Email this article On dissection of the uterine wall during laparoscopic myomectomy
- Authors: Plekhanov A.N.1,2,3, Bezhenar V.F.1, Shishkina Y.S.4, Linde V.A.1
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Affiliations:
- Academician I.P. Pavlov First Saint Petersburg State Medical University
- Saint Petersburg Clinical Hospital of the Russian Academy of Sciences
- Academy of Medical Education named after F.I. Inozemtsev
- Medi Prof Ltd.
- Issue: Vol 70, No 5 (2021)
- Pages: 157-162
- Section: Viewpoint
- URL: https://journals.eco-vector.com/jowd/article/view/65104
- DOI: https://doi.org/10.17816/JOWD65104
- ID: 65104
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Abstract
BACKGROUND: Laparoscopic myomectomy is becoming the leading method of surgical treatment of uterine fibroids while preserving reproductive and menstrual functions. Increasingly, ultrasound energy is used to dissect the myometrium. Meanwhile, the mode and direction of the ultrasound energy supply to minimize damage to the underlying tissues have not been specified.
AIM: The aim of this study was to perform a comparative analysis of the myometrium and the fibroid pseudocapsule in the projection of the myoma nodule after dissection using ultrasound energy with different initial characteristics of the surgical instrument.
MATERIALS AND METHODS: For comparison, we selected two instruments with a longitudinal ultrasound energy supply with an output frequency of 80 MHz ... 2.5 GHz and 47 kHz at intermittent operating mode of 5/10 sec and one torsion instrument with a transverse ultrasound energy supply with an output frequency of 36 kHz at intermittent operating mode of 3/30 sec.
RESULTS: Our study has shown that the smallest zone of irreversible changes is formed when using ultrasound energy with an output frequency of 36 kHz at intermittent operating mode of 3/30 sec with its transverse feed at 90 degrees to the blade, and the largest zone of irreversible changes is formed when using ultrasound energy with an output frequency of 47 kHz at intermittent operating mode of 5/10 sec with its longitudinal feed.
CONCLUSIONS: Morphometric studies with an analysis of the depth of necrotic and necrobiotic changes in the myometrial tissue showed that from the standpoint of reproductive surgery, it is preferable to use USE with an output frequency of 36 kHz at intermittent operating mode of 3/30 sec with its transverse feed.
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About the authors
Andrey N. Plekhanov
Academician I.P. Pavlov First Saint Petersburg State Medical University; Saint Petersburg Clinical Hospital of the Russian Academy of Sciences; Academy of Medical Education named after F.I. Inozemtsev
Email: a_plekhanov@mail.ru
ORCID iD: 0000-0002-5876-6119
SPIN-code: 1132-4360
MD, Dr. Sci. (Med.), Professor
Russian Federation, Saint PetersburgVitaly F. Bezhenar
Academician I.P. Pavlov First Saint Petersburg State Medical University
Email: bez-vitaly@yandex.ru
ORCID iD: 0000-0002-7807-4929
SPIN-code: 8626-7555
Scopus Author ID: 57191963583
ResearcherId: R-7055-2017
MD, Dr. Sci. (Med.), Professor
Russian Federation, Saint PetersburgYulia S. Shishkina
Medi Prof Ltd.
Author for correspondence.
Email: shyulia07@mail.ru
ORCID iD: 0000-0001-9502-298X
MD
Russian Federation, Saint PetersburgViktor A. Linde
Academician I.P. Pavlov First Saint Petersburg State Medical University
Email: vik-linde@yandex.ru
ORCID iD: 0000-0002-6032-1936
Scopus Author ID: 56825712100
MD, Dr. Sci. (Med.), Professor
Russian Federation, Saint PetersburgReferences
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