电邮这篇文章 On dissection of the uterine wall during laparoscopic myomectomy
- 作者: Plekhanov A.N.1,2,3, Bezhenar V.F.1, Shishkina Y.S.4, Linde V.A.1
-
隶属关系:
- 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.
- 期: 卷 70, 编号 5 (2021)
- 页面: 157-162
- 栏目: Viewpoint
- ##submission.dateSubmitted##: 14.04.2021
- ##submission.dateAccepted##: 14.09.2021
- ##submission.datePublished##: 02.11.2021
- URL: https://journals.eco-vector.com/jowd/article/view/65104
- DOI: https://doi.org/10.17816/JOWD65104
- ID: 65104
如何引用文章
开放存取
##reader.subscriptionAccessGranted##
详细
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.
全文:
作者简介
Andrey 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 代码: 1132-4360
MD, Dr. Sci. (Med.), Professor
俄罗斯联邦, Saint PetersburgVitaly Bezhenar
Academician I.P. Pavlov First Saint Petersburg State Medical University
Email: bez-vitaly@yandex.ru
ORCID iD: 0000-0002-7807-4929
SPIN 代码: 8626-7555
Scopus 作者 ID: 57191963583
Researcher ID: R-7055-2017
MD, Dr. Sci. (Med.), Professor
俄罗斯联邦, Saint PetersburgYulia Shishkina
Medi Prof Ltd.
编辑信件的主要联系方式.
Email: shyulia07@mail.ru
ORCID iD: 0000-0001-9502-298X
MD
俄罗斯联邦, Saint PetersburgViktor Linde
Academician I.P. Pavlov First Saint Petersburg State Medical University
Email: vik-linde@yandex.ru
ORCID iD: 0000-0002-6032-1936
Scopus 作者 ID: 56825712100
MD, Dr. Sci. (Med.), Professor
俄罗斯联邦, Saint Petersburg参考
- Bezhenar VF, Komlichenko EV, Yarmolinskaya MI, et al. Innovative approaches to reproductive function recovery in patients with uterine myoma. Obstetrics and Gynecology. 2016;(1):80−87. (In Russ.). doi: 10.18565/aig.2016.1.80-87
- D’Silva EC, Muda AM, Safiee AI, Ghazali WAHW. Five years later: a review of laparoscopic myomectomy versus open Myomectomy at Putrajaya hospital. Gynecol Minim Invasive Ther. 2018;7(4):161−166. doi: 10.4103/GMIT.GMIT_38_18
- Bashirov EV, Kutcenko II, Krutova VA, Babkina AV. Remodeling uterine scar after miomectomy and the role of dopplerometry in its assessment. Kubanskij nauchnyj medicinskij vestnik. 2017;24(4);22−26. (In Russ.). doi: 10.25207/1608-6228-2017-24-4-22-26
- Davydov AI, Pashkov VM, Shakhlamova MN, et al. Conservative myomectomy: unsolved problems and a new view of pre-operative preparation of patients. Voprosy Ginekologii, Akusherstva i Perinatologii. 2015;14(1):31−47. (In Russ.)
- Gluhov EJu. Ispol’zovanie sovremennyh jenergij pri laparoskopicheskoj i otkrytoj miomjektomii. Medicinskaja nauka i obrazovanie Urala. 2011;(1):89−93. (In Russ.)
- Kupatadze DD, Safronova MM, Il’inskaya YeV. Electronmicroscopic examination of m yometrium scar after use of mono- and bipolar c auters. Pediatrician (St Petersburg). 2017;8(3):107−110. (In Russ.). doi: 10.17816/PED83107-110. (In Russ.)
- Claeys J, Hellendoorn I, Hamerlynck T, et al. The risk of uterine rupture after myomectomy: a systematic review of the literature and meta-analysis. Gynecol Surg. 2014;11(3):197–206. doi: 10.1007/s10397-014-0842-8
- Kupatadze DD, Safronova MM, Volkov NN. Miometrij posle primenenija jelektrokoaguljacii i dissekcii pri konservativnoj miomjektomii. Vestnik SPbGU. Serija 11. Medicina. 2013;(4):111−117. (In Russ.)
- Bezhenar VF, Tsypurdeeva AA, Dolinskiy AK, et al. The experience of a standardized technique of laparoscopic myomectomy. Journal of Obstetrics and Women’s Diseases. 2012:(4):23−32. (In Russ.)
- Smith R, Pasic R. The role of vessel sealing technologies in laparoscopic surgery. Surg Technol Int. 2008;17:208−212.
- Fedorov IV. Practical use of energy in surgery and its complications. Povolzhskij onkologicheskij vestnik. 2013;(4):56−65. (In Russ.)
补充文件
