use of Sentinel Lymph Node

  23.4.6.5.1. Advanced Disease
  23.4.6.5.2. General Aspects
  23.4.6.5.3. Management of Ganglionic Chains
  23.4.6.5.4. Management of Primary Tumor

   23.4.6.5.4.1. Surgery
   23.4.6.5.4.2. Radiotherapy
   23.4.6.5.4.3. Chemotherapy

 23.4.6.6. Role of Radiotherapy in Vulvar Cancer

23.4.7. Recurrent Vulvar Cancer
23.4.8. Prognosis
23.4.9. Monitoring

23.5. Vulva Melanoma

23.5.1. Introduction
23.5.2. Clinical Characteristics
23.5.3. Pathologic Anatomy/Pathogenesis
23.5.4.  Staging
23.5.5. Treatment

 23.5.5.1. Primary Lesion Management
 23.5.5.2. Management of Ganglionic Chains

23.5.6. Prognosis

23.6. Carcinoma of Bartholin’s Gland

23.6.1.  General Aspects
23.6.2.  Treatment
23.6.3.  Prognosis

23.7.  Basal Cell Carcinoma
23.8.  Verrucous Carcinoma
23.9.  Vulva Sarcoma

23.9.1.  Introduction
23.9.2.  Leiomyosarcoma
23.9.3.  Epithelioid Sarcoma
23.9.4.  Rhabdomyosarcoma
23.9.5. Merkel Cells Carcinoma

Module 24. Uterine Sarcoma I

24.1. Introduction
24.2. Epidemiology

24.2.1. Incidence
24.2.2. Age
24.2.3. Histological Distribution
24.2.4. Racial Distribution

24.3. Risk Factors

24.3.1. Inheritance
24.3.2. Hormone Therapy
24.3.3. Radiation Exposure

24.4. Pathologic Anatomy/Pathogenesis

24.4.1.  Leiomyosarcoma
24.4.2.  STUMP
24.4.3. Benign Metastasizing Leiomyoma
24.4.4. Carcinosarcoma
24.4.5. Endometrial Stromal Neoplasms
24.4.6. Stromal Nodule
24.4.7. Endometrial Stromal Sarcoma
24.4.8. Mullerian Adenosarcoma

24.5. Clinical Manifestations
24.6. Imaging Tests

24.6.1. Magnetic Resonance
24.6.2. Tumor Markers

24.7. FIGO Staging
24.8. Conclusions

Module 25. Uterine Sarcoma II

25.1.  Introduction
25.2.  Uterine Leiomyosarcoma

25.2.1.  Early Stages

 25.2.1.1. Surgery
 25.2.1.2. Adjuvant Radiotherapy
 25.2.1.3. Chemotherapy

25.2.2. Recurrent or Metastatic Disease

 25.2.2.1. Surgery
 25.2.2.2. Chemotherapy
 25.2.2.3. Hormone Therapy

25.2.3.  Prognostic Factors

25.3. Endometrial Stromal Sarcoma

25.3.1. Early Stages

 25.3.1.1. Surgery
 25.3.1.2. Pelvic Radiotherapy
 25.3.1.3. Hormone Therapy

25.3.2.  Recurrent or Metastatic Disease

 25.3.2.1. Surgery
 25.3.2.2. Chemotherapy or Radiotherapy

25.3.3. Prognostic Factors

25.4. Undifferentiated Endometrial Sarcoma

25.4.1. Early Stages

 25.4.1.1. Surgery
 25.4.1.2. Adjuvant Radiotherapy
 25.4.1.3. Chemotherapy

25.4.2. Recurrent or Metastatic Disease

 25.4.2.1. Surgery
 25.4.2.2. Chemotherapy or Radiotherapy

25.4.3. Prognostic Factors

25.5. Conclusions

Module 26. Uncommon Gynecologic Tumors

26.1. Vagina Cancer

26.1.1. Introduction
26.1.2. Clinical Manifestations
26.1.3. Diagnosis
26.1.4. Pathologic Anatomy/Pathogenesis

 26.1.4.1. Squamous Carcinoma
 26.1.4.2. Adenocarcinoma
 26.1.4.3. Sarcoma
 26.1.4.4. Melanoma

26.1.5. Tumor Staging
26.1.6. Treatment of Disease

 26.1.6.1. Surgery
 26.1.6.2. Radiotherapy
 26.1.6.3. Treatment Complications

26.1.7. Monitoring
26.1.8. Prognosis

26.2. Gestational Trophoblastic Disease

26.2.1. Introduction and Epidemiology
26.2.2.  Clinical Forms

 26.2.2.1. Hydatidiform Mole

  26.2.2.1.1. Complete Hydatidiform Mole
  26.2.2.1.2. Partial Hydatidiform Mole

 26.2.2.2. Gestational Trophoblastic Neoplasm

  26.2.2.2.1. After Molar Pregnancy

26.2.2.2.1.1. Persistent Gestational Trophoblastic Neoplasm

 26.2.2.2.2. After Non-Molar Pregnancy

26.2.2.2.2.1. Choriocarcinoma
26.2.2.2.2.2. Placental Site Trophoblastic Tumor

26.2.3. Diagnosis

 26.2.3.1. Human Chorionic Gonadotropin
 26.2.3.2. Ultrasound Study

  26.2.3.2.1. Complete Mole
  26.2.3.2.2. Partial Mole
  26.2.3.2.3. Invasive Mole
  26.2.3.2.4. Choriocarcinoma and Placental Site Tumor

 26.2.3.3. Other Imaging Techniques

26.2.4. Pathologic Anatomy/Pathogenesis

 26.2.4.1. Hydatidiform Mole

 26.2.4.1.1. Complete Mole
 26.2.4.1.2. Partial Mole

26.2.4.2. Invasive Mole

26.2.4.3. Choriocarcinoma
26.2.4.4. Placental Site Trophoblastic Tumor
26.2.4.5. Epithelioid Trophoblastic Tumor

26.2.5. Staging
26.2.6. Treatment

 26.2.6.1. Chemotherapy

26.2.6.1.1. Low-Risk Disease
26.2.6.1.2. High-Risk Disease and Metastasis
26.2.6.1.3. Chemoresistant Disease

 26.2.6.2. Surgery

26.2.6.2.1. Molar Evacuation
26.2.6.2.2. Hysterectomy
26.2.6.2.3. Myometrial Resection
26.2.6.2.4. Pulmonary Resection
26.2.6.2.5. Craniotomy
26.2.6.2.6. Other Surgical Procedures
26.2.6.2.7. Selective Arterial Embolization

26.2.7. Post-Treatment Monitoring

26.2.7.1. Follow-Up after Molar Evacuation
26.2.7.2. Monitoring after Gestational Neoplasm Treatment

26.2.8. Prognosis

26.3. Metastatic Tumor in the Genital Tract

26.3.1. Introduction
26.3.2. Clinical Manifestations

26.3.2.1. Secondary Tumors in the Uterine Body or Cervix

26.3.2.1.1. From Genital or Pelvic Organs
26.3.2.1.2. From Extragenital or Pelvic Organs 

26.3.2.2. Secondary Tumors in the Vagina
26.3.2.3. Secondary Tumors on the Vulva
26.3.2.4. Secondary Tumors in the Ovaries

26.3.3. Diagnosis
26.3.4. Pathologic Anatomy/Pathogenesis

 26.3.4.1. Gastrointestinal Tumors

  26.3.4.1.1. Metastasis of Intestinal Cancer
  26.3.4.1.2. Krukenberg Tumor

 26.3.4.2. Ovarian Lymphona

26.3.5. Treatment and Prognosis

26.4. Neuroendocrine Tumors

26.4.1. Introduction
26.4.2. Pathologic Anatomy/Pathogenesis

 26.4.2.1. Well-Differentiated Tumors
 26.4.2.2. Poorly Differentiated Tumors

26.4.3. Clinical Manifestations and Diagnosis

 26.4.3.1. Small Cell Tumor in the Vulva and Vagina
 26.4.3.2. Small Cell Tumor in the Uterus
 26.4.3.3. Neuroendocrine Tumors in the Cervix

  26.4.3.3.1. Small Cell Neuroendocrine Carcinoma
  26.4.3.3.2. Carcinoma neuroendocrino células grandes

 26.4.3.4. Ovarian, Fallopian Tube and Wide Ligament Tumor

  26.4.3.4.1. Ovarian Carcinoid

   26.4.3.4.1.1. Insular Carcinoid
   26.4.3.4.1.2. Trabecular Carcinoid
   26.4.3.4.1.3. Mucinous Carcinoid
   26.4.3.4.1.4. Strumal Carcinoid

  26.4.3.4.2. Small Cell Lung Type
  26.4.3.4.3. Undifferentiated Non-Small Cell Carcinoma

26.4.4. Treatment
26.4.5. Monitoring
26.4.6. Prognosis

26.5. Tumors of the Recto-Vaginal Septum

Module 27. Fertility Preservation in Gynecologic Oncology 

27.1. Introduction

27.1.1. Symptomology Associated with Gynecologic Tumors

27.2.  Pain
27.3.  Gastrointestinal Symptoms

27.3.1.  Diarrhea
27.3.2.  Constipation
27.3.3.  Malignant Intestinal Obstruction

 27.3.3.1. Conservative Treatment
 27.3.3.2. Surgical Management

27.4.  Ascites
27.5.  Respiratory Symptoms

27.5.1.  Pleural Effusion

27.6.  Edema
27.7.  Anorexia and Weight Loss
27.8.  Deep Vein Thrombosis
27.9.  Pelvic Disease Progression

27.9.1.  Vaginal Bleeding
27.9.2. Fistulas

27.10.  Palliative Pelvic Exenteration
27.11.  Metastasis of Other Organs

27.11.1.  Liver
27.11.2.  Brain
27.11.3.  Bone

 27.11.3.1 Hypercalcemia

27.12.  Anxiety and Depression
27.13.  Dying Patient Care

Module 28. Endoscopic Surgery in Gynecologic Oncology

28.1. Oncologic Laparoscopy

28.1.1. Effect of Pneumoperitoneum and Dissemination
28.1.2. Port-Site Metastasis
28.1.3. Uterine Manipulator and Dissemination

28.2. Tumor Dissemination Routes

28.2.1. Peritoneal Dissemination
28.2.2. Lymphatic Dissemination
28.2.3. Hematogenous Dissemination

28.3. Nodal Selective Study

28.3.1. Sentinel Lymph Node in Ovarian Cancer
28.3.2. Sentinel Lymph Node in Cervical Cancer
28.3.3. Sentinel Lymph Node in Endometrial Cancer
28.3.4. Types of Tracers
28.3.5. Sentinel Lymph Node Detection and Dissection Technique

28.4. Laparoscopy and Ovarian Cancer

28.4.1. Exploratory Laparoscopy in Ovarian Cancer

 28.4.1.1. Suspicious Adnexal Masses
 28.4.1.2. Advanced Ovarian Cancer Laparoscopic Scores

28.4.2. Management of Borderline Tumors

 28.4.2.1. Laparoscopic Staging
 28.4.2.2. Surgical Re-Staging

28.4.3. Staging Procedures

 28.4.3.1. Abdominal Peritonectomy
 28.4.3.2. Pelvic Lymphadenectomy
 28.4.3.3. Para-Aortic Lymphadenectomy

  28.4.3.3.1. Extraperitoneal
  28.4.3.3.2. Transperitoneal

 28.4.3.4. Laparoscopic Omentectomy
 28.4.3.5. Other Procedures

28.4.4. Laparoscopy in Ovarian Cancer Recurrences
28.4.5. Laparoscopy in Interval Surgery

28.5. Laparoscopy in Cervical Cancer

28.5.1. Indications of Laparoscopy
28.5.2. Radical Laparoscopy Hysterectomy

 28.5.2.1. Classifications of Radical Hysterectomy
 28.5.2.2. Nerve Preservation
 28.5.2.3. Modulation of Radicality
 28.5.2.4. Detailed Surgical Technique

28.5.3. Special Features of Radical Trachelectomy

 28.5.3.1. Indications
 28.5.3.2. Preservation of Uterine Arteries
 28.5.3.3. Cervical Banding
 28.5.3.4. Ovarian Oophoropexy

28.5.4. Laparoscopic Parametrectomy
28.5.5. Laparoscopic Treatment of Recurrences

 28.5.5.1. Single Recurrences
 28.5.5.2. Laparoscopic Exenteration

28.6. Laparoscopy in Endometrial Cancer

28.6.1. Laparoscopy and Staging in Endometrial Cancer
28.6.2. Laparoscopic Lymph Nodal Debulking
28.6.3. Other Particularities

28.7. Laparoscopic Inguinal Lymphadenectomy

Module 29. Laparoscopy and Its Influence on Fertility

29.1. Use of Laparoscopy in Reproduction
29.2. Restoration of Fertility

29.2.1. Essure Device Removal by Laparoscopy
29.2.2. Tubal Recanalization

29.3. Adhesive Syndrome and Laparoscopy
29.4. Use of Chromopertubation
29.5. Laparoscopic Surgery and Pregnancy
29.6. Laparoscopic Inguinal Lymphadenectomy

Block III Advances in Assisted Reproduction

Module 30. Introduction Anatomy. Physiology. Cellular Cycle

30.1. Introduction to the Concepts of Assisted Reproduction Epidemiology Reproductive Problems
30.2. Concepts of Reproductive Medicine 
30.3. Epidemiology 
30.4. Female Anatomy and Physiology 
30.5. Ovogenesis
30.6. Ovarian Cycle Follicular Recruitment Waves 
30.7. Male Anatomy and Physiology
30.8. Spermatogenesis
30.9. Gametogenesis Meiotic Cycle
30.10. Ovogenesis Ovogenesis-Foliculogenesis Relationship
30.11. Oocyte Quality Markers
30.12. Factors Affecting Oocyte Quality
30.13. Spermatogenesis and Sperm Production
30.14. Semen Quality Markers
30.15. Factors which Affect Seminal Quality

Module 31. Gamete Interaction Fertilization Embryonic Development

31.1. Interaction of Gametes in the Female Tract
31.2. Acrosomal Reaction and Hyperactivation
31.3. Sperm-Oocyte Interaction
31.4. Sperm-Oocyte Fusion Oocyte Activation
31.5. Embryonic Development
31.6. Main Features in Pre-implantational Development
31.7. Implantation Embryo-Endometrium Interaction
31.8. Pathology of Fertilization and Embryo Classification 
31.9. Embryo Culture In Vitro Embryo Culture Systems Culture Media, Environmental Conditions and Supplements One Step and Sequential Cultures Renewal of Culture Media and Needs of the Embryo
31.10. Evaluation of Embryonic Development in Vitro: Morphology and Morphokinetics Classical Embryonic Morphology Time-Lapse Systems Embryonic Morphokinetics Embryonic Classification

Module 32. Study of the Female Factor Role of Surgery in Reproduction

32.1. Ovary Reserve Study 
32.2. AMH 
32.3. RFA 
32.4. Tubal Permeability Assessment Techniques 
32.5. Hysterosalpingography 
32.6. Hysterosalpingosonography 
32.7. Endometrial Assessment 
32.8. The Role of Hysteroscopy 
32.9. Endometrial Scratching 
32.10. Endometrial Culture Microbiota 
32.11. Window of Implantation Study 
32.12. Immunological Factor Study 
32.13. SOP Ovary Drilling 
32.14. Endometriosis and Adenomyosis 
32.15. Uterine Myomas and Fertility 
32.16. Hydrosalpinx Tubal Surgery in Tubal Reconstruction Techniques and Fertility Restoration 
32.17. Uterine Alterations Metroplasties Septoplasties 
32.18. Uterine Transplant 
32.19. Repeated Miscarriages Implantation Failure 

Module 33. Andrology Laboratory

33.1. Basic Analysis of Semen WHO Criteria 2010 
33.2. Sperm Mobility and Morphometry Analysis using Automated Systems (CASA/CASMA) 
33.3. Analysis of Sperm DNA: TUNEL, SCD, COMET, SCSA Relationship with Fertility 
33.4. Oxidative Damage Assessment Determination of Antioxidants, Free Radicals and Evaluation of Lipid Peroxidation
33.5. Sperm Function by Molecular Markers: Apoptosis (AnnexinV, Caspases, Mb Permeability), Ubiquitination, Protein Phosphorylation 
33.6. Epigenetic Alterations in Spermatozoa
33.7. Selection and Control of Semen Donors 
33.8. Managing a Sperm Bank
33.9. Cleaning the Sperm in Patients with HIV or Hepatitis
33.10. Semen Preparation for Artificial Insemination

Module 34. Reproductive Treatments Medication. Stimulation Protocols

34.1. Evolution of Reproductive Treatments Throughout History
34.2. Drugs Involved in Ovarian Stimulation Ovulation Induction
34.3. Artificial Insemination Techniques Results
34.4. Fertilization In Vitro Ovarian Stimulation Protocols in High, Normal and Low Responders Luteal Phase Stimulation
34.5. Adjuvant Treatments Used in Low Ovarian Reserve
34.6. Fertilization In Vitro Cycle Tracking Ovarian Puncture Embryo Transfer
34.7. Embryo Cryotransfer Endometrial Preparation in Substituted Cycles
34.8. Egg Donation Embryoreception Surrogacy
34.9. Complications in Assisted Reproduction Treatments
34.10. Multiple Pregnancy Reduction Policy

Module 35. Micromanipulation Techniques

35.1. IVF-ICSI
35.2. Use of Polarized Light Microscopy in Oocytes
35.3. Embryo Biopsy Types of Biopsy Corpuscule, Blastomere, Trophoectoderm
35.4. Collapse, Hatching, Aspiration of Fragments
35.5. Improve the Embryo Quality Transfer of Nucleus and Cytoplasm
35.6. Cloning in Mammals Background Basic Principles of Cloning Applications in Medicine
35.7. Problems with Cloning Epigenesis Reprogramming
35.8. Genetic Modification CRISPR
35.9. Improve the Cytoplasmic Quality of the Oocyte
35.10. In Vitro Gamete Production

Module 36. Gamete and Embryo Cryopreservation

36.1. Cryobiology Cryobiological Principles and Cryoprotective Agents Cryopreservation Systems Factors Affecting the Freezing Process Additives Application of Cryobiology
36.2. The Sperm Cell Structure and Functionality Physicochemical Processes that Induce Freezing in the Spermatozoon Factors Determining Sperm Fertilization and Viability after Thawing
36.3. Cryopreservation of Semen Features. Regulations
36.4. The Oocyte Characteristics and Conditioning Factors in Cryopreservation Importance and Method of Selection Ethical and Legal Aspects
36.5. Cryopreservation in Human Embryos Importance and Method of Selection Ethical and Legal Aspects
36.6. Cryopreservation of Ovarian Tissue Laboratory Technique
36.7. Factors Affecting Performance in a Cryopreservation Program
36.8. How to Manage and Organize a Biobank and its Safety

Module 37. Fertility Preservation

37.1. Fertility Preservation Cancer Epidemiology Age and Reproduction
37.2. Fertility Preservation for Non-Medical Reasons
37.3. Fertility Preservation for Oncologic Reasons
37.4. Fertility Preservation for Non-Oncologic Medical Reasons
37.5. Oocyte Vitrification Technique and Results
37.6. Ovarian Cortex Cryopreservation
37.7. Cryopreservation of Semen
37.8. Vitro Maturation of Oocytes
37.9. Other Methods of Fertility Preservation: Conservation Surgery in Gynecologic Cancer Ovarian Transposition
37.10. Treatment with GnRH Analogues Prior to Gonadotoxic Treatments

Module 38. Genetics in Reproduction 

38.1. Important Concepts in the Genetics of Reproduction
38.2. Epigenetics Influence on Reproduction
38.3. Genetic Diagnostic Techniques
38.4. Genetic Anomalies Related to Male and Female Sterility
38.5. Indications for Genetic Studies in Assisted Reproduction
38.6. Screening for Recessive Diseases. Genetic Matching
38.7. Pre-Implantational Genetic Diagnosis in Monogenic Diseases
38.8. Pre-Implantational Genetic Screening in Assisted Reproduction Techniques
38.9. Mosaicisms
38.10. Genetic Counseling and Advice

Module 39. Legislation. Quality Research and Future Techniques

39.1. Ethical and Legal Aspects of Assisted Reproduction Treatments Law 14/2006
39.2. Treatment Legislation for Gametes from Donors Assisted Human Reproduction Information System (SIRHA) Platform
39.3. Quality Indicators in the Reproduction Laboratory Quality Control
39.4. Importance of Traceability in the Laboratory Electronic Traceability Systems
39.5. Research in Assisted Reproduction
39.6. Future of Reproduction Automization
39.7. Non-Invasive Pre-Implantational Genetic Diagnosis
39.8. Artificial Intelligence
39.9. Ovarian Rejuvenation

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